T-Slim X2: What do you do for meals with multiple courses?

[RobertJ]

I think that sort of reading after a Christmas meal isn’t bad at all. It may be worth splitting your insulin by course. Or taking it after the starter. Too much panicking over the odd high reading.

Thanks, but I just think on the closed-loop system I should be avoiding this kind of thing. It's a bit disappointing to have big highs similar to what I would have had before the closed-loop and before I was on a pump at all. I thought it would intervene in a more effective way than it does.

I have had Type 1 for nearly 22 years so I really want to avoid reaching numbers like 13 or more on a regular basis. Sadly, I am all the time at the moment, including this very moment as I type this.

 

[RobertJ]

So this means 1 unit of insulin for every 12.2 grams of carbs.

That's interesting because my current ratios are lower than that: basically between 1:9 and 1:11 in different parts of the day.

 

[DChes]

I have just had my work Christmas lunch and I really tried to get things right. I did not succeed. Now I'm on a reading of 14.0 mmol/l, and I've been out of range for an hour and a half. I assume I'll be high for at least three hours now.

This was a standard Christmas dinner: turkey, one pig in blanket, stuffing, roast potatoes, swede, carrots, Brussels sprouts and gravy. For dessert I had a dark chocolate cake with cherries.

My strategy was to dose for the main meal fifteen minutes in advance (which ended up being twenty because of how long it took to queue up), and then dose for dessert while I was still eating the main course.

Previously, I've tried giving one big dose for two courses and splitting it, but I'm not sure that works.

I am just so sick of the way large meals always end up like this. The pump is supposed to prevent nasty spikes but I've had some awful experiences recently. It seems like once it starts rising fast, it's a guarantee I'll reach at least 14.0mmol/L and be high for at least three hours. It should be possible on such an advanced system to have large, high-carb meals and only experience a brief, moderate spike.

Is it possible that you have become somewhat insulin resistant over time? I have heard that the more insulin one uses, the more chance that might happen, for some people. Another idea - could you go for a 30 minute walk right before or right after you know you will eat a high carb meal - would that get you in range faster?

 

[RobertJ]

Is it possible that you have become somewhat insulin resistant over time? I have heard that the more insulin one uses, the more chance that might happen, for some people. Another idea - could you go for a 30 minute walk right before or right after you know you will eat a high carb meal - would that get you in range faster?

I do wonder if there's a diminishing returns aspect to giving large amounts of insulin. Sometimes I can't believe how much insulin I'm about to give for one meal (it's large and outside of my normal routine) but it's noticeable how often this doesn't work.

But if I have become insulin resistant over time, what do I do about that?