After meal: Increase BG after 2 hours and on...

[Pota]

Hello people,

People say that if you count your carb you can inject insulin after how much carb you eat. I find this rather hard to follow with most food. First of, let me explain my story.

With some food i can count carb and inject after how much i eat. But with ALOT other i cant.

For example:
1) If i eat 3 slices of whole bread i can usualy count carbs and insert right amount.

2) If i eat Pizza its extremly hard cause of all the fat and the fine wheat.

3)If i eat anything with fine wheat. Hot Dog bread, Pasta or so... i ALWAYS get a rise in BG after 2-12 hours.

Lets go with example 3. I eat some Hot Dog with fine wheat. I start with BG at 6 and inject 2.5IE fast acting. After 2 hours my readings are back to 5-7. Im happy. But then it just rises and rises... And if i dont repair i would climb to 20+.

The same goes with steak... Especialy Rib Eye steak.
Most of the time potatoes makes it easy for me to carb count. But with Rib Eye I cant.

If i eat Lasagne and does a carb count and inject THAT amount of insulin, i would go EXTREMLY low...

I eat ALOT because i train alot, actualy im an elite sprinter. Lets say i eat 1kg lasagne(with carb count maybe i need 12IE) I then inject 3IE fast acting and have normal readings after 2 hours... But from 2 hours and on i will rise and rise... This seems to me to be the fat and pasta which makes this rise.
Its realy hard to know where this rise is going to start. So if i miss with "repairing" i can go low.

But note. This isent just with fatty food. This also happends if i eat ALOT of meat...

Is there any "easy" way to coop with this? The Extended bolus seems kinda scary. I never know how much insulin i need after the 2 hour, and when...

NOTE: Im EXTREMLY insulin sensitive!

 

[novorapidboi26]

Being an athlete, I cant really advise you much as your bodies response to insulin and carbs will be completely different to most folk......

most quick acting bolus insulin's will last between 3 - 5 hours, peaking at 1.5.......these are just general times, they will vary with everyone......

so after the 5 hour mark, any rise in blood sugar, similar to what your have described, will not be related to your previous meal and its accompanying insulin dose, it will more likely a problem with your background insulin dose....

you mentioned similar increases in blood sugar when having steak.... I personally don't take insulin for meat alone, although some do.......it will never be a lot of insulin though...........as an athlete, do you need to consider bolusing for proteins.....?

when eating meat alone with no carbs you shouldn't need to bolus anything, although some people do, but it wont be a lot.......

pizza and lasagne as you have noticed do have a delayed absorption in the blood stream, this can be tackled with a split bolus where say half is given as normal, before the meal, and half an hour later.....these timings will have to be adjusted for each individual.......

you mentioned extended bolus so I can assume your on a pump, and so you could use the extended bolus, it will work well........you can start by experimenting with just a little of the total dose bolused over a small period of time.....

say for example you are going to eat a whole pizza to yourself.......total carbs = 134.4g carb/insulin ratio = 10:1 total units to bolus = 13.4

take 75% upfront - 10.1 and 25% over the next 1.5 hours - 3.3....

all you can do is experiments, but its worth getting the information........

how sensitive are you? whats your carb/insulin ratios...?

 

[Wurst]

............... Or go low carb. Low carb = smaller amount of insulin units = small mistakes

 

[noblehead]

It's all to do with the fat in your food:

http://care.diabetesjournals.org/content/36/4/810.full

http://www.mendosa.com/The-Fat-of-the-Matter-How-Dietary-Fat-Effects-Blood-Glucose.htm



Not a pump user myself but Novorapidboi's advice seems sound on bolusing, for myself on MDI I have to split-dose for meals that are high in fat, I also need to bolus for meals that just contain protein & fat with no visible carbs.

 

[Pota]

Alot of good advice here. But wouldent it be fatal for me to split a dose?
I mean. When i eat lasagne, i inject 3 units of insulin on a meal that needs 14.
After 2 hours my BG are back to normal. If i had split that in two it would be 7 / 7. That would be way to much.. :S

Low Carb aint possible for me who do alot of training.

 

[noblehead]

Alot of good advice here. But wouldent it be fatal for me to split a dose?
I mean. When i eat lasagne, i inject 3 units of insulin on a meal that needs 14.
After 2 hours my BG are back to normal. If i had split that in two it would be 7 / 7. That would be way to much.. :S

Low Carb aint possible for me who do alot of training.

Not a pump user but could you not do an extended bolus as Novo describes, or work it yourself going from your own bg readings over several hours.

 

[phoenix]

Not a solution, but I think that this article summarises what is known about this (ie that carbs alone aren't always a good indicator of the amount of insulin needed)
http://www.diabetesmine.com/2013/12/counting-those-carbs-may-not-be-best.html
I actually think that solutions are going to be very individual; what works for me is based on much smaller portions than you require for your lifestyle. I .agree though that they will be based on using an extended bolus
Some people do attempt to dose according to protein/carbs/fat.
Here is a post about how some of them have gone about it.
http://kellywpa.com/2010/11/10/total-available-glucose-tag-2/

As an elite athlete I think that you should get some specialist help. If you are in the UK (think that you are probably not) then there is a dedicated clinic in Reading run by Ian Gallen who has made it a specialism. (if you're not the site is still useful)

http://www.runsweet.com/