I was diagnosed with Type 2 a little over 11 years ago and found out two weeks ago that I’m actually a Type 1. I haven’t seen the endo yet but presume I have LADA. I see him next week and hope to learn more. On the day I see him I also see a CDE for the first time.
I’ve used insulin off and on for about eight of those 11 years and am okay with that but haven’t been very faithful about it. I kept trying to exercise and low carb my way back to beautiful BG (it worked before, surely it will work again, right? WRONG!) and now I know why I wasn’t successful.
Anyway, for a few weeks I’ve been ‘playing’ with my rapid acting insulin, taking smaller amounts of Novolog right before a meal then taking a little more an hour to two hours later to help with the perpetual high post prandial readings that I get despite eating a low carb meal. Someone on FB suggested I look into TAG and voila, here I am!
It’s nice to know that what I’ve been attempting has a name (other than perhaps ‘dangerous’) but it’s been a crap shoot for me. I’ve been going on gut instinct and although there have been a couple of mishaps it’s actually gone fairly well. I have Math issues, though, and am really lost on how to figure out how much to shoot and when and hopefully more reading here will give me some insight.
I’m glad I found this forum and some experienced folks. 
Thanks for being here!
Denise
Hi CookinsForMe,
Trying to do TAG with MDI is going to be more of a challenge than using the pump, but I am sure it is possible.
From your description, it sounds like you are getting a BG rise due to protein and fat. Trying to determine the length of time between when you ate your meal and when you note a secondary BG rise due to the effects of protein and fat, as well as the duration of the secondary rise, would be a good starting point. You could consider starting your second Novolog near this point in time.
One problem you could anticipate is the length of time the secondary BG rise lasts. If you ate something like pizza, which may give you a rise for 4 – 8 hours after the meal, you would probably need a different bolus technique than if the secondary BG rise only lasted a couple of hours. With a pump, I can lower the rate of delivery and extend the delivery duration for a pizza bolus. This prevents me from having early hypos during the TAG session. With the pizza bolus and MDI, you may have to consider smaller and more than one secondary bolus to prevent hypos during your metabolism of the meal.
Math issues don’t have to be an obstacle if you keep good notes of your experiences and make adjustments as needed. Also, there are others in this group that probably can share their experiences with TAG and MDI.
Thanks for the input, Ricardo. I eat low carb most of the time so yeah, I think it’s the fat/protein that are getting me. I’ve been trying to pinpoint that secondary rise time and it seems to really vary but I’m still plugging away at it! I’ve kept meticulous records and will continue that, hoping to see patterns emerge. Thanks again.
