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Mimi
04-23-2009, 10:39 AM
I need some clarification on this. I've read many posts discussing fat spikes or delayed fat spikes....is this the same thing? And secondly, is the reason a meal with a higher fat content, say restaurant food, causes a spike in BG hours later is because the high fat content delays the absorption of carbs therefore the insulin calculated for the meal is gone?

Thanks.

Abby-Dabby-Doo
04-23-2009, 10:56 AM
Fat turns into sugar in our bodies.
It takes a while for fat to do this- so it's a delayed spike in your blood sugar because it usually happens gradually over a couple of hours.
That's why pizza and ice cream make us pull our hair out (just two examples)- loaded with fat!:cool:

saxmaniac
04-23-2009, 11:15 AM
Fat can slow absorption of carbs, so there's that - an extended bolus helps a lot here, or something like Regular insulin.

According to Gary Scheiner, the fat also causes the liver to put out more gluocse, and the way to treat that is with a temp basal. We've had much better success with this, than doing it proportional to the meal.

Mimi
04-23-2009, 11:50 AM
Fat turns into sugar in our bodies.
It takes a while for fat to do this- so it's a delayed spike in your blood sugar because it usually happens gradually over a couple of hours.
That's why pizza and ice cream make us pull our hair out (just two examples)- loaded with fat!:cool:

We haven't noticed issues with pizza yet...and I keep looking because I've read about it here. We have had delayed spikes a couple times from when we've eaten out. Took a few times before I figured that one out, though. :cwds:


Fat can slow absorption of carbs, so there's that - an extended bolus helps a lot here, or something like Regular insulin.

According to Gary Scheiner, the fat also causes the liver to put out more gluocse, and the way to treat that is with a temp basal. We've had much better success with this, than doing it proportional to the meal.

After a higher fat meal, we can test at 2 hours and she will be in range. The fat spike happens much later, like 4 or 5 hours later. Does that make sense?

Makes for a long night of testing after a correction shot. :cwds:

Cabins Crue
04-23-2009, 11:51 AM
Can you explain the temp basal? sounds like something we should try..

Thanks

wilf
04-24-2009, 02:19 AM
We haven't noticed issues with pizza yet...and I keep looking because I've read about it here. We have had delayed spikes a couple times from when we've eaten out. Took a few times before I figured that one out, though. :cwds:

After a higher fat meal, we can test at 2 hours and she will be in range. The fat spike happens much later, like 4 or 5 hours later. Does that make sense?

Makes for a long night of testing after a correction shot. :cwds:

We keep "Regular" insulin on hand specifically for fatty or restaurant meals. We bolus for the carbs in restaurant meals, and then as much again of Regular to deal with the fat and its effects. Works well for us.

If we didn't have Regular, I'd give a second bolus about 3 hours after the meal to cover the fat..

saxmaniac
04-26-2009, 09:06 PM
Can you explain the temp basal? sounds like something we should try.

The theory is high fat foods cause the liver to put out more glucose, so adding extra insulin proportional to the meal isn't enough. We just did this with Chinese food for lunch - +50% over 7 hours and he just wound up a 96. It's not perfect but it's working much better than giving an extra amount based on the meal size.

Jacob'sDad
04-26-2009, 09:55 PM
I do something very similar to the temp basal method except that I use a 0% up front 100% extended bolus instead for up to 8 hours. Usually I use 1.6u and extend it for 8 hours. That makes .2u per hour.

In addition to that I subtract .6u from the meal bolus to keep him from going low from the slow absorption. For example, if he needed 5u to cover the carbs, I would give a 4.4u bolus and then immediately start a 0% up front 100% combo for 8 hours. The amount of the combo would be 1.6u.

With really fatty meals though, I think I am finding that this is STILL not enough. I could probably run the extended bolus even longer.


I do believe that the fat causes the liver to release glucose. I'm not sure I understand what the body's function is in doing this. I think all things that occur in the body serve a purpose and the purpose of basal is to handle the glucose that is always present in the blood stream which is needed for all the body's automatic functions. So why would the body's need for basal change just because of fat?:confused:

Anyway, my method results in the added insulin being recorded in the pump as bolus and not basal. For now I'm happy with that because I am not sure if the glucose released from the liver due to fat is really "true basal" and serving the "normal" basal function. If someone wants to try to convince me otherwise, I'm all ears.:cwds: