Pasta hypo's and highs

[hennypenny]

Hi can any one help i'm getting confused. my son's insulin regime has been changed from twice daily mixed to seperates, no problems with it apart from the pasta. he has eaten pasta twice in the last 3 weeks and both times had a hypo before bed and gone very high, around 20 by midnight. this has woken him up both times. we always gave him something sugary after pasta before or he would have a hypo but this doesn't help now. The DSN said it's not the pasta but a rebound from the hypo but this has not happened when he has had a hypo when i gave him a bit too much insulin.

Having read about about the GI i am now confused how this works with injecting rapid insulin at meal times. Is pasta now off the menu? i dare not feed him anymore pasta at the moment. anybody with any ideas, please help. Rosie

 

[kegstore]

Hi Rosie

Any low GI food - including pasta - is a tricky one to deal with when on MDI. I have a pump so it's easier, and I program it to deliver the meal bolus over 4 hours which works for me. Delivering it all in one injection is a sure-fire way to go hypo. The only way I can see to mimic this on MDI would be to try splitting the meal bolus in 4, and injecting the split dose every hour. You would have to fine-tune this with your son, as different people have different reactions to the same GI food, it might only need a 3 hour split.

Your DSN is right about the rebound, blood sugar level gets so low that the liver releases a large quantity of glycogen into the bloodstream. This sends bg level skyward, and a reading of 20 is not uncommon in this scenario.

Other T1s on MDI may have different strategies for dealing with low GI foods, hopefully they'll chip in here!

 

[suzi]

Hi Rosie,
Pasta is a nightmare, my son Andrew loves it and has experienced similar episodes after eating pasta like your son. We found by calculating the carb ratio and giving half the units before and then the other half of units about an 1hr later seemed to stop both the highs and lows. Two injections for one meal isn't perfect but if it allows them to enjoy their favourite foods without reprocussions, then i think you'll find its worth it. Another thing we found and i'm not sure if this just applies to Andrews pasta as its gluten free, but whislt boiling if you can change the water at least twice and get rid of as much starch as possible, you'll find he wont need as many total units. Hope this helps,
but unfortunately as with all foods its all trial and error,
Goodluck,
Suzi x

 

[hennypenny]

Hi thanks for that, at the moment i think i may just take pasta off the menu. Ethan's 4 so i don't think he would let us give him more injections yet, he's been fab already with with going from 2 to 4. he also goes to bed quite early 7pm so i have to make sure dinner is on the table on time or he ends up having his rapid and lantus quite close together. it is something to keep in mind when he gets a bit older, he can have the choice then. thanks Rosie

 

[Toms mum]

we always have trouble with pasta and mashed potato
and he is quite often abit too high later in the evening