High fat meals

I may be wrong here but I was under the impression that eating fats delays the processing of glucose which is why we get less spiking on the high fat diet. So if you're testing OK 2 and 4 hours later that would indicate the fats are doing their job. Testing after that would be going into the realms of 5 hours or so after eating, so wouldn't the reason for the spike at that point be due to a liver dump? Apparently if we go 5 hours or more without eating, the liver automatically dumps glycogen into the blood stream. So could that be the possible cause for the late spiking and not be due to eating fats? :think:

If this only happens when you eat fatty food and not every day, what I would do was take about 50-60 percent of my expected insulin dose when I start the meal. Then after a couple of hours, I would take the rest.

Fat slows down the digestion. So does a very large meal. That's why you think 'now I'm out of the woods' and then the real fun starts.

Several small things could be tweaked, too. Have a fatty meal, but only half a pizza, half whatever - and have a salad with it. Eat slightly earlier in the day when you know you're going to have this type of food so you can watch what happens at hr 5 and 6 too.

Try have that type of meal on a weekend for lunch and see what happens?

It is very individual too how fast or slow you process food - and I think if you are on a high dose of insulin, I would be a little bit careful with above approach if I'm just off to bed. But otherwise if you know how you normally react, a split dose is probably the best you can do.

You could also look at it maths wise: You take the insulin you think will fit. That works. However, the meal keeps hitting your bloodstream later. Now, if you had to do a correction dose, what would that be? 12-6 mmol would be 1 unit of insulin for me, 2 for most people I think. So give that extra later. If the pattern is consitent.

Good luck, but do test and experiment, it's not always an exact science like that and I'd do it while I was awake

GraceK, I have a weakness for pizzas - I know I shouldn't, but sometimes I just cannot resist.

Eat half a pizza or there abouts - 100g carbs. I need 5 insulin to cover that at the moment.

When I start I take 3 units. Munch away.

After 1.5 hours, I will do a test. It will normally show something like 7.5, my insulin will not yet be working very much.

I take 2 more units of insulin.

My blood sugar will stay in the 7-8 range for 3-4 hours, after about 5 hours, I'll start seeing 6's again. At the 6th hr, I'll be back around my 5s.

That's how my body does it, it seems. I can live with the once or twice a month spike to 8. I don't really think it has to do with lack of food for 5 hours at least in my case - I think it's just slow-release carbohydrates covered in fat. On a low carb diet, you'll get the benefit of the very few carbs get buffered by fat. But a pizza has so many carbs that it becomes a timing problem rather than a relative lack of carbohydrates causing the liver to supply more. In my understanding and opinion anyway.

I think you'll get into a bit of trouble if you upped your lantus, really. If I recall right, lantus kicks in about 2-4 hours after it is injected, effectively. This could be fine in theory if it wasn't for the long action profile - that would probably see you having trouble hitting your insulin:carb ratio for the day or two, or send you slightly hypo - I don't think I would do that personally.

Perhaps for you it would work better to give all your insulin with the meal as you do now, and then 2 units before bed. Or you could try a 75/25 percent split.

I don't think you'd entirely avoid a certain spike but I personally would prefer a 8 mmol spike for a couple hours to a 12 mmol spike all through the night.

Good luck working it out.

bennyg70 said:

All what you say makes sense! My only concern would be my blood sugar reading 2 hours after would be higher if I did say 60% insulin? Is that just a sacrifice? Im certainly starting to see a pattern however. Its quite consistenly a rise of 6 - 8mmol after a higher fat meal which would be about 2 u of insulin for me correction. Ive thought about trying to bolus 2 u as late as possible before bed. Although like you suggest Ill try it in the day one day first!

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Most Saturdays my evening meal is high fat and to overcome the delayed bg rise I split my insulin dose much like Mileana explained earlier, when considering split doses its always wise to discuss this with your diabetes team and proceed with caution, I would be careful injecting QA insulin prior to bed as you don't want to hypo during your sleep.

I tend to take my insulin in one bolus but delay the bolus instead of injecting before the meal I tend to inject as soon as I start.
Perhaps think about the timing of your insulin or ask for a longer durration insulin for the fatty meals. I know people who low carb and high fat use this method when using insulin.

I was talking to my dsn yesterday about this as this happens uf u eat a chinese meal. Im on a pumo so its a bit easier to spread the dise but i get exactly the same. Its all giid until the mirning after. She said high fat meals can actually make u more insulin resustant so you may also need to change ur ratio if thats the case. Be careful thou as the furst time i did this i didnt space the dose out enough and ended up hypo about an hour after inly to creep right up the following morning. Think it deffinitely yhe cas of trial and error just be sure to test frequently whils getting the balance right.
Good luck

So, maybe for a start, try taking 1 unit of insulin per 8 grams of carb. That would in that example be 10 units total.

As 8 works to keep your bg sensible until around bedtime, take this first.

After two hours, take 2 more units.

Try it in the day time as we talked about above.

If you use Rapid Acting insulin, the peak in insulin effectiveness should kick in at around 2-2.5 hours after the injection. That means that just around when your first dose is starting to properly work (and the meal is being converted to blood sugar), you inject a new dose. The first dose will lose it's effect just around the time when the new dose starts working properly.

I still say try it lunch time. Fiddle with it until your happy.

bennyg70 said:

So I eat a high fat / medium - high carb meal evening time - There are 80g carbs lets say and the meal consists of something like chinese food.

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Chinese food is a difficult one to judge as they use a lot of sugar in the sauces and curries, you'd have to be very careful on the portion size of the rice or chips to get your meal to be around 80g of carbs.

What I do ( I always get a chicken curry and fried rice) is inject two thirds of my insulin before eating then inject the remainder around 2 hours after eating, as a rule this works well and keeps my bg within my own personal target range.

The best thing to do when eating chinese takeaways is to stick to the same establishment, that way the portion size remains pretty much the same and after a few weeks of testing you will begin to see a pattern emerge of what your bg does postprandial, it is trial and error at first (and again I suggest you speak with your diabetes team first about split doses) but it's worth it for the occasional treat