Spaghetti spikes Blood Glucose after 3-7hours

If you're know you're having a high fat meal try injecting after eating instead of before

Are you also sure you correctly counted the carbs? And that your ratio is correct? I am very insulin sensitive and for a "standard" portion (slim female who doesn't have a lot to eat) it's around 30g carb and so 2 units Novorapid.

Your portion size will have an effect!

What ratio did you use?

A little more insulin would take you to 4-5 at 2 hours and then you have scope to rise again if that's what the food is doing.

What was your reading at 3 hours?

Scheiner discusses this when talking about the pizza effect.

The final insult brought on by high-fat foods like pizza is the prolonged, gradual blood sugar rise that occurs many hours after eating. And guess what...it's not carbs that are causing the rise. It's the fat. But not directly. Here's how.

High fat meals and snacks cause an increase in serum triglycerides for many hours. When the liver is confronted by large amounts of triglycerides, it becomes resistant to insulin. And that results in greater secretion of glucose by the liver. Without a concurrent increase in insulin, blood sugar levels are going to go up, up, up.

Click to expand...

His solutions aren't so easy for people using injections as they involve either taking a small dose of intermediate NPH insulin after eating or using a temp basal on an insulin pump. He increases his basal by 60% for eight hours after a very high fat meals. I've increased my basal after big, highish fat meals but I've never done it to more than 30% and not for as long.
http://diatribe.us/issues/32/thinking-like-a-pancreas

Re: R: Spaghetti spikes Blood Glucose after 3-7hours

Yes, in these cases (pizza/spaghetti) using an insulin pump is extremely useful. You can split your bolus into 2, 3 or even 4 parts and take the insulin gradually. In place of a pump, using a basal insulin ("the slow one" like Lantus or Humulin I or others) is definitely the right solution (always according to your consultant's recommendation )

~ Arianna ~

Did you eat too much? i.e. you didn't just feel full, but stuffed. If so, it could also be the Chinese restaurant effect.

There was some research at Joslin recently about fatty meals and insulin requirements. They are going to follow it up by investigating optimal dosing for such meals .
[youtube]LjHaa-GIJ7M[/youtube]

More detail:
http://www.joslin.org/dietary-fat-can-a ... betes.html:

One solution to the pizza effect is to not to eat the carb element I would say? In that Joslin video they refer to 'high fat' meals but they really mean 'high carb and high fat'. 'Low fat' means high carb and low fat.

The issue of fat slowing the digestion of carbohydrate and decreasing insulin sensitivity is an interesting one but moot if there is little or no carbs; I think many low carbers know that you have to keep injecting some insulin to cover food (as explained by the 'Chinese Restaurant' effect) but if you are just having protein and fat I find that the amount is acceptable.

I would think it would be almost impossible to get to a situation where you had to treat fat as if it were carbohydrate when calculating your bolus amount, which means even though fat (may) make you less sensitive to insulin who cares if you are not eating carbs?

If I were to eat spaghetti bolognese I would probably opt for a longer lasting short acting insulin (like Humulin s) and have to take more of it than the carbs would ordinarily suggest. Much easier just to eat the bolognese bit and forget about the spaghetti.

Best

Dillinger

Pota said:

Very Very interesting article you got there Phoenix!

Click to expand...

It is interesting and answers a lot of the unanswered questions we've been wondering about for years. I don't eat spaghetti bolognese that often but do love my wife's homemade lasagna which is just about the same with a similar amount of fat, for this I just split my insulin dose and inject 2/3 upfront and the rest 3-4 hours later when my bg starts to rise, took some working out but it does work for me. Will admit though that I tend to eat these sort of meals on a weekend where a glass of red wine is included..... so don't know if that helps matters

Dillinger
I think the original poster in their post said that they didn't wish to cut either carbs or fat because of being underweight. He says that he is very insulin sensitive. He ate some spaghetti and a lot of meat and cheese.

The explanation given by Scheiner shows why there is both a delayed affect caused by absorption This would be covered fine by the regular insulin you suggest but the later rise caused by the insulin resistance still needs to be covered. This, as I said isn't so easy to cope with using injected insulin.
The Joslin research also demonstrates this late rise .

Whilst you choose to eat low carb, others don't and more importantly can still have good control. This includes G. Scheiner who is not only a well known and well respected diabetes educator He is also a longstanding and healthy T1 diabetic.

I rarely eat pizza type meals , a woman of my age doesn't need huge amounts of calories of any denomination.
However, learning about what may happen and what to do is empowering. It means whenI eat out and especially when I eat in other peoples homes, I have some idea how to deal with it. This enables me to keep good control whilst not detracting from my quality of life.

Hi all, no real advice to give but I experienced something similar last night. Had a Chinese takeaway, jabbed 1unit/10g carbs as normal. Sugars were 4.something 2 hours later at midnight (yay!). I didn't test at 3am as normal because they were good at 12, woke up in the morning and they were 17. Gulp!!!! :S


Sent from the Diabetes Forum App

LadyFarmer said:

Hi all, no real advice to give but I experienced something similar last night. Had a Chinese takeaway, jabbed 1unit/10g carbs as normal. Sugars were 4.something 2 hours later at midnight (yay!). I didn't test at 3am as normal because they were good at 12, woke up in the morning and they were 17. Gulp!!!! :S


Sent from the Diabetes Forum App

Click to expand...

Sorry off topic but do you really wake yourself up at 3am to test your blood?

Yep! I'm a really deep sleeper so sometimes sleep through the alarm but my boyfriend is ace and literally shakes me awake!
I had a useless 'specialist' who put me on twice as much levamir as I needed (60u/ day!) which resulted in a really really bad hypo one night (thank god for my boyfriend or I wouldn't be here!) I'm on muchly reduced levamir now but it scared us quite a bit so its no bother really to test them. I'm hopefully going for a pump because I need a bit more flexibility with giving insulin. I'm quite active in the day on the farm so need less, but by the following morning they rise a bit so would like to tighten up in that! (Sorry for the essay/ hijacking!!) )


Sent from the Diabetes Forum App

phoenix said:

Dillinger
I think the original poster in their post said that they didn't wish to cut either carbs or fat because of being underweight. He says that he is very insulin sensitive. He ate some spaghetti and a lot of meat and cheese.

The explanation given by Scheiner shows why there is both a delayed affect caused by absorption ..... The Joslin research also demonstrates this late rise .

Click to expand...

I don't believe we are arguing Phoenix (god forbid etc., etc.,) - I don't dispute the Pizza Effect; I just dispute how to deal with it.

I think the original poster is posing a bit of a problematic question if they say; 'I'm doing something, it's going wrong, but I don't want to change what I'm doing; so what should I do?' My advice is ditch the carbs; but OK, the OP wants to put on weight, well the alternative is ditch the fat then; if you do nothing then the same situation will occur.

There are consequences with going for the carbs though that include higher triglyceride levels, greater risk of obesity (which might be desired in this case but is hardly a normal dietary desire), and I would suggest harder blood glucose management.

Additionally, the problem of the Pizza Effect is one constructed by eating carbs in the first place; if like me you keep them to a minimum then there is no obvious Pizza Effect.

I know you like to eat a varied diet but you are on a pump with good access to blood testing strips so are in a good position to manage the consequences of that; not everyone is in that happy position.

Best

Dillinger

Dillinger said:

There are consequences with going for the carbs though that include higher triglyceride levels, greater risk of obesity (which might be desired in this case but is hardly a normal dietary desire), and I would suggest harder blood glucose management.

Click to expand...

Or not as the case may be, at my last cholesterol check my Trigs was 0.5 and the time before that it was 0.7 which is below the recommended target level of 1.7mmol/l for diabetics, how does mine compare to yours Dillinger?

To say blood glucose management is harder is not entirely true, we have many type 1's on this forum who are well controlled but don't follow a LCHF diet, what unites us all is that we are all proactive with our diabetes management and determined to get it under control come what may, having access to a great support network to bounce questions and ideas off is invaluable and that alone can give someone the determination to get a handle on their diabetes. If you take a look at other forums such as the DUK affiliated diabetes support forum you will also see again that there's type 1's on there who have Hba1c's below 7 and even a few in the 5's, this is without anyone following a very low-carb diet, personally I find eating moderate amounts of carbs in a meal much easier and predictable to bolus for and in most cases don't have to resort to injecting twice or three times to cover one meal.

I really thought you'd be interested in what Scheiner has to say about fat in the diet and the results of the Joslin Study, I remember you were saying only a year or two back that your insulin requirement were quite high considering you were following a LCHF diet of below 30g a day ( was it 1 unit of insulin to every 1g of carbs) and you thought you'd become resistant to the insulin you injected, you did say that your Endo thought it might be related to your diet but you didn't elaborate further on the subject.... which is unfortunate as I suspect he may have been thinking along the same lines a Scheiner.

Dillinger I also have good BG control. My latest hba1c was 6.1% despite eating plenty carbs. I have about 100 - 150g per day on average (for my ages sex and height this is a suitable amount)

With the help from the good people on this forum and Mr G.S. I've managed to time my injections appropriately to counteract potential spikes. I am not on a pump, I do 1 injection per meal (unless there are multiple courses)

I don't doubt many people have benefitted from a LCHF diet, but suggesting that's the only way to succeed is a bit unfair.

To the OP - have you friend injecting earlier yet? I usually do about 15-20 minutes fruit to a meal like that

That should say "prior to".... Not fruit. New app I can't see down far enough to correct it!

Pasta will in general cause a rise in blood sugar after a few hours. I am T1 and eat a lot of pasta/spaghetti and have weighed plates at over a kg before!!

I have found that splitting the insulin works best, half with the meal and half 2-3hrs later. As I generally eat later in the evening it's my morning readings that determine if this works and so far so good.