MDI pizza bolus

shivles

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How do you handle it? Making the kids pizza for tea and need to decide how to bolus for my 18 month old DD :)
 

azure

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@shivles When I was on MDI, I split my bolus, having most upfront but bolusing again later to catch any rise from the fat. I can't remember exactly how I split it as it depended on how big a serving I had and what I was having with it.

With such a young child, it may be a case of experimenting to see what works. At least you have the Dexcom which will give you great information about any effect.
 

shivles

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@shivles When I was on MDI, I split my bolus, having most upfront but bolusing again later to catch any rise from the fat. I can't remember exactly how I split it as it depended on how big a serving I had and what I was having with it.

With such a young child, it may be a case of experimenting to see what works. At least you have the Dexcom which will give you great information about any effect.
It was 2.5 units so trying 1.5 and 1 split see how it goes!
 
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CathP

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We tend to make the 'fathead' pizza, and that doesn't really give a spike :)
 
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shivles

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Considering she was around 8 when she started eating I think that's gone pretty well!
 
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azure

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Especially as it's your first time experimenting like this :)
 

shivles

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The pizza hump was tiny but she went hyper after going to bed! No idea why
 

CathP

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I think that's the high fat/ high carb combo, it comes back to haunt you later. We went out for fish and chips a couple of nights ago, first high carb meal in 10 months. We got cocky and thought we'd nailed it, she went to bed at 7.1mmol. Half past midnight and the dexcom was alarming 17 mmol double arrow up!!! Terrifying, we haven't seen those sorts of numbers since dx! We'll not do that again, we were literally up all night giving corrections :( I think the fat slows the absorption of the carbs in those sorts of meals.
 

Jaylee

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The pizza hump was tiny but she went hyper after going to bed! No idea why

That's pizza for you.. It's like doing a deal with the "mob"? They make an offer "you can't refuse" & send the "boys" round later..
There is a possibility the basal profile had tailed off from the day before, (if given at bed time?) & last nights shot kicked in a little slow. Leaving the kid with a lower basal rate for while in the night? Hence the high.
This is only a thought..!

What were her numbers this morning?
 

pinewood

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I find pizza challenging but I have a routine that keeps me in the 5-8 range. To do this I, unfortunately, need 3 or 4 bolus shots....

40% up front;
30% after 1 hour;
30% units after 2.5 hours.

Sometimes I need another 2 units at the 4ish hour mark as I find pizza digests really slowly due to the high fat content and I suffer badly from delayed spikes. That's why I try to eat it as early as possible in the evening, otherwise I can go to bed on target at 5ish mmol but then end up spending the whole night in the teens without realising until I read my Libre the next morning.

I think that's the high fat/ high carb combo, it comes back to haunt you later. We went out for fish and chips a couple of nights ago, first high carb meal in 10 months. We got cocky and thought we'd nailed it, she went to bed at 7.1mmol. Half past midnight and the dexcom was alarming 17 mmol double arrow up!!! Terrifying, we haven't seen those sorts of numbers since dx! We'll not do that again, we were literally up all night giving corrections :( I think the fat slows the absorption of the carbs in those sorts of meals.
Yes, happened to me last night actually. Indulged after work with friends and had a milkshake (bad idea), burger and fries. Happily went to bed at midnight at 6mmol with downward arrow on my Libre. Woke at 2am at 12mmol and upwards arrow; spent the whole night waking every couple of hours to correct. :banghead:

It's notoriously hard to nail it when you have high-fat meals like this; the easiest way I find to manage it is:

(a) eat your meal as early as possible so you can try and nip the spikes in the bud before sleeping; and

(b) try to do some moderate exercise after eating as this can help speed up digestion and reduce the spikes; even a 20 minute walk can be hugely helpful for me to maintain the 5-8mmol range the whole time with no big delayed rises; and

(c) obviously not for kids(!) but I tend to find even just one glass of wine can help stop delayed postprandial rises. Experiment with caution, though.
 
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