Carb counting and fat

So I have searched all morning, here and elsewhere, and can’t seem to find any info…HELP!!!

I notice some highs after eating foods higher in fat than I need to be eating, but sometimes a girl NEEDS french fries and a cheeseburger.

How do you all adjust your carbs in high fat food? Like fried clams, pizza, yada yada yada. I am asuming there has to be some sort of tested and true formula that might work for me.

Any advice would be appreciated,
Thanks tracy

Keeping in mind that every one is different. I found that if I use the extend function on my pump…15% of the calculated total insulin dose immediately and the balance extended over the next hour and a half …it works perfectly for me. But it will take you a little trial and error to find out what’s right for you.

For foods like pizza/mexican/chinese, I actually add a unit or two and extend 10-15% of the bolus out for 3 to 3.5 hours with near perfect flat line levels post-meal. For ALL foods from fast food joints or restaurants (even if it seems “healthy”), I extend 5-10% of my bolus out by at least another 2 hours. That fat hits me hard.

My CDE recommends extending a portion of your bolus out for any meal with 20g or more of fat. 10% of all the fat we eat converts to glucose with about 8 hours of eating it, so a high fat meal is going to have a significant effect on your glucose between 6 and 10 hours later. Roughly 50% of the protein we eat hits us at the 4-6 hour mark, so also be careful about heavy protein meals like steak and burgers.

Like Janice recommended, play with it and see what works for you. Just make sure you’re testing every couple of hours for a meal like that and don’t immediately react to every number you see. An hour or two after a pizza bolus, I may find I’ve dropped into the 70s, but I rest easy knowing that it’s definitely on its way up. As long as it doesn’t continue to drop and I feel okay, I know I’ve spaced things out just fine.

for me its alot easier to manage hi fat foods with my ping insulin pump than injections. for junk food, i like cheese curds and potato chips, and this requires a bit more insulin. milkfats will convert to sugar as they are digested, so a combo bolus, or a longer acting one helps. also hi fat content seems to delay the absorption of sugars into the blood, so hi readings might linger a little longer.
it depends on alot of other things too, complex vs simple carbs, milkfats vs animal fats vs vegetable fats.
the little carb counter books help quite a bit too.
interestingly the old regular insulin lasted about 5 hours so this problem wasnt as common.
however, lo’s were more common…

I dose for the grams of carbs I estimate, then use either the square wave or dual-wave bolus on my 522 to “spread out” the insulin over an extended period. I usually use 90 or 120 minutes.

I do not agree with your statement, “sometimes a girl NEEDS french fries and a cheeseburger.” I have not eaten a cheeseburger in 20 years. That being said, I recommend a square wave or dual wave bolus for high carb + high fat food. The book “Pumping Insulin” has some good on this.

THIS girl sometimes needs a burger and fries, or hummus and pita chips, or pizza (as we speak.) I am testing (as we speak) extending my bolus out for 3 hours…wish me luck and I’ll let you if it worked for me.

Well…my technique didn’t work out great for me. I had to do 2 correction boluses through the night. I dosed based on the # of carbs but did not give extra as I was also drinking wine and didn’t want to go too low in the night. The pizza was a frozen Amy’s…not as much cheese as a restaurant pizza and with a whole wheat crust, and I ate 2 small-ish peices. “Real” pizza would have been a dissaster, I suspect. I spread about 50% over 3 hours, and was great at 1 and 2 hours after eating… 3 and 6 hours, not so good. Next time I would give myself an extra unit in the extended bolus. I worry when I am eating these things at night because I am not going to check as often as I would during the day.

I worry about night time sugars all the time. The other night I must have had an air bubble. I went to sleep with a normal sugar and at 3:30 A.M. my sugar was 402. This is not the norm so my basals are adjusted properly. It made me so frusttrated because I have been trying so hard to see no numbers above the 200s. I have been working so hard to keep my numbers in a good range. BTW I make my own pizza. I thinly roll out Trader Joe’s whole wheat dough, I use Barilla pasta sauce and put some veggies and and slices of my home grown tomatoes on top. I do not put cheese on my pizza. I have a higher quality pizza this way in less time then Papa John’s can deliver one of their crappy pizzas with maybe some boring hot house tomatoes if I am lucky. I can use a regular bolus for the carbs because the only fat is from the olive oil and olives on my pizza. When I had pizza in Italy it often did not have cheese and red sauce at the same time so it is more authentic this way.

Sounds delish and healthy…
It is frustrating to try and be on top of things and still come up with high #'s.