Thought I had the “perfect formula” for pizza: multiply total number of carbs by 1.42 and prebolus by 22.7 minutes utilizing an extended bolus of 75% up front with the remaining 25% spread over 4 hours. Actually worked for awhile. Now no amount of tweaking is effective and I, like many others, have learned to accept the fact that pizza is “The Devil’s Food”. 
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There no such thing as one and done with pizza. If u only rose to 134 consider it a great success
Devil’s food. Buttercream frosting. Sigh.
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I slept in late this morning, I woke up at 10 AM with a fasting BG 93. Overall, it was a success. Thank you @Sam19 and all the other folks who have been so encouraging and helpful 
It seems like the pizza/salmon/veg/ice cream meal needed that I bolus for it about 3 times. The following is the timeline of events:
6 pm - pre meal BG 103
6:05 pm - BOLUS : 5 units Novolog
6:15 pm - 2 small slices - thin crust pizza with prosciutto arugula, small tasting of pasta carbonara, salmon, veggies, small scoop ice cream
7:30 finished meal - tested BG 147, BOLUS : took 1.5 units
7:45 - 9 pm - 3 mile stroll
9:30 pm - BG 105
10:30 pm - BG 131 , BOLUS : 0.5 unit correction
11:30 pm - BG 137
next day 10 AM fasting BG 93.
Many of you and the book Using Insulin said that fats and proteins delay the BG rise.
Did the protein and fats cause the BG rise from 10:30 pm to 11:30 pm? (does it take longer for fats and protein to convert to glucose?) Or did the protein and fats delay the carbohydrate conversion to glucose which caused the rise during 10:30 to 11:30? From the data, I think that the 5 units of Novolog addressed most of the carb content of the meal. I am wondering if the 0.5 unit correction at 10:30 was needed to address the protein & fats.
I apologize if I am slow in grasping this concept.
It’s open to debate and in the end it’s as much an academic one as anything. In my own view both protein and fat can slow carbohydrate metabolism, protein itself can in some people to some extent in some circumstances metabolize to glucose as well but fat can only slow the digestion of other things. The long and short of it is that meals which are heavy in protein and fat can take longer to digest than your single bolus lasts, so additional measures are often needed… like the follow up bolus you did. There’s other views on the subject than mine… but what really matters is that you figure out what works for you… Which it sure looks like you’re doing , so congrats!
to do this, you really need meals you know what are the CPF grams are, to work out how it works for you. Later I would think you would have the experience to ‘judge’ a pizza.
did you google how to work out and chart a TAG bolus? I’ve seen some forms to work it out.
you have the right idea to how it works a prebolus, a split bolus with a correction at 10:30
also it would be very important to do miss a meal basal testing to make sure that isn’t impaction on your I:C ratios
Yes, I think there is lots of evidence that this is true.
I would also note that a 3 mile walk will suppress your blood sugar as your body demands more glucose to be taken up during the exercise. If you had not walked you would likely have had an even higher rise between dinner and 9:30pm and probably would have been much higher. Exercise can offset insulin requirements.
Thank you and everyone for all the helpful feedback and encouragement!
In the distant past (life before diabetes), I would not have thought of salmon as being fatty. Creamy pasta sauce, yes I would associate with being a fatty dish. The funny thing is I used to think of ice cream, cheesecake as “sugary”. I did not realize that these are high fat and high carb.
It seems like I need some help deciphering nutritional label. How do you determine if a food is “high carb, high fat” and will likely lead to a delayed BG rise?
I searched calorieking.com for pizza, cheesecake. The information is shown above. The cheesecake has 20.4 g carbs, and 18g fat. It looks like a high carb, high fat food. The pizza has more carbs than the cheesecake. The fat to carb ratio looks like approx. 1:3 for the pizza, whereas for the cheesecake it looks like almost 1:1. Is there something else that I missed?
Below is a comparison of salmon and cheesecake. For the salmon, the fat to carb (protein using TAG) is 14:12, almost 1:1. Is that why the salmon’s impact on BG falls into the slow/delayed BG rise group?
While I agree with you about the body demands more glucose during exercise - it makes sense, in the past, if I had a high BG, even when I walked MUCH faster for about 20 minutes, for about 1 1/2 mile, it did not seem to lower my BG. Maybe I need to reach some minimum threshold of exercise. Diabetes is definitely quite puzzling at times. Diabetes can be so exasperating!! And at other times, everything seems to work out ok.
No bolus for me at the moment, but for me I have a slightly similar possibility. I can go on a one hour bike ride on an empty stomach, flirt with BGs in the low 60s, and then eat up to 50g of carbs in a sitting and never go past 100 mg/dL!
Totally idiotic, which is why I stopped doing it… but was the closest I’ve come to managing some kind of “pre-bolusing” for carbs without having exogenous insulin.
On the “high-fat, high-carb” deal, I can only suggest a few simple rules:
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Salmon has no carbs, so the amount of fat doesn’t really matter (except it will probably slow the small spike from the protein you get if you’re insulin-low);
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Sugar = carbs = sugar = carbs. While different carbs do metabolize at different rates, all carbs matter! Total carbs are what will determine how much insulin you need to metabolize the meal properly.
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If you’re meal has a lot of carbs and a lot of fat (not one or the other), and/or a lot of insoluble fiber, and a healthy dose of protein, you’re likely to metabolize the carbohydrate portion more slowly than you would if you just ate the same quantity of carbs. That means you’ll have a spike, but it will be more slow in developing after you eat…
I’m not sure you can really make hard and fast rules. Everyone has to figure these things out for themselves. For me, it doesn’t really matter how “slow” my carbs digest: if I eat too many, my BG spikes higher than I want it to. Slow, fast, not really a big difference for me. I don’t want my BG over a certain (arbitrary) level that I’ve established as my upper limit of “good control.” So I eat only as many carbs in a meal as I know won’t take me over that limit within one hour of eating.
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Another complicating thing re: exercise is that sometimes in my experience it can increase BGs temporarily, I’m assuming through increased liver output. I find that lower intensity sustained exercise consistently lowers BG, whereas high intensity exercise, especially into the anaerobic range, is highly variable and can cause initial spikes prior to the lowering effect. That adrenaline and fight or flight mode are the same mechanisms that spur on the liver to dump glucose, since as far as your body knows, you might be trying to outrun a bear or whatever, and a non-diabetic would be able to utilize that extra energy. Anyway, my guess is that for most people, longer duration/moderate intensity exercise (whatever that means for you) is the most consistent way to lower BG, since it may lessen the amount of extra glucose released (if at all) and gives you time to burn past any extra it does initially dump into whatever was already there.
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That’s interesting…maybe it is the duration. Maybe 1 hour is necessary.
Every case is individual and there are countless variables that influence results, but the general rule of thumb is that aerobic exercise lowers BG while strength training raises it, temporarily.
If I’m not following LCHF (I consume about 100g carbs daily), do I still calculate carbs using TAG? For example, my lunch meal is approx. 38 to 40 g. The brown rice is ~15g, fruit ~10g, dark chocolate 3g, “protein” (fish, chicken, beef…etc) 10 -15g using TAG. The carb contribution from the protein would be approximately 25% or more which is not insignificant. I tend to lean towards using TAG. I’d like to know whether I am doing this correctly. I am looking to members of the community for clarification and assistance. Thanks! (I googled “chart TAG bolus” and saw square wave or dual wave for insulin pumps. I did not see anything for MDI. Do you have a link ?
this shows the working it out on a chart. ❤️cfun 코인❤️ 💲새우 스테이크💲 cfun 코인 cgf 코인 캔디 카지노 먹튀 kellywpa.com
you may be better using “total available glucose” in google.
if you drop and then rise at 3-6 hrs then you may need to tag.
@jack16 Thank you for the link to TAG!
I estimated that generally speaking for lunch and dinner, I have about 12-15 g that I have to cover for protein. I “throw in” about 2g that need to be covered for fat. At 10 % for fat, it’s not a large number therefore if I err, the mistake would not be huge. The straight carbohydrates of my meal is by far the largest portion, varying between 25 to 33 g, therefore having the greatest impact on BG rise.
I just weighed my pork loin and it weighed 150g. The protein content of this pork loin is 46g. Applying the TAG system, I have about 23g to cover for protein. WOW !! That just blew me away.
The question is if you have the motivation and the ability to do what it takes to manage your diabetes type 2 without meds.
If you think you are capable of and have the time to walk for 40 minutes three times a day, then you are in a good position to manage your type 2.
You will also need to follow dietary programs, the best being the low GI diet,.