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High carb bolus?

With a pump, I use the combo bolus for high carb meals.
Pizza works well over four and a half hours with about 30% up front.
Pasta works over about 3 hours with about 50% up front.
I still need some more trial and error with Indian.

With cake, I bolus all up front because my pump does not allow combo bolus stacking and I struggle with a single slice but I try.
Bread and cheese is similar to pizza ... but not as hot (unless it’s cheese on toast).
 
I don't eat stuff like that too often because I'm usually too lazy for at least 6 hours of actively having diabetes instead of a relaxing evening, but I do love the occasional Chinese take away. So when I do I try to eat relatively early to give me more hours to get things stable again before bed. I start with a substantial bolus, say a little less than I think I need but a bit more than I'm comfortable taking at once. And then it's testing a lot, both with Libre and test strips and correcting quite agressively for the next 4 hours. Which gives me another 2 hours of correcting more subtle to see if things look stable enough for bed. Sometimes it's worth it, though
 
Pizza I would use a dual wave bolus 60/30 over 3 hours seems to work pretty well. I love pizza as well. Chinese again dual wave 50/50 over 2 hours....a fair bit of guesswork in the carbs for that. Cake (mmmmm) square wave over 1 1/2 hours. Boy I like Mike the pump
 
After 48 years of T1 with fairly poor control (and being told what to eat or not to eat) being to be able to eat what I want and get my A1C to 47 is pretty impressive in my eyes
 
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I usually do a 50% bolus a half hour before and the other 50% when I eat. This has worked really well for me. There is usually at most a 20 point spike. If it's a higher fat meal with high carbs, then I will do 25% when I eat, 50% a half hour later and the last 25% the hour after I eat. The trick is remembering that last dose. For me that would be gaucomole and (tortilla) chips, taro donut, almond cluster "cookies". My Omnipod allows an extension but only one, so I have to remember that third dose or otherwise I'm on my exercise bike trying to bring down any spike as fast as possible!!!
 
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kitedoc said:
The mantra of eat what you want and dose for it is not always wise.
Click to expand...
No one says it is.
It is however wise to read up on how other people tackle unusual meals to give you ideas about approaching them. Nothing wrong with declining the more difficult meals, but nothing wrong with learning about dealing with them either.
 
Being chinese and growing up in a chinese takeaway, not that I ate off the menu everyday, I think it depends on what it is. For example: if it’s chinese food the savoury kind - stir fry veg and plain rice, I don’t split dose it. If it’s pancake rolls, sweet and sour veg, whatever fried extras, I tend to do 50/60% up front and do the remaining after 30mins. For pizza, I’m still working on that but so far 50% up front and remaining 50% after 30 mins could go either way for my blood sugar. Nandos, McDonalds and TGI fridays I have no issues with because I’m only tackling chips or wrap or a burger bun for carbs.
 
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kitedoc said:
The mantra of eat what you want and dose for it is not always wise.
Click to expand...
Doesn't it depend?
On what you want? How often you want it? What the rest of your lifestyle is like? ...

For example, I eat (homemade, thin crust) pizza when I want which is about once a month. I eat it often enough to have worked out what the best dosing pattern is for me. I enjoy vegetables a lot. I am slim. I exercise a lot. I feel no guilt eating pizza.
If I was overweight, did not exercise and wanted pizza every night. That is a very different scenario.

And all those "depends" have nothing to do with having diabetes.
Which kind of relates back to the DAFNE course where the "FNE" stands for "For Normal Eating".
 
Please read: :
Efficacy of carbohydrate counting in Type 1 Diabetes: A systemic review and meta-analysis Lancet Diabetes Feb 2(2) 133-140 2014. Brand-Miller et al
And re-see: The Fat Emporer podcast: E 25 Dr Lustig - Processed food
'Normal eating' is a misnomer, a misguided term. DAFNE does not define it is any way that is guaranteed to be healthy.
It is a food-industry influenced concept, developed over the past 50 + years through advertising and promotion, not for health reasons but to maximise profit.
The above podcast makes that clear.
Eating anything you like is where the PHNE in DAPHNE comes in.
 
But it is an expert opinion based on years of clinical experience and decades of research about diabetes, metabolic syndrome, nutrition, statistical analysis, biochemistry, history, and epidemiology.
There are also other podcasts and papers.
 
Ladies and gents, please let's not go round the tired old "my way of eating's better than your way of eating" loop again.

I remind you all of rules, B3, B4 and several others in this regard. Thanks.
 
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