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

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...?

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

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 said:

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.

Click to expand...

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.

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/