Okay, I went out and had McDonalds tonight. My BG before eating was 74. I got a small fry and a McChicken. According to my Calorie King, that meant 70 carbs. I bolused and began eating. However… as I began eating, I noticed that the “small” fry looked extremely whimpy. I thought that maybe I might go low later… because of the “extra-small” serving of fries. However, I didn’t eat anything extra. That was at 7 pm, or so. Now it’s 11. I checked my BG about an hour and a half ago… it was 124. Instead of correcting that… I decided to wait and check again later. So, 30 minutes ago, I checked again. This time… it was 166. Not knowing what was going on… I waited another 15 minutes. At this point, it’s 172.
So, I wanted to point out that it’s rare for me to even go over 120. That only happens once or twice a week. But… 172 is very high for me. I’ve only gotten that high once or twice since being diagnosed in August. Anyways… that BG was about 10 minutes ago. So, I corrected for all of it. I just thought I’d add that I didn’t take into consideration any of the FAT content of the meal. I’ve never done anything about the fat… so I didn’t bother doing anything about it this time, either.
Whoever’s on this late at night… please respond and tell me what to do! I want to go to bed… but I have a feeling I’m supposed to wait quite a while and check again because I just bolused. So… help! I want to go to bed! I have a really early morning tomorrow! Thanks!
I had to go check your profile to see if you were newly diagnosed because this sounds like a case of the ‘honeymoon’ starting to end. And lo and behold, that might be the case. I’m not a doctor, just a T1 since I was 10 years old, but I know that if I had done each thing you’ve done, I’d probably be 350 mg/dL.
70g of carbs is a really carb-heavy meal and MickeyD’s fat content alone is enough to cause some major insulin resistance and absorption issues over the next 6-8 hours. It also sounds like you bolused right on top of your meal, which is another factor causing a steeper spike in your sugars post-meal.
For tonight, the best thing and most realistic thing you can do is go to bed and set an alarm to do a 2am or 3am check on your sugars. If they have continued to rise even after the bolus has left your system (3-6 hours from your bolus), you should check for ketones. If your blood sugar drops from all of the insulin, you can treat the impending low.
In the future, you may find that (a) that’s too many carbs, (b) your insulin needs are changing as your body un-honeymoons, © you need to spread the bolus out over an extended period of time or do a combination bolus (fat stays in your system many hours after your insulin has left and yet it causes your body to be resistant to the insulin you took), or (d) you should bolus 20-30min before you eat a high-carb meal so your insulin has time to peak before your carbs rush your system.
Just my two cents. Good luck!
Hi Emily; You seem to be doing well and are conscientious,in maintaining the blood glucose targets and ranges that you described: Congrats to you!! However, as Melissa noted, the 70 gram carb serving of fries PLUS the McChicken sandwhich( batter-fried patty with the thick two-part bun) would spike me into the 300’s unless I had prepared and bolussed “Just perfectly” for it
I hate to say this to a new type 1, but some fat-laden, carb-heavy foods, no matter how good they taste, have to be consumed, if at all, very infreqently…WHY? Because Portion sizes vary from Mickey-d’s to Mickey-D’s, and the “Calorie King” carb amount, though generally accurate, is just an average of the total carbs per serving. It is a hassle to set pre-bolusses, extended bolusses and multiple post prandial alarms and tests, just for the " crunchy , fried feel" in your mouth… A salad is just as tasty and easier on the Blood glucose. For further episodes of missbolussing or carb counting crashing ( WE ALL do it , from time to time) Do not fret about impending suspected highs…set your alarm and go to sleep; Stress and lack of rest will raise my blood sugars, it may do that for you, too…
Hope .this helps…
I see you have and omni pod. I am on a pump (minimed) and what I do in a case where it’s high carb/high fat, is do a square wave bolus. That’s where you give part (depending on how high the fat is for me) at the time you are eating, and the other part in a steady amt over the next hour or 2 hours. For me, I would have probably done 30% at the time I was eating and the other 70% over the next 2 hours. It helps to keep you level.
But each person’s needs are different. You may want to chat with a diabetes educator about that. It’s also trial and error. It took me a while to figure out how I needed to bolus for what types of foods.
Hey, thanks for you help!
Just to make it clear… the fries were not 70 carbs. According to the Carlorie King, the fries were 30 carbs. My whole meal altogether was 70 carbs.
So… this is what ended up happening: I was checking my BG about every 15 minutes for the last hour. I slowly saw my BG go down. At about 12:15, it was down to 125. So, I decided to go to bed. I set an alarm for 2 am. When the alarm went off, I almost just went back to sleep… because I thought… “Well, I woke up! I feel fine. Now I just want to sleep…”. lol. But, I decided to check, anyways. I was 65ish.So… I went and ate 2 cookies… (delicious, btw). I went back to bed. I woke up at 91. So… I guess everything worked out. Only, I sure am glad I chose to set my alarm and check… or else I would have been really really low.
Oh, and… I’m not so sure I’m honeymooning right now. Why? Well… there was a week or so about a month after diagnosis… where I was barely taking any insulin at all. Like, I would go meals without taking insulin. Or, if I took any, it’d be 1 unit. But, that was quickly over. Now, I’m taking enough insulin that makes me think I can’t be honeymooning. I’m on a 0.40 u/Hr basal. My carb-insulin ratio is 14-1, My correction factor is 40:1. And… I’m pretty sure that that’s what most people who AREN’T honeymooning are doing. So… I don’t know. They didn’t really tell me what to expect as far as honeymooning goes.
mc donalds is a sketchy place, never know whats in that stuff. i don’t trust it and avoid it all together
Amounts vary for everyone. My carb insulin ratio varies from 6:1 to 9:1. So much higher than yours. My basal runs anywhere from .08 to 1.0.
So, it could be changes.
I will say this for potatoes of any kind, they make me spike. I rarely eat white potatoes (fries, mashed, baked, chips) because of the spike that almost always happens.
My ratios and basal rates are more similar to Cara’s. And I try to eat under 45ish grams at most meals unless it’s a special occasion and I intend to splurge.
If i were to eat potatoes or rice, i would have to bolus at 4:1. So i just don’t go there. My former favorite breakfast of oatmeal and fruit do the same thing. We have to adjust…
Thats on a good day… 8^P
A McChicken and Small fries is about 70grams of Carbs, and 26 Grams of fat… Thats under ideal conditions. A overstuffed fry baggie could boots the carbs a bit, but… If they were not cooking them in oit that was at the correct temp it will leave a_lot more fat behind on the fry. low oil temp could boost the amount of fat upwards to 300% Also if they were in the fryer too long they will start absorbing oil instead of the steam from the cooking repelling it.
Fast food is supposedly more consistent and therefore safer. I chose to go to mom and pops places because their handling practices tend to scare the heck out of me less.