Which raises bg higher carbs or higher dosages?

[Judy&Alli]

So I have noticed that when Alli eats a high carb meal and then needs a mega-bolus to cover it she takes a lot longer to come back into range. Are the higher numbers related to the carbs or the larger amont of novalog? Just wondering if anyone knew. Thanks, and yet another variable for me to put in the back of my head to manage her d.
Judy:)

[twodoor2]

So I have noticed that when Alli eats a high carb meal and then needs a mega-bolus to cover it she takes a lot longer to come back into range. Are the higher numbers related to the carbs or the larger amont of novalog? Just wondering if anyone knew. Thanks, and yet another variable for me to put in the back of my head to manage her d.
Judy:)

I would imagine the more carbs you eat, the harder it is to get the BG down. There should be enough insulin to cover it, but generally the more carbs, and if they're high GI, or high fat, the bigger the spikes. On that caveat, sometimes giving more insulin also causes a bigger drop toward the tail end.

[mph]

We find that BOTH will do it and DO do it.........so, we pre-bolus a SUPER bolus (a bit more than the carbs may require) if he is going to eat a lot and we ALSO break that larger blous into 2. One syringe, but we inject about half and half into 2 different sites. It helps a lot.;)

I also try to make sure that if he is going to eat a lot, that his big meal does contain fast AND slower acting carbs/fat. That way the super bolus doesn't drop him too quick before the fatty foods kick in, kwim?:)

We just check often to see if he needs a tiny snack at the end (hourly for about 5 hrs.....though it works so well now, so I just check at 3 or 4 hrs and then at 5 hrs to check that tail if it is not another meal time). Not something we like to do regularly, but parties and buffets....... it tends to be more often than I like.:rolleyes:.

I can't wait to get CGMS to see what REALLY happens with this!!!!:D

[Twinklet]

If Emily eats a very high-carb meal, we have to pre-bolus by 15-30 minutes and that helps TREMENDOUSLY. If there is a lot of fat, we add on about 30% more insulin and spread it out over 6-8 hours.

[twodoor2]

We find that BOTH will do it and DO do it.........so, we pre-bolus a SUPER bolus (a bit more than the carbs may require) if he is going to eat a lot and we ALSO break that larger blous into 2. One syringe, but we inject about half and half into 2 different sites. It helps a lot.;)



That's the MDI surface area affect.:) Two or more injections of the same amount of insulin in different sites, have a stronger effect than injecting the same amount of insulin all at once in the same site. This doesn't really apply as much to pumping though since everything gets injected into the same site.

[Judy&Alli]

If Emily eats a very high-carb meal, we have to pre-bolus by 15-30 minutes and that helps TREMENDOUSLY. If there is a lot of fat, we add on about 30% more insulin and spread it out over 6-8 hours.


I have been wanting to try the dual wave bolus but I am scared to death. We went over it with the endo last Friday. The cde said to just take good notes til you find what works for her. :eek:

So did you do a trial and error or did it just work the first time. I would love to find a way to safely dose pizza, chicken nuggets, and fries LOL!

Thanks that's good info!
Judy:)

[twodoor2]

We had a fat spike at lunch. I gave her a teaspoon of flax seed oil in her yogurt for lunch with some lightly breaded tilapia. It wasn't a ton of fat, but enough for a spike. She was 104 only one and a half hours later after her bolus, and then I knew, ah - it's going to be a fat spike. Sure enough she was 244 by dinner time. Even good fats give a fat spike (flax seed oil??). I probably need to try the dual wave, but everytime I've done it, it's had disasterous results. That 244 would have been a 344 if I did the dual wave. It's always up in the air because I truly think it depends on the number of fat grams. I'm so into counting carbs, now I have to figure out how to count fat grams.:rolleyes:

[Judy&Alli]

We had a fat spike at lunch. I gave her a teaspoon of flax seed oil in her yogurt for lunch with some lightly breaded tilapia. It wasn't a ton of fat, but enough for a spike. She was 104 only one and a half hours later after her bolus, and then I knew, ah - it's going to be a fat spike. Sure enough she was 244 by dinner time. Even good fats give a fat spike (flax seed oil??). I probably need to try the dual wave, but everytime I've done it, it's had disasterous results. That 244 would have been a 344 if I did the dual wave. It's always up in the air because I truly think it depends on the number of fat grams. I'm so into counting carbs, now I have to figure out how to count fat grams.:rolleyes:

So it is a trial and error??????? Let me know when you figure out how to dose the fatty foods that my daughter so loves. In the meantime maybe we can pick twinklets brain!;) I think I will have to stick with correcting cuz I don't have the you know what to try the dual wave yet!

What does the flax seed oil do??????

[mph]

That's the MDI surface area affect.:) Two or more injections of the same amount of insulin in different sites, have a stronger effect than injecting the same amount of insulin all at once in the same site. This doesn't really apply as much to pumping though since everything gets injected into the same site.

I just thought right now........that I forgot to mention we use MDI. oops.

I suppose you "could" do part with the pump and part with a syringe if you were so inclined;). I know we will be doing that until we figure out the dual and square waves.:)

Good luck figuring what works for your dd.

[Boo]

I have been wanting to try the dual wave bolus but I am scared to death. We went over it with the endo last Friday. The cde said to just take good notes til you find what works for her. :eek:

So did you do a trial and error or did it just work the first time. I would love to find a way to safely dose pizza, chicken nuggets, and fries LOL!

Thanks that's good info!
Judy:)


Don't be afraid to try a dual wave. Unfortunately, it is pretty much trial & error...and what works for one person might not work for another (and, sadly, what works one day might not work the next, but that is the reality of type 1, isn't it?!) Start with "short" experiments (maybe dual wave for 2 hours) at 50%/50%. Monitor BG at 1 hour, 2 hour, 3 hour and 4 hours post-meal, and that will give you a better feel for what's going on.

We dual wave all the time.

[twodoor2]

So it is a trial and error??????? Let me know when you figure out how to dose the fatty foods that my daughter so loves. In the meantime maybe we can pick twinklets brain!;) I think I will have to stick with correcting cuz I don't have the you know what to try the dual wave yet!

What does the flax seed oil do??????

Payam77777 had a thread here where he had some guidelines on how to dual wave, but you need to know the grams of fat in the food (how do you figure that out if you're at a restaurant?).

http://forums.childrenwithdiabetes.com/showthread.php?t=14190

Flax seed oil is high in omega-3's so I started adding it to things that I cook or make. Just trying something new since I always use olive oil.