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Controlling blood glucose levels when eating foods with large saturated fat content

doyco385

Member
Messages
12
Location
New Zealand - Dunedin
Type of diabetes
Type 1
Treatment type
Pump
Hi everyone,

I am an athlete. I play football to a representative level and I love having my fatty foods before games just to help increase my calorie intake. However, I have rather big issues with controlling the spike in blood glucose that the fat causes some time after eating the food. I am on an insulin pump (Animas Vibe) but don't have a continuous glucose monitor (too expensive in my country - New Zealand).

I have been trying to use the combo bolus to its advantage for this, doing 60% of my bolus to begin with and then 40% over 2.5 hours. I've been doing a lot of analysis of my diabetes since im currently recovering from ankle surgery and really wanting to make sure I get the routine of analyzing my blood sugars and changing my ratios and basal rates accordingly.

How do you all manage with the spike in blood glucose from saturated fat? I don't want to hear that I shouldn't be eating it, because its how I want to manage my diabetes and I have great control as is, I just want to make it perfect and this is literally the last thing I need to figure out to get it pin pointed.

Im seeing my diabetic team in 5 weeks time, I'd love to turn up and tell them that I have everything sorted and prove it to them too.

Cheers everyone!!
 
Ive started on a pump nearly 2 months ago and still working on how to bolus for fatty meals. I haven't mastered it yet (few more pizzas to eat ) but what I can see you will probably need longer delay. It all depends how big is a meal and if it contains any carbs. For big meals you may need a few more units than carb count shows you. How did it work when you used 60:40 and 2.5h delay?
 
Hi Doyco
I eat quite a lot of saturated fats, but i find it does not spike me at all. infact thats why i eat fats. I can eat a block of cheese or loads of olive oil and it doesn't impact one bit.
Just realised i am not being very helpful to you!.... something doesn't seem quite normal... .are you eating carbs with the fat?
there is a good graph in this video showing the effects of Fat, Carbs and protein on glucose look to 4mins 20secs.
 
I cant see any video. can you repost it please. I would love to see it
 

Hey Ewelina,

Well im currently doing it right now, had dinner of fish and chips around an hour and a half ago. I was 6.1mmol/L before dinner and ate 115g of carbohydrate. I did a bolus of 5.75U (3.45u with dinner and then 2.3u over 2.5 hours, I use novorapid as well) and an hour and a half later, I am now 8.3mmol/L. Just to make it clear, I haven't used a delay, i've basically just increased my basal rate over this time by 2.3u/2.5 hours = 0.92u per hour.

I remember reading an article about needing to increase the bolus amount by around 25% when eating foods with high amounts of saturated fat to counteract this, and from the looks of how my blood sugars are going, I would say atleast for me that would be true. Im going to order pizza tomorrow and give it a go! I'll make sure to let you know how I go!
 
What is your ratio? So you gave about 9u for 115g? I guess increasing basal is the same like giving extended bolus. Im very curious to see your result. My bet is you will go a bit high in about 5h but maybe Im wrong. I think I will have pizza tonight to test it
 

Hi Zebediah,

Sorry I should have mentioned, yes all fat I eat is with carbs. I always eat carbs else I don't maintain my weight due to my physical exertion being very high (obviously not right now with my injury however). I can eat fats and proteins with no fluctuation what so ever in my blood sugars. Thanks for the video link! Defs will have a look into it
 

Nope I only gave 5.75U for the 115g. My insulin to carbohydrate ratio is 1u:20g of carbohydrate during the day and night, I have a different ratio for the morning. Im not up with all the lingo obviously, I did use an extended bolus, my bad! As you can, im new to these forums !

I'll put a post in the morning to let you know how it goes
 
@doyco385 Fish and Chips is one of the most difficult to manage, along with Pizza. Both can still be having an effect on BG levels six hours after eating. Whilst I don't have a pump, I do have CGM and I tend to bolus 50% at the meal, 50% 2 hours later, and between 25% and 50% two hours after that to manage the effects.
 
Oh yeah for sure I totally agree, I've always had issues with foods like pizza and fish and chips, its just that with being injured and recovering from surgery, its giving me time to put all my effort into learning how to cope with them! . So you would say to increase your total amount of insulin by 25-50% for foods high in fat? Based on individual needs of course?
 
My experience is that I need about 50% more insulin, yes!
 
I also find I need more insulin for very high-fat meals. The Libre has taught me that my BS can still be rising 5-6 hours later for pizza - which makes it difficult to control if I am eating the meal late at night.

I'm not on a pump but actually had a take-away pizza last night. I kept my levels between 4-7mmol at all times by following this routine:

Immediately before eating: 3 units
1 hour after eating: 2 units
2.5 hours after eating: 1.5 units
3.5 to 4 hours after eating: 2 units

Not ideal to inject 4 times but it kept my BS steady and I had a nice flat-line over night (5.5mmol) which was good. Previously when I'd had pizza I'd went to bed at a good level but on waking I saw that I'd spiked during the night - so the "3 hour after eating bolus" helped nip that in the bud this time round. Previously I'd gone a little too low after the 2 hour injection so reducing that a little also helped. It's trial and error...and I'm sure that once I've "cracked it" it will all change next time round!
 
Snap, I;ve done exactly the same thing. It all looks good when you go to bed, then about an hour after going to sleep it starts to rise.
 
Much like Pinewood I find I need a lot more insulin when eating high-fat meals then I do with meals that are low or have moderate amounts of fat.

TBH @doyco385 o385 its all trial & error, on a Saturday night I eat a high-fat meal and find using use a dual wave bolus and also setting a TBR helps to deal with the delayed spike, in the book Think Like a Pancreas Gary Scheiner discussed bolusing for high-fat meals using Dual Wave and TBR's, sure it's also discussed in the book Pumping Insulin too.
 

So here are my results, just to let you know I actually only did a 50/50 split, I forgot to change the settings (whoops).



I'd say that if I did a 60/40, or even a 65/35 split I would stop the increase over the first 2 hours pretty well and then the extended bolus would hopefully be decreased enough to stop the rapid drop 2.5 hours later. I also think its because my ISF and basal rates are changing rather rapidly as i'm starting to increase my activity levels as the pain from my ankle surgery is decreasing. I will test this theory again at some stage in the near future and make sure to put a post up!

@noblehead, I think you are right. That's why im kind of blessed to be able to have the time to fully commit to getting this all sorted, feel rather lucky to be honest.

Thank you everyone else for your input! Much appreciated
 

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Great thank you. It looks not too bad considering you ate fish&chips. Im trying to loose weight, so gave pizza a miss., but I will definitely look into extended bolus for pizza and similar.
I did it for a protein based meal yesterday and it worked perfectly.
Looking at your graph I agree you would need 60:40 split but I would extend that 40% for longer time as well. I think that would prevent that rapid drop 4h later. There was too much active insulin in that 4 h block
 
Oh dear I hope I don't have to do the basal/basal regime. I don't understand it one bit. All looks extremely complicated!!! Good on you all who manage this!!!
 
Good luck on your weight loss goals! I've found that the 60/40 regime works really well for anything made with regular flour pretty much. Totally agree on the 4 hour for the extended bolus, gave it ago tonight with some chips (such a good excuse to have fatty foods! ) and it worked perfectly so pretty happy. Thank you for your help!
 
fred1234 said:
Oh dear I hope I don't have to do the basal/basal regime. I don't understand it one bit. All looks extremely complicated!!! Good on you all who manage this!!!
Click to expand...
Its not that bad! Honestly its all about routine. If you can keep the same routine each day for a week to figure out how your body reacts to certain foods and then how you can change your regime according to that, then it gives you the principles to be able to do it when you need to adapt around your lifestyle. Trust me, when I first started on the pump I didn't know anywhere near the amount of stuff I do, studying physiotherapy and learning the physiology of the body has been helpful to understand what is going on but you definitely dont need to know that to be able to get it perfect! Trial and error with a bit determination will get you a long way! The other stuff you can ask your diabetic team to help you with
 
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