Fatty Foods, Insulin and going High

Every time I eat fatty food my sugar goes up really high - usually after about an hour or so. I love steak and hot dogs and would love to be able to continue to eat them. Any suggestions on dosing methods would be appreciated! Thanks!

Steak? I rarely see any spike with steak. Hot dogs on the other hand just take a long time to break down and then you "can" see a spike. If it is consistent though and you are using a pump you could do a square bolus.

Steak, hot dogs, lamb all cause spike for me. I don't use the pump, just Humalog shots. what is a square bolus? can I replicate it with shots?

For fatty meals, my CDE suggested using an extended bolus - 70% up front and 30% over the next 2 hours (for meals with up to 25% fat). For very fatty meals, try 60% up front and 40% over a longer time 2-4 hours. You have to experiment to see how it works for your body.

Pizza is the worst for me... its high carb AND high fat.... so I rarely eat it...but I know people who manage it with symlin + extended bolus.

SO last night for example I had a hand full of hot dogs and too the following insulin. Dosages are all Humalog - 4U @7:54, 1U @8:44, 2U @ 8:53, 1.5U @ 9:56, 2U @ 10:42, 2.5U @ 1:13am, 2U @ 4:09am and was still high this morning

Those foods are not all that fatty. I bet it's something you are eating with them. Did you eat those hotdogs on buns? Something doesn't make sense here unless your basal rate is not right!

When I eat fatty foods, I go high 6-8 hours after my meal. It might be worth checking 6 and 8 hours out, and bolusing at one of those times (I’d try 6 hours first). Hope this helps!

I have found that not only do I have to cover carbs at meals, but also fats. I use my normal ratio for carbs and I add 1 unit extra of insulin for every 10 grams of fat. Plus, I extend my bolus out to cover 2 - 3 hours. That works for me, particularly in high fat meals like pizza hamburgers, etc. Good luck.

Your body might not find them fatty, but my does.

I do not eat them with bunds. I usually eat them with two slices of whole wheat bread.

Thanks. I will def try taking insulin for the fat and start by using such a ratio.

Two slices of bread is a *huge* amount of carb. about 20-25 grams per slice of very fast carb, so about 40-50 grams per hot dog

How many is "a handful" of hot dogs ?

I would have sky high blood sugar too with that much bread.

Just to clarify, the bread is 15grams per slice and I only have two slices in total. 5 hot dogs.

ah, ok.

Yes, fatty foods increase mine to. I see two problems here. One is the whole wheat bread, which is complex carbs. Both complex carbs and fatty foods cause my blood sugar to rise slower and require me to do an extended bolus with a little extra insulin. Otherwise I get the same problem you are having, which is weird because when I don't extend it I end up using more insulin total just to get it back down to normal. But when I extend it with about 60% up front it does much better.

Meda-Key, what's your carb to insulin ratio? Having a fat to insulin ratio seems like a great idea, but I'd like to try to find a calculation for it.

If you look up "TAG" you can find formulas for it. It stands for Total Available Glucose and includes fat - and protein I think.

With shots, it is absolutely harder than a pump, especially with an evening meal when you will be less active and presumably sleeping after. Depending on what time you eat, and what time you go to sleep, you could bolus a percentage 20 mintes or so before meal time and 25% of that each half hour for 3 or 4 hours and see if that works. (This would take lots of trial and error.) I can stretch out dosing for pizza that way, but ice cream or chips seem to peak in the middle of the night for me. You would be a way better PWD (person with Diabetes,) than I to be willing to get up all night to dose.
Good luck to you.

I must correct for protein all the time, not necessarily for fat. If I eat a steak and the carbs come in as zero, I will get slammed about 3 hours later with very high BG. Therefore I have a dual approach; Use an extended bolus like was mentioned earlier, and use a carb counting program that has corrections for protein and fiber. There are very few available. I am currently using DiabetesPilot. It is expensive ($12) but it does a nice job of calculating insulin doses for protein. You input your own personal sensitivity. Fiber is a relatively small effect, nevertheless it counts as well. I use a correction of 25 for protein and it works well for me. My BG’s and HbA1c are much better using this program. All the luck, Jack