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Thread: At endo appt today her educator said...huh?

  1. #1

    Default At endo appt today her educator said...huh?

    I was mentioning that I have been working hard on preventing fat spikes with dual boluses and temp basals lately. Her response was that they don't normally see those kind of issues in kids her age...what? I was a little thrown off by this. I see fat spikes in probably close to half the meals I prepare. Is this more uncommon than I realize? I know ydmv but fat is fat I would think. Anyways, I was just surprised is all. A1C 7.6 Id like to see it under 7, but maybe next time if I keep cracking these meals
    Amanda, mother to Alliana(Alli) dob 3/21/2006. dx'd 11/11/2009
    Pumping since 11/10/2010 MM Revel with humulog
    and sure t infusion sets
    Nov 2010 A1C 9.9
    Jan 2011 A1C 8.3
    Apr 2011 AIC 7.4

    Mother to Breck dob 11/18/2007 non dx
    Mother to Caden dob 11/24/2010 non dx
    Wife to Jake, my loving and supportive husband!


  2. #2

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    I think fat spikes are pretty timeles ;-) idk... only do combos for ice cream, pizza, and chicken nuggets
    - Jess, age 18- dx with t1d 2/3/10
    PINGING!!!!!11/8/10
    DEXCOMING! with the G4
    Carteract free since 10/28/10


    Check out my blog - http://savedbythesnow.blogspot.com

    college student (Class of 2017) and a nursing major

  3. #3
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    Quote Originally Posted by mandapanda1980 View Post
    I was mentioning that I have been working hard on preventing fat spikes with dual boluses and temp basals lately. Her response was that they don't normally see those kind of issues in kids her age...what? I was a little thrown off by this. I see fat spikes in probably close to half the meals I prepare. Is this more uncommon than I realize? I know ydmv but fat is fat I would think. Anyways, I was just surprised is all. A1C 7.6 Id like to see it under 7, but maybe next time if I keep cracking these meals
    She's either lying or she doesn't know the stats...
    Do you pre-bolus? Is the I:C ratio correct? 7.6 is very acceptable... especially if the there's not a very big SD. Our initial goal was to eliminate all low lows -- which we achieved (the of course, she'd had a couple this past week alone!) Now to get rid of the high highs.
    ~Ivy
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    ~K (dd3) diagnosed 4/17/10 at 6 years 4 months.
    Pink MM 722 Nov. 24, '10 w/ novolog
    Pink MM 523 April 22, '11 w/ novolog
    Dexcom -- sometimes

    "And we know that all things work together for good to them that love God, to them who are the called according to his purpose." Rom. 8:28

  4. #4
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    Quote Originally Posted by mandapanda1980 View Post
    Her response was that they don't normally see those kind of issues in kids her age...what? I was a little thrown off by this.
    I think you should have been.. honestly it may be that most of the time medpro's just don't care to fine-tune insulin doses to that degree, but it doesn't mean that the fat spikes don't happen, or that they couldn't achieve better control if they were managed better.

    The best CDE I've ever seen looked at me once when I was explaining that I combo bolus for nearly everything I eat because Apidra works so fast, and she said "You know more about this than I do, and I'm not even going to try to argue" - I wish all of them could be so flexible rather than insisting things can be done a "simpler" way.

    I also have another theory about Apidra that if I bolus more than about 3u at once, it's not as effective if I drag it out over an hour or so. That goes for food *and* corrections. My correction factor is higher (so less insulin is required) with an extended bolus than if I just gave it all at once... it works for me, and I've documented it many times.
    Sarah T1 dx @ 20 (10/2000)
    mom to 3 non-D kids (6, 8, & 13)
    PINGing Apidra,
    with the occasional help of Dexcom

  5. #5
    Join Date
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    I have to do extended boluses for almost any food with fat for Hana. Chocolate, pizza, fries, red meat (the absolute worst! She will be in the 400s about 5 hours after eating beef if we don't do some sort of extended bolus) - not to mention pasta and bagels! Yeah, we pretty much do extended boluses for everything!
    Aimee in New Jersey
    mom to Sean (14)- non D
    Hana (13) T1 dx 3/3/10
    Case (10) non D
    wife to Scott
    Pumping with OmniPod
    Dex G4

  6. #6

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    The 2 CDE's in our endo's office are clueless. There, I said it!
    ~Christina
    My son is 15, dx'd 10/03/06
    t:slim and Dexcom G4
    formerly Omnipod

  7. #7

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    I have found that foods have affected BG's much more as Rachel gets older. When she was smaller we only had to combo bolus for pasta/noodles. Now at 10 we are finding many more problem foods including fatty foods.
    Very few of our meals need anything but a normal bolus though.
    Jane Mum of Rachel, 13, dx'd @11 months and Anna, 18, dx'd @ 17 .

    Keep Calm and Treat the Number

  8. #8

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    Caroline is just 2 months older (and still honeymooning), and she has so many 11pm fat spikes I've been wondering if it's a basal problem. On low fat nights she consistently has fine numbers so I think it's the fat. I've just resolved to have more low fat dinners until we get her pumping end of May because I can't get good numbers lately.
    Linda, Mom to:

    Caroline: 8yrs dx 8/11, Pinging, DexG4
    DS: 12yrs
    DS: 16yrs

  9. #9

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    Fat spikes are more obvious when you eat a variety of different meals. For people who eat consistently low fat food, they don't see fat spikes. For people who eat consistently high fat food at a particular time, they might not realise that they are even having a fat spike and simply adjust basal, thinking there is a higher basal need at that time. And then there are many people outside of CWD who just don't do that kind of 'advanced' D management. And then I'm sure there are a few people whose bodies actually metabolise fat differently and who don't have fat spikes.
    EMMA - 21
    diagnosed T1 6th july 2007
    pumping with MM522 since july 2008
    MM523 since august 2012
    MM CGMS since november 2009

    cetirizine hydrochloride for solar urticaria dx'd in 2002
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    twitter @emm142

  10. #10

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    When my daughter has cheese, I never know what to expect. Sometimes it requires a 175% basal for hours; other times no adjustment. I don't get it. She's trying to figure it out.
    8/2010 - 9/2011 MDI, Lantus & Humalog
    9/2011- Medtronic Revel 723 & CGM
    11/2012 - Dexcom G4

    "Life is not waiting for the storms to pass, but learning to DANCE in the rain."

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