Gastroparesis Question

[Sharrryn]

For those with gastroparesis do you find you need to bolus after food instead of before or with food ? I find at dinner time I often have to wait for the dexcom up arrow to appear otherwise I'll go too low. Sometimes I even wait and just correct later. It's a horrid complication and I find dinner time the worst. I try and low carb it and night.

 

[kitedoc]

Hi @Sharrryn,
I do not have this condition but a friend of mine does. She tells me she waits for the BSL to swing up before having the insulin.
Have you talked to your doctor about the various types of short acting insulin to see whether one might suit you better than another ? ( unsure what insulin you are prescribed).

 

[Diakat]

@donnellysdogs might have some info.

 

[Sharrryn]

Hi @Sharrryn,
I do not have this condition but a friend of mine does. She tells me she waits for the BSL to swing up before having the insulin.
Have you talked to your doctor about the various types of short acting insulin to see whether one might suit you better than another ? ( unsure what insulin you are prescribed).

I'm on novorapid for bolus. Doctor happy with that. He says just bolus after food on " bad days". It's just so unpredictable..... and painful

 

[kitedoc]

Perhaps ask your doctor if Fiasp, being quicker in action than Novorapid, might work better, especially if given after the meal (or perhaps always given after).

 

[anniehi41]

Hi Sharyn, I have the same problem. I have this problem mainly after lunch. It is scary, I never bonus before eating, sometimes I can remain at 4mmol or below for 2 hours or more after eating before BG starts to rise. I can extend my bolus with my pump so the insulin goes in over an hour or so but I don’t do this until my BG is rising.

 

[Sharrryn]

Hi Sharyn, I have the same problem. I have this problem mainly after lunch. It is scary, I never bonus before eating, sometimes I can remain at 4mmol or below for 2 hours or more after eating before BG starts to rise. I can extend my bolus with my pump so the insulin goes in over an hour or so but I don’t do this until my BG is rising.

Yes. I used to use an extended bolus when I was on the pump. It's harder now I'm back on injections. I often inject half a dose when my sugar starts to rise and then the other half a bit later if it still continues to rise. Last night I didn't even bolus at all for dinner as my sugar didn't budge. It was a 15g carb dinner so not much but still it's just so unpredictable

 

[anniehi41]

Yes, the maddening thing is the unpredictability. Tried to find which foods maybe cause it but no luck. Like you sometimes I don’t even have to bolus for a meal because B G doesn’t rise at all. I have have had a total pancreatectomy so no natural insulin is being produced. I think you are doing well managing without a pump.

 

[Seacrow]

I've just been diagnosed with gastroparesis, which suddenly explained a whole range of symptoms. I've found that meals with a large amount of cheese are a definite bolus after. If I bolus before I eat, I try to have a fairly high sugar pud to provide a glucose spike as the insulin kicks in.

I have had a conversation with a dietician about the contrast in recommended diet, and she was no help at all.

 

[Sharrryn]

I've just been diagnosed with gastroparesis, which suddenly explained a whole range of symptoms. I've found that meals with a large amount of cheese are a definite bolus after. If I bolus before I eat, I try to have a fairly high sugar pud to provide a glucose spike as the insulin kicks in.

I have had a conversation with a dietician about the contrast in recommended diet, and she was no help at all.

Yes, unfortunately I don't think many dieticians have expertise in gastroparesis- they just don't get it. My gastroenterologist just suggests small meals regularly. I don't think he really had any helpful advice either. It's the pain and the unpredictability in an already unpredictable disease which is so stressful.