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Bolus for fat
- Thread starter vxrich
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When eating Low Carb, I've never bolused for fat due to the conversion rate that takes place. It's a very slow process. The majority of us bolus for protein though as this has a much more marked effect on glucose levels.
OK great thanks. So when you bolus for protein do you do it over a period of a few hours (it's called multiwave on my pump) or in one go. Since doing lchf my insulin qty has dropped loads obviously due to the lack of carbs but because the qty of insulin needed now is so low, sometimes 1 unit I just have it in one go? Ta
I've only had a pump for a few days and I find multiwave bolus is brilliant for high protein meals. For a meal that contains 50g protein, 16g fat and 10g carbs, I bolus for 35g of carb equivalence - I halve the amount of protein and treat it as carbs. My I:C ratio is 1:12, so I have a bolus of 2.9 for that amount. I multiwave it with 1.5u upfront (applied about 20 mins before eating) and the rest over the next 45 mins and it seems to do a great job of keeping my levels suitably flat. It's one of the main things I wanted a pump for and it does a great job of managing post meal rises!
I make most of my own food and work out the macros on them as I weight train and need to know what that looks like. The fats are simply a part of it and not something I include in my bolus calculation.
I'm tagging @ewelina as I know that the model she uses for bolus calculations includes an allowance for fat, mainly to derive the impact of fat slowing the absorption of carbs. You might find it useful.
This paper is quite interesting in respect of what we have been discussing:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2901033/
It basically discusses bolusing using a multiwave programme (in the context of the paper, it talks about a Normal Wave [standard bolus] for carbs and Square Wave [extended bolus] for fat a protein). It recommends normal I:C ratio for the carbs and then applies 1u of insulin for every 100 calories of fat and protein, in a square wave of varying duration.
The duration of the extended bolus based on percentage of meal made up of fat and protein vs carbs.
According to the paper, the calculations they developed come from use of the observed empirical data.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2901033/
It basically discusses bolusing using a multiwave programme (in the context of the paper, it talks about a Normal Wave [standard bolus] for carbs and Square Wave [extended bolus] for fat a protein). It recommends normal I:C ratio for the carbs and then applies 1u of insulin for every 100 calories of fat and protein, in a square wave of varying duration.
The duration of the extended bolus based on percentage of meal made up of fat and protein vs carbs.
According to the paper, the calculations they developed come from use of the observed empirical data.
That's great Cheers. I'll have a look later. My biggest problem at the mo is that my bs levels were spot on for about 6 weeks afters starting lchf. It doesn't seem quite as easy now. Think I've got some kinda virus that's affecting insulin? I'm training for a triathlon and also weight train (used to be into body building but it's more kinda circuit training now) Really does my head in when things change for no real apparent reason!
Welcome to Type 1! What is it that you are seeing, and more importantly when?
I was welcomed 15 years ago! Hehe. Still narks me when I don't know what's happening tho! Like I say I started lchf about 6 weeks now and started off great. However my sugars have been hovering around 10 for the last few days even tho I've been giving myself extra insulin to combat the higher bs level. Like u say u feel a bit run down so I think it's affecting my insulin somehow.
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why can't everyone get on........
Happy to have a chat with you about it. The reason I'm using it is because I was doing something very similar with MDI, just using multiple injections to achieve the same thing. As a result it's a fairly straightforward crossover (and was one of the main reasons I've been trying to get a pump!)
tim2000 just out of interest what is the difference between your bolus and basal rates on days that you train and don't train. I'm trying to work out what could be happening to me at the moment and as I've been feeling a bit under the weather I haven't been training half as much as usual but have not adjusted my bolus or basal rates. Also how do you find weight training effects your bs. Weights actually raise my bs slightly but riding seems to stay level. Running also keeps bs level whilst running but rises a bit after. Interesting to know what happens to other people
I don't really have a handle on that with the pump yet. I've only trained three times with it. The first was on day one with it, when it was clear my basal rate was far too high and needed to be brought down.
I took the decision to remove the pump when doing weights so that I've limited my basal for the period when I'm likely to take a dive low post session (and I find the lifting belt and motions are incompatible with the tubing). I've used that on one day's high volume training and it worked very well.
I've also done a HIIT session where I did a TBRof 80% for 2.5 hours beforehand. That was pretty good, although I think that 75% will be slightly better.
I'm still in the experimenting stage at the moment, but trying to document everything so I can get it all clearly defined.
I find I only need to adjust my background if I'm running or biking mainly because my weights session only lasts around 40mins but when running or biking I have a tbr of 40% and to be honest since lchf I don't even need to take on extra carbs whilst training which is a godsend! I actually had a meeting with Steve Redgraves Dr last year and he recommended turning the tbr back to 100% straight after training.
ewelina
Well-Known Member
The approach Ive been using is described in the article posted by Tim. Its widely used in Poland for pump users. It takes some hard work at the beginning, as you need to establish your insulin ratios, separately for carb and protein/fat. Also deciding on how to extend boluses is a bit of trial and error. I think 3 hours is definitely too long(at least for me), unless your meal is something really high in fat (as pizza or fish&chips). This approach is kind of similar to blousing 50% protein and 10%fat but much better for high fat meals, where you probably need more insulin than from this simple calculation.
