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Offline Pattidevans

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Re: Finally got bolus insulin.
« Reply #30 on: 12 November 2016, 09:59:11 PM »
You see, for all of us it is totally confusing and insulin does not necesssarily simplify it.
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


© 2015 Patti Evans

Offline Quantum Learning

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Re: Finally got bolus insulin.
« Reply #31 on: 19 November 2016, 02:25:14 PM »
Been hesitating to post this as you may all think I'm just stupid trying to eat rice but it was in the interests of science  :P  and I would like some advice on corrections?

Was last Saturday and OH decided he would like Chinese as our weekly takeaway. We haven't been having this for a few months as over the last couple of years I have been eating king prawn omelette with ribs or another meat dish (over 2 days) which doesn't affect my BG's badly but I have become sick & tired of the omelette & don't feel I can eat them any more. OH has only been able to have a chicken curry with plain boiled rice and has got a little sick of that too. So last Sat he decided he would like to try chow mein as the general consensus seems to be they're fairly low fat and our Chinese isn't a very oily one. As I'm now the proud owner of NovoRapid I thought well I could try a rice dish. So I ordered a roast pork/chicken fried rice with bbq sauce (not much bbq sauce in it). Started with BG of 6.1 injected 3 units (still being on the cautious side) ate half the portion of rice (was full by then) 1hr later BG 8.4, 2hrs later 10.6, 3 hrs later 13.4. Gave up testing at this point as depressing but back down to 10.4 some hrs later when going to bed.

So with hindsight, obviously didn't inject enough to cover the meal but should I have done a correction? and at which point would you do it? Would you have tested more frequently to see if BG's were still rising as I was leaving it an hr each time? Would you think double that amount of units to start with would possible cover it? I know I have IR by the amount of basal I have to inject so presumably I might need more bolus than someone else who doesn't? I realise these are all questions that no-one can answer definitively but I'm just curious for your opinions on what you would all do?

On the basal front I am so happy I could do a happy dance (if it wouldn't hurt my back). BG's have been between 5.2 and 6.7 all week, that's fasting, before meals and at bedtime. I haven't been testing after meals as I have been back on VLC all week. Don't know if I can expect to get it any tighter than this without risking hypos so will leave it at the 80 units for a while and see.  :)
Type 2 dx Nov 2012 with fasting BG 14%/129.5
HbA1c Jan 2013 79/9.3%
April 2013 50/6.7%
July 2013 39/5.7%
Oct 2013 39/5.7% Chol 5.9
July 2014 45/6.3% Chol 5.5
Aug 2015 61/7.7% Chol 5.9
May 2016 84/9.7% Chol 6.9
Oct 2016 53/7%  Chol 6.3
Dec 2016 41/5.9% Chol 6.0
June 2017 51/6.8% Chol 6.1
Oct 2017 52/6.9% Chol
Metformin SR 2000mg, Candesarten Cilexetil 4mg Omeprazole 20mg, Fexofenadine 180mg Co-Codamol 30/500g when needed. Amitriptyline 20mg
Toujeo/NovoRapid, Allergic to Levemir.

Offline Liam

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Re: Finally got bolus insulin.
« Reply #32 on: 19 November 2016, 03:02:01 PM »
A half tray (Chinese takeaway style) of rice is about 60g of carbs. So you only had 1 unit per 20 grams of carbs which is really low, 1unit to 10g is the normal starting place for someone without IR. Fried rice is just fatty by nature (even if it doesn't feel like it when eating) plus it is pretty 'bulky'. So I'd be thinking the peak would be later than normal and that if I took enough insulin to deal with that that I'd likely hypo 1-2hrs in. Your numbers went up steady so I'd start with using more insulin next time.

I'd have corrected at 3hrs most likely. For me at least the last hour of rapid insulin (lasts about 4hrs) doesn't do much.  The starting point for corrections is that 1 unit drops you by 3. That isn't the case for me (1 unit drops me by 2 most of the time) but you can only really find out by trying.
DX Type I 1994.    Novorapid Animas Vibe pump
HbA1c 3/10 10.2%, 7/10 8.1%, 12/10 7.5%.
2/11 7.8%, 8/11 8.6% 9/11 8.3%.
3/12 62 (7.8%). 10/12 67 (8.3%)
4/13 63 (7.9%) 6/13 59 (7.5%)
1/14 71 (8.6%) 7/14 59 (7.5%) 11/14 (6.7%)
3/15 56 (7.3%) 12/15 49 (6.6%)
Ramipril: 10mg Quetiapine: 550mg Metformin: 2000mg

Offline nytquill17

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Re: Finally got bolus insulin.
« Reply #33 on: 19 November 2016, 03:38:51 PM »
I can tell you what I would do, but I handle things in a very not-textbook kind of way for myself, so it's not something I can really recommend that other people do, even though it works pretty well for me.

Novorapid lasts around 5 hours for most people (4 for some, 6 for others, and the more you inject the slower it absorbs - you know the drill!). It starts working within 10-15 minutes of when you inject it and it hits its peak level of absorption or peak activity level around 2-3 hours after injection. After that, in the last hour or two, you do still have IOB (insulin on board) but it's weakening. For some people they find their rapid insulin is basically gone after hour 3.

So the textbook way is to wait until 4-5 hours after you injected, and if BGs are still high then, you can take a correction if one is needed. That way you're not stacking insulin on top of insulin, which can cause hypos and just generally makes the appropriate dose harder to calculate (how many units of insulin are still working in my body? how long will they be working? how should I account for them in calculating my next dose?) Personally I often start taking mini-corrections after 2-3 hours and every 2-3 hours as needed, but I don't recommend doing it that way for anyone else. For one, it's dose stacking, which has all the possible complications mentioned above, and for two, it also can cloud whether or not my basal insulin is working appropriately if I'm constantly "topping up" with fast-acting. I'm comfortable with this method for myself though and I get decent results with it so I'll stick with it, but I have 20+ years of experience now using insulin, I'm familiar with how my body tends to react, BG-wise in a lot of different situations, plus I am a T1 with no residual insulin production of my own and no IR. None of those apply in your situation at the moment so I don't think it'd be an appropriate method for you!

Corrections are calculated by a formula: (current BG - target BG)/correction factor.  The correction factor is the bit that varies based on your body's needs; it's how many mmol/L of BG that one unit of insulin reduces your BG by. For most T1s at least it's somewhere around 2-3. But it can vary by time of day too just like carb ratios can, and of course it can be whatever your body ultimately needs it to be, which may not be anywhere near 2-3!

So let's say that your BG at 5 hours after the meal was up to 14, your target BG is 6, and your correction factor is 3. This gives you (14-6)/3 or 8/3 or 2.67; rounded up to whole units that means you would have needed 3u as a correction. This does NOT mean, however, that you should have taken 3u more when you first ate the meal, necessarily. Mathematically it seems like it should, but "biology isn't math" as I like to say, so it doesn't always work out that way.

FWIW I think you did a great job with your meal! You were trying a food that you knew might be problematic, and you're still new to bolus insulin so you were cautious about it. That was the right thing to do. This is how you learn! There is a lot to take in and a lot to account for in situations like this. For example, some meals are like the Energizer bunny in terms of the post-meal rise: it keeps going and going and going and... That is to say, although for most people and for most meals the post-meal spike will happen at 1-2 hours out, it doesn't always. Especially if the meal is quite large in terms of volume, or high-carb or high-fat or both compared to what you normally eat, the spike might come much later - 3, 4, 5 hours or more! Pizza is so famous for doing this that this pattern is sometimes referred to as the "pizza phenomenon"! It is notoriously a tricky situation to deal with when dosing meal insulin, something that takes a lot of trial and error to get a feel for and even the most experienced among us don't always get it "right"!

So don't give in to feeling defeated here. You did exactly what you were supposed to do, which is try, observe, and learn from what happens. No one could have done any better! And it doesn't mean that you should never eat that meal again, either. It's a bit of a different ballgame on insulin with regards to eliminating/limiting foods that give you results outside of target. Sure, there are some things that from long experience I know I can never eat and expect good BGs afterwards, so I try to limit those foods most days. But even the most experienced among us have probably a 50/50 chance of getting our dosing such that our numbers are on target afterwards when we're dealing with restaurant meals or even just food someone else has cooked! So out-of-target results are no longer an indictment of the food, they're just a reminder that you "can't win 'em all" when you're dosing insulin in the real world!

I think that I would stick to eating meals that were a bit easier to work with at first. Things you make yourself at home or things that you can measure and count that come with nutrition labels. That is, things where you can be reasonably sure of the carb count to start with. That lets you do the same kinds of trial and error tests and get a feel for what your I:C ratio is. That is, I actually wouldn't be going VLC right now, because it doesn't give you any information to work with that helps you get the hang of your insulin. You've gotta get your ratios worked out and your carb counting down pat before you can expect to have much success with restaurant meals where you have to guesstimate the carbs. By the same token, though, I wouldn't worry too much about having the occasional take-out or treat meal, just know that for now it's not likely that you're going to have any idea what dose you actually need to cover that meal so you might get some wonky results after. Even that is a chance to observe and learn, but you might not be able to do anything with that information right away while you're still getting the hang of everything else.

p.s. I would not have tested more frequently. On injected insulin, we get the chance to adjust/correct every 3-4 hours at most (2 hours on sick days but that's a different story!). So knowing what your BG is every half hour won't be information you can really act on. Taking it every hour can be useful for some things, like learning "oh, this meal peaks a lot later and for a lot longer than what I more typically eat" which can be good to know for next time, but it still doesn't let you intervene any earlier this time. If I'm just wanting to check on my post-meal rise and see whether I need to make any adjustments, I would probably only test at 2h and 4h or something like that, personally. Yes, the true peak of the meal may well be closer to 1h but as a T1 there is often very little I can do about that 1h peak anyway, so the 2-3 hour mark is more interesting for me because that's the peak action of the insulin I took, so if my dosing was off, that's where I'll see it (whereas a 1h peak doesn't say anything to me about the insulin I took, it just says "oh yeah, remember how you don't produce any of your own insulin when you eat food?") and then the 4-5 hour mark when the insulin is finished or nearly so, so I can see where I ended up and if anything remains to be done, like a correction. But that's me! You have to find your own way :)
T1 DX 1995
Levemir + Novorapid
 
  ~-~-~-~
"If you can't ride, can you fall?"
"I suppose anyone can fall," said Shasta.
"I mean can you fall and get up again without crying, and mount again and fall again and yet not be afraid of falling?"
"I - I'll try," said Shasta.
  ~C.S. Lewis, The Horse and His Boy
  ~-~-~-~
"There is no answer; seek it lovingly."

Offline Quantum Learning

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Re: Finally got bolus insulin.
« Reply #34 on: 19 November 2016, 04:28:11 PM »
Thanks guys that's very helpful, lots to think about, still looking forward to my mince pie in a few weeks  ;)
Type 2 dx Nov 2012 with fasting BG 14%/129.5
HbA1c Jan 2013 79/9.3%
April 2013 50/6.7%
July 2013 39/5.7%
Oct 2013 39/5.7% Chol 5.9
July 2014 45/6.3% Chol 5.5
Aug 2015 61/7.7% Chol 5.9
May 2016 84/9.7% Chol 6.9
Oct 2016 53/7%  Chol 6.3
Dec 2016 41/5.9% Chol 6.0
June 2017 51/6.8% Chol 6.1
Oct 2017 52/6.9% Chol
Metformin SR 2000mg, Candesarten Cilexetil 4mg Omeprazole 20mg, Fexofenadine 180mg Co-Codamol 30/500g when needed. Amitriptyline 20mg
Toujeo/NovoRapid, Allergic to Levemir.

Offline sedge

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Re: Finally got bolus insulin.
« Reply #35 on: 19 November 2016, 07:36:08 PM »
Hee hee at the mince pie - you'll have the absolutely opposite effect of fat slowing the rice down - the sugar will hit way before the insulin hits - so if you must eat em you'll just have to weather the spikes.  Inject enough to squish the early spike - difficult to jab it far enough in front to entirely prevent it as you could be hypo before you eat it, inject it before taking the first bite and you'll just be hypo after. 

I was going to say none of 'using insulin' is an exact science so in any situation to just have to experiment using yourself as the lab rat!  I mean should your pre-meal BG be different and/or you've done more /less exercise the day before/the same day or the ambient temp is more/less - then you'll get a quite different result - but nobody including you, can possibly predict what it will be !

Welcome to our world.
Jenny

T1 DX 1972, pumping Novorapid 24/05/11

HbA1c - 7/07 8.7, 1/08 7.8, 9/08 8.4, 3/09 7.3, 7/09 7.2, 12/09 7.3, 11/10 8.1, 2/11 8.6, 9/11 6.5 2/12 6.4  5/12 50/6.7  11/12 52/6.9  01/13 46/6.4  06/16 46/6.4  12/16 45/6.4

Offline Pattidevans

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Re: Finally got bolus insulin.
« Reply #36 on: 20 November 2016, 10:09:31 AM »
Q


Sorry, once again late to the party.  Mainly because I meant to look into the forum last night after dinner (we were out all day) but instead I fell asleep on the sofa and woke up in time to go to bed!  No doubt due to being 11.5 as the fancy pump bolus for the Moussaka (rather fatty with the yoghurt/feta topping) didn't exactly do what I thought it would.


Anyway, you've had some great responses.  I have been chatting with Mike (Everydayupsandowns) about his World Diabetes Day Facebook entries regarding his day and how it went BG wise.  He's now put it all onto his blog and it occurs to me that you might like to read it.  He does it very well with no whinging, unlike something I read elsewhere.  See http://www.everydayupsanddowns.co.uk/
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


© 2015 Patti Evans

Offline Pattidevans

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Re: Finally got bolus insulin.
« Reply #37 on: 20 November 2016, 10:11:39 AM »
PS.  Had my mince pie last week... decided yet again that it wasn't worth it.  I do that every year!
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


© 2015 Patti Evans

Offline Quantum Learning

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Re: Finally got bolus insulin.
« Reply #38 on: 20 November 2016, 12:10:51 PM »
Q


Sorry, once again late to the party.  Mainly because I meant to look into the forum last night after dinner (we were out all day) but instead I fell asleep on the sofa and woke up in time to go to bed!  No doubt due to being 11.5 as the fancy pump bolus for the Moussaka (rather fatty with the yoghurt/feta topping) didn't exactly do what I thought it would.


Anyway, you've had some great responses.  I have been chatting with Mike (Everydayupsandowns) about his World Diabetes Day Facebook entries regarding his day and how it went BG wise.  He's now put it all onto his blog and it occurs to me that you might like to read it.  He does it very well with no whinging, unlike something I read elsewhere.  See http://www.everydayupsanddowns.co.uk/

it's amazing isn't it I would think anyone without D would be shocked at the amount of work he has to put in.
Type 2 dx Nov 2012 with fasting BG 14%/129.5
HbA1c Jan 2013 79/9.3%
April 2013 50/6.7%
July 2013 39/5.7%
Oct 2013 39/5.7% Chol 5.9
July 2014 45/6.3% Chol 5.5
Aug 2015 61/7.7% Chol 5.9
May 2016 84/9.7% Chol 6.9
Oct 2016 53/7%  Chol 6.3
Dec 2016 41/5.9% Chol 6.0
June 2017 51/6.8% Chol 6.1
Oct 2017 52/6.9% Chol
Metformin SR 2000mg, Candesarten Cilexetil 4mg Omeprazole 20mg, Fexofenadine 180mg Co-Codamol 30/500g when needed. Amitriptyline 20mg
Toujeo/NovoRapid, Allergic to Levemir.

Offline Pattidevans

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Re: Finally got bolus insulin.
« Reply #39 on: 20 November 2016, 12:40:43 PM »
Well,  it'a not just Mike.  That's life for anyone on a pump and to a degree, anyone on basal bolus.


Most of my friends don't "see it" because I do all that calculating and bolussing quietly whilst conversation goes on around me.  I guess we all do.


When I say "calculating", I know my pump does the calculating for the carbs I programme in,  but I mean all the "I'll need a TBR because I'm going to be walking" stuff.
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


© 2015 Patti Evans

Offline Quantum Learning

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Re: Finally got bolus insulin.
« Reply #40 on: 20 November 2016, 04:05:26 PM »
Ok, part 2 of the rice experiment  :P

Had fried rice again last night (same qty as last week) but with duck this time to see what the additional fat would do.

Started a little higher, due I think to not having eaten enough during the day.

Injected 6 units this time immediately b4 meal.
B4 meal 7.7
1hr after 8.6
2hr after 11.1
3hr after 8.6 hooray
4hr after 6.7 hooray hooray
Would normally take this last as a bedtime reading but decided to stay up and read a rather good book I'm halfway through.
So 6hr after 11.8  :o what on earth!!!
Woke this am to 8.9 highest it's been all week  :(

Have been reading 'think like a pancreas' so know he says white rice is high GI so should affect BG's fast. Also know the high fat in the meal would slow everything down but still a shock after 6 hrs.

So I suppose my question is, with a fantastic reading of 6.7 after 4 hrs how could I know what would happen over the next 2 hrs? If I did I could've taken a correction at 5 hrs knowing that the IOB would be running out but with a 6.7 I wouldn't correct and was kinda in the dark. In fact if I hadn't stayed up till 2.20am reading & then testing again I would've had no idea that BG's went back up again  :(

I realise I am trying this experiment with the worst possible food (for me anyway, would be hard to see how pizza could be any worse) but I'm generally happy with my LCHF diet every day and only want to use the rapid on odd occasions like eating out, takeaway, mince pies  ;) etc.

If we have Chinese again next Sat (takeaway night) I shall try the pork/chicken rice again with the 6 units (maybe 7) but I think I will delay the injection till at least after I have eaten, if not longer as I don't seem to get a rise till 2hrs after eating.

Reminder of last week's BG's after the pork/chicken rice:

Injected 3 units immediately b4 meal
B4 meal 6.1
1hr after 8.4
2hr after 10.6
3hr after 13.4
2-3 hrs later b4 bed 10.4, next am 7.6
Type 2 dx Nov 2012 with fasting BG 14%/129.5
HbA1c Jan 2013 79/9.3%
April 2013 50/6.7%
July 2013 39/5.7%
Oct 2013 39/5.7% Chol 5.9
July 2014 45/6.3% Chol 5.5
Aug 2015 61/7.7% Chol 5.9
May 2016 84/9.7% Chol 6.9
Oct 2016 53/7%  Chol 6.3
Dec 2016 41/5.9% Chol 6.0
June 2017 51/6.8% Chol 6.1
Oct 2017 52/6.9% Chol
Metformin SR 2000mg, Candesarten Cilexetil 4mg Omeprazole 20mg, Fexofenadine 180mg Co-Codamol 30/500g when needed. Amitriptyline 20mg
Toujeo/NovoRapid, Allergic to Levemir.

Offline sedge

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Re: Finally got bolus insulin.
« Reply #41 on: 20 November 2016, 08:28:29 PM »
Hee hee - when you have over a certain amount of fat with carbs, a late second 'spike' often occurs and so if you're going to persist eating 'that' exact amount of fat with 'that' exact amount of fat - you need to split the bolus to cater for it.

Google 'Pizza effect' if you don't believe me !

What I do personally is limit the amount of carbs I have with any fatty accompaniment (eg chilli gone barmy and rice, or spag bol for instance - both always fatty since I fry the onions and meat for both and however much you drain em, to get onions to go soft and transparent they always absorb more fat than you'd think possible) to only that amount of carb my body can handle with such things - and in fact I didn't really ever manage to get the jabs 'just' right until some time after I had my first pump.  So the late spike had been with me nearly 40 years by then.  For me - regularly, it's after 5 or 6 hours when it hit !

You either need to instantly stop eating it - but that's wimping out! - or you simply have to experiment and there's an end to it!  I welcomed you to our world earlier, do you think you like it here as much as you initially thought?  LOL
Jenny

T1 DX 1972, pumping Novorapid 24/05/11

HbA1c - 7/07 8.7, 1/08 7.8, 9/08 8.4, 3/09 7.3, 7/09 7.2, 12/09 7.3, 11/10 8.1, 2/11 8.6, 9/11 6.5 2/12 6.4  5/12 50/6.7  11/12 52/6.9  01/13 46/6.4  06/16 46/6.4  12/16 45/6.4

Offline Lucy

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Re: Finally got bolus insulin.
« Reply #42 on: 20 November 2016, 10:31:28 PM »
I actually find one of the easiest foods to bolus for to be cake. It just seems to have a good mix of sugar/carbs/fat. I can bolus straight before and have a nice smooth bg curve afterwards. I havent tried mince pies as i dont like them. I guess they have more weighting to carbs than fat compared to cake so may be spikier.
Type: Lucy. A1C 44 / 6.0% Jan17.
Lantus, Victoza and Apidra. Metformin XR, Bisoprolol (for SVT). Dexcom G4 with xdrip and nightscout.

Offline Quantum Learning

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Re: Finally got bolus insulin.
« Reply #43 on: 21 November 2016, 01:20:36 AM »
Hee hee - when you have over a certain amount of fat with carbs, a late second 'spike' often occurs and so if you're going to persist eating 'that' exact amount of fat with 'that' exact amount of fat - you need to split the bolus to cater for it.

Google 'Pizza effect' if you don't believe me !

What I do personally is limit the amount of carbs I have with any fatty accompaniment (eg chilli gone barmy and rice, or spag bol for instance - both always fatty since I fry the onions and meat for both and however much you drain em, to get onions to go soft and transparent they always absorb more fat than you'd think possible) to only that amount of carb my body can handle with such things - and in fact I didn't really ever manage to get the jabs 'just' right until some time after I had my first pump.  So the late spike had been with me nearly 40 years by then.  For me - regularly, it's after 5 or 6 hours when it hit !

You either need to instantly stop eating it - but that's wimping out! - or you simply have to experiment and there's an end to it!  I welcomed you to our world earlier, do you think you like it here as much as you initially thought?  LOL

When you say split the bolus do you mean only inject half the amount you've decided the meal needs and then the other half after say 5 hrs? I'm not sure that would've worked last night. I'm not sure the 6 units were enough anyway and with hindsight I maybe needed an additional amount later although I wouldn't have a clue how much that should be  :(

I will continue to experiment but am feeling a bit disheartened. Having followed a strict LCHF diet for 4 years which worked really well initially and now doesn't seem to work at all without at least a basal insulin, I'm having trouble changing mindsets. The meals I'm experimenting with are all my faves from before Dx that I haven't touched for 4 years but they do seem to be quite high carb. I don't think I know how to do moderate carb, it's all or nothing for me at the moment.

I don't know about 'liking it here' like everyone else who uses the forum I didn't want D to begin with but hey ho, LOL.
I certainly didn't want to have to inject myself several times a day but as I have to do that now whether I like it or not I thought well at least I can maybe eat a bit more flexibly but as I've said I don't know how to do moderate carb and the occasional high carb is certainly turning out to be much harder than I was expecting  :(

That's actually very interesting that you say you limit the carbs when having a lot of fat though, again you see, different mindset. With my diet controlled type 2 I followed a LCHF diet and never considered the fat much as it was so low carb it didn't really make much difference.

Tried my 2nd stew experiment tonight and that didn't really work either. Was nice to be able to eat the same meal together with OH again but not worth it for the spike.   :(

In the meantime I really appreciate anyone who takes the time to post an answer to my ramblings, so thanks again  :)
Type 2 dx Nov 2012 with fasting BG 14%/129.5
HbA1c Jan 2013 79/9.3%
April 2013 50/6.7%
July 2013 39/5.7%
Oct 2013 39/5.7% Chol 5.9
July 2014 45/6.3% Chol 5.5
Aug 2015 61/7.7% Chol 5.9
May 2016 84/9.7% Chol 6.9
Oct 2016 53/7%  Chol 6.3
Dec 2016 41/5.9% Chol 6.0
June 2017 51/6.8% Chol 6.1
Oct 2017 52/6.9% Chol
Metformin SR 2000mg, Candesarten Cilexetil 4mg Omeprazole 20mg, Fexofenadine 180mg Co-Codamol 30/500g when needed. Amitriptyline 20mg
Toujeo/NovoRapid, Allergic to Levemir.

Offline Pattidevans

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Re: Finally got bolus insulin.
« Reply #44 on: 21 November 2016, 10:01:26 AM »
Q


In truth there are so many factors at play here that we don't know what is going on.  For example, have you tried not eating one evening and testing regularly to see whether your BGs naturally rise at the times you are seeing now?  There's a chance it could be your basal and nothing to do with eating rice.  Or, you may just have a very slow digestion, it could be to do with the omeprazole, or any one of a number of factors.  I suppose you test after eating low carb and don't see the rise?  But then again you say you don't use a bolus for low carb?


It certainly doesn't seem as simple as carbs in, match with insulin (not that you have yet calculated your ratios), have immediate spike and then drop back to normal figures that would be expected for a T1.  So it's rather hard to comment as our comments could be completely irrelevant.


I am wondering when your appointment with the Endo is supposed to be?  Meantime is it worth talking with the nurse you see and asking her what you should expect after a higher carb meal when bolussing.  She may be able to give you some advice on ratios.
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


© 2015 Patti Evans