How Would You Bolus For These Scenarios

[O_DP_T1]

Hi all,

Just a quick question as I’m so new to MDI how would you bolus for these two scenarios if say BGL were around the 5 mark?

A) 10g Carbs 20g Fats 60g Protein

B) 10g Carbs 50g Fats 60g Protein

Cheers in advance all.

 

[Knikki]

Depends on what insulin your using because if you use Nova Rapid as an example, most tend to inject a fair while before injecting.

However if it was me if my trend was going down then I would inject 9 both of them. I personnally would only calculate for the carbs I don't count in the rest. BUT THAT IS JUST ME.

I would also watch levels too see what happens later on after eating.

 

[Deleted Account]

We are all different: some never need to bolus for fat or protein, some only need to bolus for fat and protein if they have no carbs, some always bolus for fat or protein, ...

How would I bolus for it?
I would bolus for the carbs (with my usual carb ratio), test after a couple of hours, assume half of my bolus has gone, make any necessary correction and record what I did for next time I ate a similar meal.

 

[porl69]

I would have to agree with @Knikki on this one. Depends on what insulin you are using and if you are lucky enough to be on a CGM/Libre to see what your trend arrow is looking like. I would also only bolus for the carbs, again that is just what I would do.
We are unable to give out any medical advise on here. Everyone is different and what would work for me probably wouldn't work for you

 

[O_DP_T1]

Currently on NovoRapid and yes I have Libre

 

[SamJB]

I'm on LCHF diet and need to inject for protein. I don't adjust for fat, but through trial-and-error I've found that 20% of protein gets converted into glucose, via glucneogenesis. I'm on 1u Novorapid per 5g carbs, so I'd inject 2u for the carbs and 2u for the protein.

 

[Alison54321]

60g protein, and 50g fat? what are you eating, the whole suckling pig?

I don't know, I would probably start with however many units I inject for 10g carbs, and see how it goes.

 

[Kristin251]

For me, I would have to split my bolus for 60g of protein. I’d probably have to bolus 3 x. Fat delays everything so taking it all at once would surely cause me to hypo then get a steep long rise.
I’m carnivore so I gluconeogenisis quickly. And of course add the glucagon element. But THATS JUST WHAT I WOULD DO.

I kept a journal for many years playing with macros.

 

[NicoleC1971]

Bolus according to your ratio the standard being 1 u for 10g of carb but this varies according to insulin sensitivity (fatvs. muscle mass), if you are in the boneymoon period etc.? Exercise scenarios throw another curve ball in so let's not go there.....
In theory the larger fat content in meal 2 would slow your absorption of the glucose down therefore a split dose* could work. The ratio for protein is reckoned to be about half that of the one for carb e.g. 1u for 20g but I find that on a low carb regime I am naturally producing more glucose from my liver so sometimes need more...
*If you were to get a pump then that should give you an 'extended bolus' type option to cover just this type of scenario i.e. risking going hypo if you eat a high fat meal. Better than having to jab yourself twice!

 

[LooperCat]

Depends on the type of carbs - are they fast carbs like potatoes or pasta? Or slower carbs like broccoli?

If that was my meal, it would be the slow, vegetabley type of carbs, so I’d take a unit for those, extended over an hour. Depending on the type of protein, I’d take three units for that, extended over two hours for the lower fat meal scenario, and up to four hours for the higher fat one.