So I'm a Paleo eater, 'people who eat all veggies, low sugar fruits, nuts, seeds and meat' (I eat meat occasionally). I'm slowy trying to get off of Cheese.But, in the meantime I absolutely LOVE CHEESE! Since I don't eat sweets or complex carbs, CHEESE is my desert. I eat a good amount, enough to affect my blood glucose leveles :( I will have a 120 mg/dL for breakfest and if I add in cheese my level spikes to 156 mg/dL and stays for a LONG time! Occasionally getting in the low 200s! is there a Bolus technique you guys use to help with this? I absolutely LOVE my CHEESE! LOL!
P.S. I understand there are difficulties bolusing for cheese, I'm just looking for some advice so I don't have to worry about those ugly looong lasting spikes.
I use an insulin pump. Medtronic Minimed 723 Revel!
Do you go low from the bolus, and then spike? If so, it is all about the fat. Fat is a problem, as it absorbed very slowly and affects BG over a long time period. I use a square wave bolus. The higher the fat, the longer the bolus. Your minimed will do that for you.
Try starting with the ratio suggested by the pump - wave duration is important because if you are like me, too short a duration means the BG will stay down then once the bolus is over it goes back up. Squares are really great for long duration or fatty meals. If you can stand it, try eating a given amount of your favorite cheese and experiment around with the square. Don't worry too much because the total amount of the bolus will be the same regardless of the duration. I'd give the 30 minute duration a crack first - if the wave is too long the BG will rise early but the remaining wave won't be enough to cover it all.
I bolus for 1-2G of carbs, as a "cheese stick" is my mental amount of cheese? Oh who I am I kidding, I bolus for 5-7G of carbs and throw down some nuts and broccoli too!
I like the theory of "dual wave" boluses but I haven't ever run into useful directions for figuring it out and haven't ever gotten very decent results from them. I just use a regular bolus.
uh huh, I cant figure it out either. I usually do a regular bolus for cheese but its definitely not working! I go low and then I go high, I think I'll play around with it and see what happens.
Cheese often has carbs. It may just be a couple per serving, but often the "serving" of a cheese is depressingly small. So I buy my cheese at Costco, where they sell "manly" size blocks of cheese. You just need to figure out what kinds of cheeses have residual carbs and account for it (oh and the fat too). My experience is that the more highly aged and fermented cheeses have the lowest carb levels.
I buy my cheese at Costco too in "womanly" sized blocks lol. The Cabot black label 3 yr cheddar is what I usually eat, or their swiss. If it's only a few slices I don't have to bolus for it. Packaged cheese, or soft cheeses like brie are another story.
Ok. Admission time. I buy Costco blue cheese, I love the stinky stuff. I also buy brie and an assortment of generally aged strong flavored cheeses. We also get the swiss and provologne to make roll-ups with deli mean.
But one of my favorites right now is the Kerrygold cheddar, made from grass-fed dairy and aged for two years.
I bolus in egg units. I know that for lunch I need 2 units per egg. A "hunk" of cheese for me is half an egg.
Make sense?
The only way to find out for sure is to test. Have only cheese for lunch every day until you titrate a good bolus. Then test it out on varying quantities.
The main idea of that about 60% of protein gets converted to glucose and 10% of fat we eat is converted to glucose. Protein is converted slower than carbs and fat is converted the slowest. If you are eating a high fat meal, (pizza) TAG may help use a dual wave bolus to combat the PP spike.
My personal opinion is that digestion is too variable to reasonalby predict digestion this precisely. But, the idea that the protein and fat in cheese (espesically a good helping) will affect your BG differently than a similar meal of crackers is certainly real.
If you are interested in trying dual-wave bolus with your minimed pump I can recomend a starting place that works ok for me. Please adjust as necessary. I would try bolusing 80% up front and the remaining 20% over a half hour (if small) and an hour (if large). For instance I am eating a bunch of pizza and plan to bolus 5 units. I would TAG and dual wave bolus 4 units (80%) up front and the additional 1 unit (20%) over 1 hour because I consider it a signifigant amount.
I am currently eating about 50g carbs per day compared to my previous 120-150. I’m finding that I need almost as much insulin for my 6g breakfast as I needed for my previous 34g breakfast. Some of it is that dawn phenomenon ( or really post-awakening highs) are much more pronounced now when I’m not having a significant breakfast bolus. And the highs continue through the morning probably as I digest eggs and cheese. So I’ve actually increased my breakfast carb count to about 12 and am doing much better than I was on 6.
I’ve always eaten a lot of cheese and nuts and they can cause wicked highs several hours after the fact. Nuts are much worse for me than cheese. So I’m limiting nuts and giving myself some slack on cheese.
Type 1 is just plain hard to totally control. Often solving one problem just opens the door to a different problem. At some point we have to eat something…
i like to make large salads sometimes for dinner. i use baby arugula, blue cheese, and walnuts.
i also use balsamic vinegar which has sugar in it. so i bolus for around 10 grams with a 50/50 dual wave split over 1 hour. it works like a charm. i don’t spike and i don’t go low. maybe my formula will be helpful.
