when you notice a trend after eating certain foods, for example after eating an english muffin, and you see a rise in BG after 2 hours, do you try doing a dual bolus? and, while experimenting w/ this dual bolus (which you are making your best guess over after watching similar trends on your cgm), do you maintain your other carbs as a base rate? for example: whenever i eat and english muffin or any other bread carbs (rolls, etc) i spike after about 1 and a 1/2 hours to 2 hours. so today, i decided to experiment w/ a dual bolus rather than giving up eating my coveted english muffins. in order to see how this experiment worked, i decided to keep a “regular” food in the mix. i know that i need to cover 10 grams of carbs for eating one serving of tuna fish. not that i wanted to mix tuna w/ my muffin, but it seemed to make some sense to me. this way, i would know that i was not responding to the tuna, but any weird change in my BG (and potential spike) would have to be related to the muffin alone.
have you figured out a solution with blousing that works for you? how did you figure it out? and how did you get to that solution (obviously, by experimenting)? this is the very first time i am experimenting w/ the dual bolus w/ anything other than high fat foods. i am anxious about the results. how can i just take a deep breath and let the insulin do its thing?
I wouldn’t do that. Stretching out a bolus for an english muffin would set me up for a later low. I’d take more insulin initially if I was getting high at 2 hours, rather than doing an extended bolus. If I was worried about going low right after eating, then I would try to time the bolus so that the muffin kicked in before the insulin. Novolog and Humalog action should keep your bg’s reasonably in check if taken in correct amount and at the correct time. Bolusing properly includes considering your bg prior to a meal–not just thinking about I:C ratios. There are many factors to think about for successfully covering a meal. Anyway, I would not advocate doing a square wave for that. For pizza–YES. For Mexican–YES, depending on how fatty that food is. A couple of tacos at Taco Bell is pretty benign. A big two or three selection dinner at a sit-down Mexican restaurant, with chips, beans, rice, and other goodies, would best be covered with a DUAL WAVE.
well, its too late now; i already did the dual bolus. it was my CDE who suggested this to me, so i was kind of taking this direction from her. your way makes a lot of sense to me, though.
i bolused for my regular serving of tuna salad (covering 10 grams carbs) just to keep things focused on the muffin alone. i know that all food combos work together, but i figured i needed some sort of base line in place, and i heard that you should always eat a carb w/ a protein. its been 1 hour now, and my BG are 119. i am really anxious. i wish i weren’t. this is one reason why i have just given up foods i have enjoyed b/c its just too much of a challenge for me to play around with my bolusing. do you have any suggestions for relieving the anxiety? i rally need some help w/ this if i want to continue to learn how to bolus for other favorite foods i want to eat.
oh yeah, by the way, my BG before pre-bolusing was 115. so after 1 hour, its 119. don’t know if that is telling or not, just thought i would give you the info.
Have you tried bolusing and eating just an English muffin? When a fast acting carb, like bread, is eaten with another food, like peanut butter, the digestion and subsequent BG profile changes. The gut digests and metabolizes the food mixture.
I doubt that the bread by itself will wait 1.5-2 hours to spike the average person’s BG. For me bread affects my BG not too long after juice or glucose tablets. The second bread hits your mouth, the enzymes in your mouth start scissoring the bonds of the long glucose chain that bread is. If there’s nothing else in the stomach, it passes through almost as fast as liquids.
Now, I known there is variability from person to person. Doing the bread only and then the other food only experiment will inform you how your metabolism handles each food component.
i have yet to try just 1 english muffin alone w/out other foods. i would really like to be able to have it w/ eggs and coffee in the morning for breakfast. i know i spike from AM coffee and i know that eggs have fat in them, which would slow down absorption overall. but this morning i did an experiment w/ breakfast. i skipped the coffee altogether and just had eggs alone. my BG were as steady as a rock. no ups or downs on the cgm. i haven’t had a coffee all day, b/c i have been so curious about the english muffin.
as there’s been some time passed since i 1st posted this forum, i can say this: i did a 65/35% split over 2 hrs. i went from 115 to 119 after 1 hour. soon after that i started spiking and went up to 192 at the 2 hour mark. i gave myself 1/2 unit novolog (which is what i use in my MM pump) and now, after 2 1/2 hours, my BGs are starting to steady off and even coming down a bit to 175. i don’t want to over-correct, so i am letting the IOB do its thing. i still have 1.6 units onboard. i am hoping i don’t drop low. what irony.
i HATE D. i hate watching my husband eating all the things i don’t. i am so frustrated. i get so anxious. i want to be a real trooper and a pro at this but no matter how hard i try i just want to 1) scream; 2) cry; 3) stop eating altogether; 4) eat whatever the F i want and not care so much for my health. but i refuse to give up and i am grateful to all of you who continue to inspire me every day.
I now look at bread like a treat. And a not very sustaining one at that.
The only reason I suggested to eat the English muffin alone is to learn whether it’s the reason for your 2-hour spike after breakfast or if it’s really the food that you add to the muffin that does it. Interesting that coffee alone triggers for your BG spikes.
I’ve always found eggs to hold my post-meal BGs steady. They’re more nutritious than bread as well.
I’ve switched a few months ago to eating eggs in lieu of an English muffin/peanut butter. I’m much more stable due to cutting out the carbs. Since we are so active, I can’t afford to have my bg’s swinging wildly in the morning.
What I like to do with foods that I like is to eat them and deal with the relatively minor consequences. One of the benefits I realize is that I don’t have to tiptoe around those foods, plus I don’t have to worry about my spouse eating something that I don’t/won’t, plus plus I get to satisfy the craving.
For me, there is a definite trade-off between the consequences of eating pizza, for example, and the joy of eating it. The result is that I have pizza every so often, make my best guess at “dual bolusing” and then I just prepare for a bit more testing 6+ hours after eating, followed by a correction bolus (or three!) when my BG starts to rise from the pizza. I always view it as a “win-win” because, “I get pizza, baby!” and later, “I am IN range again - Woo Hoo!” Due to the effort involved though, I don’t get the craving for pizza very often.
With English Muffins (what are they called in England?), I find the sourdough seemingly doubles the carb effect and delays its delivery. So, like pizza, I do my best guess and then clean it up later. Note that pizza is a sourdough as well, so they have that in common.
I do also limit the amount, aka the portion size. Pizza is never more than two slices, English Muffins are almost always limited to one. Pretzels (another sourdough item that wreaks havoc) is limited to two large ones or 19 of the mini sized twists. Cookies and milk are limited to 1 glass and 3 Chips Ahoy (34g carb). Hershey’s Dark Chocolate Kisses? Only 2 of the little darlings, please (9g carb).
I just try to relax a bit over the whole food thing. In part, this is because I know that even if I had the same boring food at the same time every day, my diabetes would yield different results.
I find them fairly high GI and a prebolus (rather than an extended bolous) is the way to go. I use extended boluses routinely for low GI carbs or for large meals with a significant amount of fat in them. With pasta or pizza it helps avoid the low BG at 1.5 h followed by a rise at 3 h. I can keep my BG essentially flat even with a half a 16 inch pizza.
Thank you. i am definitely going to try this recipe. i have avoided pizza b/c i can’t seem to get the equation right. i tend to swing low after eating and then swing high and spike after 3 to 4 hours. then i can’t bring myself down until about 4 or 5 corrections. its a days event. and this bums me out b/c when my BG swings, so does my mood and sense of well being.also, when my BGs are high, i feel like i have the flu, which is no fun at all. i get really cranky and all i want to do is drink water and sleep. my BGs tend to go as high as the 400s. UGH.so this is why i avoid pizza, which is a real shame.
For pizza you might try starting with 50% (or maybe 60%) immediately and the remainder spread over 2 hours. That is what I would do, but we are all differerent so you will just have to work out the details by trial and error. I would do the same for pasta. If you are using a CGM, keep watching the trace. If it starts to rise at around 1.5 - 2 hours, you probably need more upfront the next time., if it drops then the opposite. Without the CGM I could NEVER have got this worked out.
It took me ages of experimentation to get it anywhere near right (particulary with pasta). Chips (french fries) also give a late kick and need an extended bolus. You have to be brave and be prepared to accept some out of range readings before you you start to get it nailed. If/when this happens try not to stress - you won’t suffer irreparable damage from the odd bad number and if you can get it right, you will gain in the long run.
thanks joel. i will try this formula next time out. my other problem is that i have NO idea how many carbs to bolus for; there are 2 different types of pizza that i enjoy: one is thin crusted brick oven, and the other is the “classic” i have no idea whether they add sugar to the tomato sauce though in either type.
generally i like to eat 1 & 1/2 slices of the “classic” (while my husband eats up the remaining 1/2) and i am guessing that that is about 65gms of carbs. for the thin crusted, i prefer to eat 3 slices, and i am estimating that that would also be about 65gms. if you think differently regarding the carb count, please PLEASE send me your opinion !!!
Daisy Mae
Have you tried looking online (or asking at the restaurant) to see if there’s any nutritional information available? Small restaurants often don’t have it, but medium and larger restaurants (especially chain restaurants) usually do, even if it’s not advertized.
@Daisy_Mae - I think this is a tremendously important insight for both your psyche and your physical well-being. Stress in and of itself can lead to high BG levels. If you couple being stressed with something that is going to throw your numbers off, you can get a double whammy (ouch!)
I always try to remember that the numbers - whether low, high or in the “just right” range that would satisfy Goldilocks - are just information. They aren’t good or bad and neither am I. They are information, period. Once I have information, I can take appropriate action.
If you want stress, try NO NUMBERS so that you are walking on a tightrope without a net.
