- advertisement -

pizza and NPH

Discussion in 'Parents of Children with Type 1' started by Tena, Jun 13, 2008.

  1. Tena

    Tena Approved members

    Joined:
    Apr 18, 2007
    Messages:
    221
    My daughter is on the diabetes teen talk forum a lot. She said one girl uses NPH to bolus when she has pizza as it takes a while to get started and peaks about the time the pizza does then tapers off pretty quick after that. What do you think?
     
  2. twodoor2

    twodoor2 Approved members

    Joined:
    Oct 30, 2007
    Messages:
    6,440
    I think a lot of MDI'ers use regular for that reason, I'm not so sure about NPH because it is longer, and has a basal aspect to it as well.
     
  3. danismom79

    danismom79 Approved members

    Joined:
    Apr 21, 2008
    Messages:
    5,300
    I guess it would depend on how long it takes the pizza to hit her. The Regular peak happens before an NPH peak would.
     
  4. MissEmi

    MissEmi Approved members

    Joined:
    Mar 21, 2008
    Messages:
    1,899
    Maybe Jill did say Regular......*makes mad dash for DTT* ......Okay she said regular and put Novolin in () so yeah...
     
  5. saxmaniac

    saxmaniac Approved members

    Joined:
    Jun 1, 2007
    Messages:
    4,057
    Wilf is an advocate for using Regular for high-fat foods. Makes sense to me, if you're not pumping.
     
  6. MissEmi

    MissEmi Approved members

    Joined:
    Mar 21, 2008
    Messages:
    1,899
    :( I am pumping though. Too bad I guess. But I MAY have some Novolin...I don't know, but mom would know... Jill WAS on Lantus when she did this...I think.
     
  7. saxmaniac

    saxmaniac Approved members

    Joined:
    Jun 1, 2007
    Messages:
    4,057
    If you're pumping, you can just do an extended bolus for the time that Regular would take, right?
     
  8. Adinsmom

    Adinsmom Approved members

    Joined:
    Sep 12, 2006
    Messages:
    2,995
    My son was on NPH for a little bit after diagnosis, I neither hate it or love it. I see its value at times. I guess in theory NPH would work depending on how the fat and pizza digests in your child. But keeping NPH around for those 2 time's a month when we eat pizza wouldn't be worth it when on MDI IMO.

    Besides there is alot of timing and variables with NPH regardless. What works today might not work tomorrow.
     
    Last edited: Jun 14, 2008
  9. MissEmi

    MissEmi Approved members

    Joined:
    Mar 21, 2008
    Messages:
    1,899
    True, very true. She wasn't on NPH at the time, just used it to bolus instead of Log. If it worked, I was thinking it might be worth trying, though, if anyone else did that.
     
  10. deafmack

    deafmack Approved members

    Joined:
    Sep 22, 2006
    Messages:
    3,209
    I know of using Regular to cover things like Pizza. The thing with regular is you have to take it 30 minutes before eating but it works really well for things like Pizza. The reason is because it peaks about the same time the carbs from the pizza would peak so is really good for that.
     
  11. wilf

    wilf Approved members

    Joined:
    Aug 27, 2007
    Messages:
    9,652
    Those folks lucky enough to be on MDI have the luxury of trying out different insulins to deal with different kinds of foods or situations.

    Here are some typical (for us) times for the different insulins:
    Novolog - peaks at about 1.5 hours, lasts about 4 hours
    Regular - peaks at about 2-2.5 hours, lasts about 5 hours
    NPH - peaks at about 4-5 hours, lasts about 8 hours
    Note that these times will be different for everyone depending on size, weight, activity level and size of injection..

    That having been said, we find that for a typical pizza (esp. if followed by ice cream for dessert) a combined bolus of Regular and NPH (given AFTER the ice cream is done) works like a charm to cover the carbs.

    Other foods that Regular works well with include Chinese food and fast foods.

    A combination of Regular and NPH is ideal for grazing in a longer party-type situation, where there is food available to nibble on for hours.
     
  12. Ashti

    Ashti Approved members

    Joined:
    Sep 4, 2007
    Messages:
    224
    Think like a pancreas guy uses NPH

    Hi Everyone,

    I remember reading what Gary Scheider from "Think like a pancreas" said about pizza. He uses NPH to cover the pizza carbs and for him that works well ie) the insulin is there when the pizza carbs and cheese are finally digested.

    Ashti :)
     
  13. allisa

    allisa Approved members

    Joined:
    Jan 13, 2006
    Messages:
    1,619
    I agree...it works like a charm for us, too.....but as we all know....YDMV
     
  14. twodoor2

    twodoor2 Approved members

    Joined:
    Oct 30, 2007
    Messages:
    6,440
    There's probably a bigger learning curve to using regular and NPH properly I would imagine. I say "properly" because I'm unconvinced that many endos understand how to make it work to it's best potential, unlike Wilf and Gary Scheiner.

    I use Lantus/Novolog in a similar way. I give a higher dose of Novolog at dinnertime to accomodate a bedtime snack two hours later, and I've started doing this as well at lunchtime, but exercise also naturally increases the need for a snack. Unfortunately, I haven't mastered high fat foods yet (her digestion time is based on the fat grams, and I cannot eyeball or figure out fat grams in everything). However, I find using a temp basal two hours after the food is eaten has helped reduce the fat spikes. I can kind of see the fat spike coming on if she's in the low target range one hour after eating, and I know I dosed the carbs correctly.
     
  15. Tena

    Tena Approved members

    Joined:
    Apr 18, 2007
    Messages:
    221
    Well Emily is on the pump so I don't have NPH on hand but was wondering if it would work. We are trying to get pizza figured out because we are going on a trip with our church at the end of this week and the first place they are going to eat is Pizza Hut. We have tried it twice now and both time messed up and got it all wrong. We did 50/50 combo over 4 hours both times but the first time she also had bread sticks with the pizza. Both times she was High at the 1 hr mark post meal and steadily rose throughout the 4 hour bolus. I think she needs more insulin up front and maybe only over a 2 hr extended. We are thinking 60/40 over 2 hours, what do you think? After eating pizza Friday night we are going to a play and then to a theme park on Saturday and I really want her to be feeling good for those things. Highs make her feel so bad and really really sleepy. Any other ideas?
     
  16. Adinsmom

    Adinsmom Approved members

    Joined:
    Sep 12, 2006
    Messages:
    2,995
    The greasier the pizza the harder it is for us to get the insulin timing worked out. When we order pizza hut we usually get the thin crust pizza. Would she be willing to try thin crust? I hope other's post their ideas. We don't have the our extended bolus ratio's on target either.
     
  17. Mama Belle

    Mama Belle Approved members

    Joined:
    Jan 23, 2007
    Messages:
    4,540
    I have to say that our endo is pretty darn good when it comes to NPH. My DD was on it for 5 years, used in a very similar manner as Wilf uses it. However, it became obvious to me that the variability in its peak was HUGE with Samantha. For a long time we loved using NPH with our Log in the morning. But, we eventually ended up having to treat too many lows and correct for too many highs. I think that this is again a case of YDMV. I really do think that NPH is a good insulin for some folks. We just aren't those folks.
     
  18. twodoor2

    twodoor2 Approved members

    Joined:
    Oct 30, 2007
    Messages:
    6,440
    Pizza Hut pizza is also infamous for highs. I don't know if this helps much, but I always pat the pizza with napkins to absorb some of the grease.
     
  19. Lee

    Lee Approved members

    Joined:
    Oct 5, 2006
    Messages:
    9,633
    Per our endo, I dose the entire thing up front (unless it is thin crust) to cover the crust and veggies ( Where the carbs are), and then I dose 15 carbs on a temp for three hours for the fat.

    Thinner crusts we have no problem with though.
     
  20. hawkeyegirl

    hawkeyegirl Approved members

    Joined:
    Nov 15, 2007
    Messages:
    13,157
    Last time we had pizza, I somehow hit the nail on the head with our combo bolus. Here's what I did:

    It was my dad's birthday, so we had pizza and mini frosted cupcakes. Jack wanted one before his meal, and I thought it might help with our "normal" one hour lows after pizza, so I let him, and dosed him for the carbs in it with a normal bolus. (14 carbs)

    Then, after he ate his pizza and second cupcake, I gave him a dual wave, where he got all the carbs for the second cupcake upfront, and the carbs for the pizza, PLUS 20% of the pizza carbs, spread out over 4 hours.

    It worked like a dream. He stayed at 120-160 all night long. Who knew that frosted cupcakes were the answer to the pizza dilemma?! :rolleyes:
     

Share This Page

- advertisement -

  1. This site uses cookies to help personalise content, tailor your experience and to keep you logged in if you register.
    By continuing to use this site, you are consenting to our use of cookies.
    Dismiss Notice