Hi everyone,
I'm type 1 and just heard of TAG today. It seems like a great idea. Can anyone explain the specifics of how to bolus using TAG, or point me to a discussion that does explain it?
Thanks very much!
Elizabeth
I am still new at it, and could be wrong about any of this (hope not!), so keep looking at the site...but so far what I am doing is working great for me, and here's how I understand it:
Obviously, the theory is you bolus to cover more than just the carb in foods. When I was on shots, my basal rate insulin (long-acting) had to cover the proteins and fats, and I used the short-acting to cover carbs and to make corrections. TAG bolusing is in my experience almost impossible to do unless you are on a pump, because protein and fat is digested more slowly than carbohydrate. An extended bolus, which is possible on a pump, in contrast offers an effective and safe way to cover the TAG in all food, allowing more flexibility in your diet and more accuracy in your bolusing. I tried covering protein, per Dr Bernstein's suggested formula (about half the insulin necessary to cover each ounce of protein as compared to each ounce of carbohydrate) when I was on multiple injections, but it was a roller coaster ride. I went back to just trying to eat the exact amount of protein every day at the same time, until I got on the pump.
So, on the pump, instead of just bolusing to cover carbs, I bolus to cover protein (at a lower rate, apparently people are saying it should be 58%, but I use 50% with success); and also to cover fats, at the lower rate of 10%. For example, for 1 T of fat, assuming it's about 12g, I bolus what I would for 1.2g of carbohydrate. Make sense? and for 1 ounce of protein, I bolus 50% of what I would for 1 ounce of carbohydrate.
I am still working on how long to extend the bolus, but in general I am finding 3-4 hours works for me for fat and protein together. I eat fat at each meal as part of adhering to Dr Bernstein's Diabetes Diet Solution recommendations.
I hope this helps. I use Apidra in my pump, and my carb factor is 1 unit for every 10 carbs. I take a total (bolus and basal) of about 22U of Apidra each day. I have been Type 1 for 32 years, on OmniPod since January 2013.