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How do you bolus for pasta??

Discussion in 'Parents of Children with Type 1' started by lisac, Sep 17, 2011.

  1. lisac

    lisac Approved members

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    Tonight Hadlee had pasta for supper. She also had a piece of cake. Before supper, her bg was 161, really good for her. She had 1 cup of pasta and 1/12 piece of cake. My husband has to work late tonight and I have to be at work early in the morning, so I was trying to let her run a little higher (we still have a lot of overnight lows) So, I didn't count the carbs for the icing, just the pasta (43) and the cake (37) cut it back to a total carb bolus of 65. Manually subtracted out for IOB. Didn't give insulin until after she finished her pasta. Checked her bg before bed 68 (with 2+ IOB!!!)
    The last time we had pasta the same thing happened (I posted that night too, but have made the connection now.) The insulin is kicking in before the pasta has time to digest. So how do you guys bolus for pasta? How much at first and then how long do you drag out the rest of it?
    Guess I didn't need any sleep tonight anyway...:rolleyes:
     
  2. mom24grlz

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    so far we seem to be lucky (knock on wood) and don't have troubles with pasta, so we just bolus as we would any other type of food. I can't remember if it says in your post, but do you give the insulin before or after she eats? maybe with the pasta you can try giving it to her after she eats. And I always ask this on pasta posts, but are you making sure the carb amount is based on cooked pasta and not uncooked (the boxes give the carb amount, as uncooked). The pasta we use uncooked is .75 carbs per gram, but when i cook it I give .27 carbs per gram. (not sure how much that is in cups LOL!).

    I hope her BS came back up. I was up dealing with a low BS too. It took 1 juice box and 3 glucose tabs to get her up from a 61 around 1am. I blame the cheesecake. I think i guessed on to many carbs.
     
  3. NomadIvy

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    Pasta - 75% upfront, 25% over 2 1/2 hours.
    Dd gets a spike from regular cake and the carbs also don't "hit" right away. We do an extended/square bolus for cake as well, usually over 4-6 hours + an increased basal (roughly 130%).
     
  4. Melissata

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    The recommended place to start when using extended boluses is a 50/50 split for three hours. That was what the pump trainer at Joslin center suggested to people. We use that most times and it works well. You can always cancel and change it if she gets too high or low, and try a different amount next time. It really is trial and error, but Melissa could never eat pasta with a regular bolus. If it isn't working out for one reason or another during that 3 hours, you just check to see how much insulin is left to go in the history and can give it sooner, or spread it out even further, or cancel the remainder if you think you need to. That is the beauty of it. You CAN actually take the insulin back!
     
  5. Nancy in VA

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    I could never get pasta right using the carb count on the box - it never, ever worked for me.

    Someone here with a Salter scale told me that it used the carb factor of our .15. We used to use .15 for our carb factor but we've upped it to .18 and that seems to work ok.

    So, for 100 grams of pasta, its 18 grams of carbs. 150 grams of pasta, 27 carbs. 150 grams of most pasta is more than a cup, and you see, much less than the 45g the box mentions - we used to get extreme lows like you when we did it off the box.

    I actually think you underdosed the cake if you didn't bolus for the icing - I would have done closer to 50, so I definitely think pasta needs a look/see
     
  6. ecs1516

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    That is close to what we are using for pasta. I use .2 factor for pasta. I measured out the dry pasta then boiled it then measured weight and that is how I got .2
     
  7. swimmom

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    We were taught that 1/2 cup cooked pasta = 15g (and that fits with the .18 or so carb factor). So 43g for a cup would be 13 more grams than you should bolus for.
     
  8. lisac

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    I have been going by the Food List in Hadlee's Ping meter remote. I don't think I've ever measured a thing in grams!!:eek: I will have to try this. I admit, we have not been doing well with keeping Hadlee's bgs at a stable level. She has crazy highs and crazy lows and I have a hard time finding a pattern. We are working closely with our endos office, but I almost never make changes on my own. I am trying to learn all I can so that I can take more control. We DO try to count carbs as closely as possible, but we are just not doing enough. 2 years in, her A1c should be better than 9:(
     
  9. Melissata

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    If you can get a scale and start weighing, you can at least eliminate most of the uncertainty of foods causing the problems. Right now you don't know if your carb counting is off, or your duration of insulin is wrong. If you can't afford to get the one with the Database of foods, then get a digital one and use a carb factor list to do the math. The more expensive scale is nice because it remembers the foods that she eats most often, and you can type others in, then just put the food on and it tells you the carb count of each.
    Some people seem to get by more easily with guesstimating carbs. My son and daughter are prime examples. My son looks at the meal and boluses his best guess, and has always done it this way. There is no way in hell that we could ever do that with my daughter. If I am off by 5 grams of carb, she suffers. The other day she made a mistake and only counted one slice of bread instead of two. Her Dex immediately went to two arrows straight up!
     
  10. lisac

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    Hadlee is the same way!!! I can be off by less than 10 grams of carb and it will send her SOARING. She's also very insulin sensitive, so I feel like I'm usually picking between her bg's will be too high or they'll be too low:(
    Where do you get a scale with a database of foods? I bought a "Paula Dean" scale at Wal-Mart after she was dx'd, but we usually measure in cups or teaspoons. I've never been taught to measure by grams. Where can I find a book or something to teach me how to do this, as her endo doesn't teach this way?
     
  11. ROVERT81402

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    We use dreamfield's pasta, and just dose as we would normally. He doesn't get a spike from dreamfield's but he does with any other kind of pasta.
     
  12. pancake111

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    What I always do is 1/2 a cup is 15g. That always seems to work well with me, but I've been staying away from pasta lately. It's just too many carbs.
     
  13. Flutterby

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    Pasta, we bolus 20 up front for a 1/2c, then bolus the rest when she's done, in a squarewave between 2-3 hours, depending on how much she at and what her bg was before dinner.
     
  14. Lenoremm

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  15. Melissata

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    We have the Salter scale, and you don't need a book to learn to do it. When you put something on the scale, it tells you the carb count for that food, I believe it even subtracts out the fiber and gives only net carbs. If you use a regular scale that will measure in grams, you only need a copy of the carb factors that is available somewhere around here. Maybe someone has a link. Mine is old and we have it laminated, but really only use it when we are camping now since we don't take the Salter scale. When you use carb factors you just weigh the food and mulitply the gram weight of the food by the carb factor from the list. It is MUCH more accurate than using measuring cups. I did that for years, and if you try it both ways, you will see a huge discrepancy.


    The ONLY food that I have found to be incorrect on the Salter is the white rice, and that may be because I use converted rice. Someone here told me to use the brown rice setting and it is perfect.
     

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