My BG can go up to 170 after steak. I’ve decided to bolus when I see the Dex trend up rather than pre bolus a steak meal. It seems that I have to correct once the rise begins even if I tried pre bolusing. It almost looks like I use more insulin by pre bolusing. It seems weird. (I may be inaccurate in my carb estimate).
I’m fond of red wine and almost any cheese but I don’t give in often these days. When I was working, on most work-nights, I came home from the afternoon shift around midnight and enjoyed a glass or two of wine and snacks. The wine itself is not so bad but it really boosted my appetite. Just one more slice of cheese…
Now I don’t buy the bottle of wine to tempt me at home and I limit it to one glass with restaurant meals. It is tasty.
I’m also at the upper range of normal weight.
The point that Stephen Ponder (Sugar Surfing author and T1D) made about the inexact and variable nature of both food metabolism and insulin absorption persuades me to think that any algorithmic solutions really just gets you into the right neighborhood, BG-wise, and then you need to nudge it one way or the other with carbs, insulin or exercise.
I still use Afrezza but consider it more of a shove than a nudge. I like 1-2 unit IM corrections a lot.
OCD can be sheer torture. it works for my D, but it is horrible in other areas. oh well.
i did create a post on the forum about schizophrenia and mental disorders. check it out.
thanks so much
full fat yogurt is exactly that: Full Fat Yogurt. it is not 0% or 2% fat free.
Fage has one and i think that both trader joe’s as well as ciobani makes one. it is
delicious plain w/ no extras (fruit, Splenda, etc)
do you worry about stacking your insulin?
I do fine with a lean cut like flank steak but tend to run higher for my favorite New Yorks or ribeyes. @Daisy_Mae, what kind of steak did you eat?
I agree with @Helmut that I pretty much figure if there’s a big spike, I simply didn’t take enough insulin. I also agree with @Sam19 and @Terry4’s points as to the imprecision in carb counting and that we may benefit from thinking about it diffferently, as spelled out in “Sugar Surfing”. I mostly think in terms of carbs anyway but I think of them as “chunks” of carbs.
I do a lot of prebolusing and try to sort of “pregame” larger piles of food by pushing my BG down to c. 70 before I start to dig in. Sometimes I will build in some additional “coverage” with a 200% basal too. I think the heavy basal seems to “push” the bolus insulin a bit but I haven’t seen any studies or analysis proving this, just based on my N=1 observations.
I still spike but 60-70 points still leaves me 130-140. If it goes higher than that, I think "well, maybe I missed some carbs and will bolus for them or maybe walk the dog while it’s still nice out!
I don’t ever say I cannot tolerate a food. Just that I have to get crafty with insulin.
i so rarely (no pun intended) eat steak that i suppose this is no great problem, but i would love to know how to aim for a good BG after devouring a nice piece of meat. currently,
i have been trying to figure out how to eat a large, kind of fatty, burger, bun and ketchup included. i tried my dual bolus (70/30% over a 3 hour period, but needed to do 2 corrections
later in the evening. my BG didn’t go any higher than 250, but going from 120 BG to 250 is a large rise. at least for me. when i ate the steak, i ordered a shank stake, which is more fatty than most, but thin and i like to eat the entire steak, which is definitely not one serving size. any suggestions are greatly appreciated.
I use an insulin dosing technique for high protein meals that works well for me and a few others that have tried it. I’ve laid out the details in another forum discussion that parallels your topic. I apologize if you’ve already read and discarded this idea. It does require some personal experimentation to adapt to your unique needs. Keeping a log helps. Anyway, that’s my suggestion.
Maybe you should try to aim for a lower BG before you start to eat, as @acidrock23 does? The rise wouldn´t be that bad and maybe you should not consider the corrections as “failures”? If you already catch the rise using your CGM you could do the corrections earlier and the end result would be what you initially aimed for. Wouldn´t it?
thanks, siri
i was thinking that i could try an 80/20% over 3 or 31/2 hours. this way i could account for the bun and the ketchup and let the fatty hamburger take its time. but i think you’re definitely on to something about watching the CGM tell me where i am going and when (fast arrow up, slow arrow up, etc) strangely enough, i have this exact same problem with an english muffin and with greek yogurt (doesn’t matter if its full fat, 0% or 2%) i stay flat for the first 2 hrs, but then i start to spike up. i think i need to try and do a dual bolus for those foods as well. have you ever had this problem w/ any other foods besides beef? ironically, peanut butter keeps my BGs steady if i nibble at it throughout the day. our individual bodies can create such maham and inconsistencies. what works for one does not work for another.
If you bolus normally, does it cause you to go low? Uusally I tend to think of combo boluses as useful for situations where I’d go low if I bolused the full amount up front. Otherwise, you’re essentially taking part of the bolus away, so it makes sense that you’d go high. If doing a reuglar bolus doesn’t cause you to go low, I’d just bolus regularly and then do a second bolus an hour or two later, rather than doing a combo bolus.
when you bolus a second time (after and hour or so) do you re-test your BG and then rely upon the Wizard feature to tell you how much to bolus for, or do you just estimate how much more insulin bolus you think you need?
It depends, I would re-test if I didn’t have a CGM, but with a CGM I probably wouldn’t. I wouldn’t rely on the pump since it will probably recommend no bolus with insulin on board. I’d just try to figure out (from experience) how much extra insulin you need so that you don’t go high. I used to do this for hamburgers even back when I was on MDI and didn’t have a CGM, and I’ve never found the combo bolus feature to work as well (again, since it takes insulin away from the initial bolus, so it always ends up making me high).
I have the same issues, 90% of the time those will spike me… I have been gluten/grain free for a while which is supposed to be good for possible hashimotos too but I do cheat very rarely. I asked my cd what my ratio should be for those foods but she never replied, lol.
thanks jen. i really appreciate your suggestions. they do make a lot of sense to me. before i was on the pump and doing MDI and i didn’t have the “wizard” feature (even my 1st 2 pumps didn’t have this feature), i just ball-parked my dosage. i suppose it can’t be that difficult to try that again. i think that the wizard feature has spoiled me and i have become somewhat jaded.
Maybe start with just doing one extra unit for the second bolus, and then going up from there as needed. That’s what I’d do. :) Good luck!
@Daisy_Mae. If you have the means, get a CGM. My guess is that I will live 15 years longer because of my Dex. My BG is close to normal. Before Dex, I started to see complications and my life was taking a turn for the worse. My complications have stabilized now and I believe that I am ahead of my non-diabetic peers.
helmut, i definitely know where you’re going w/ this. before my dex, my A1c were 8.9; since i’ve been on the cgm, my BG have gone down to 6.5. it makes life a lot easier and helps me with the trending. i’ve been better able to program my pumps basal rates and to track which foods i react to. i have only been on it for about 9 months, but i would never go w/out it (despite the multiple problems i do get w/ it: i am so lean that it is hard for me to find the fatty tissue needed and so sometimes during insertion i hit a muscle or a nerve)