My son had a cup of pasta and 1/2 a cup of broccoli for dinner tonight. He was at 133 before he ate. We gave him 40carbs for the pasta and 10 for the broccoli. About an hour later he dropped to 23! It is not often that he eats pasta but it seems that every time he drops. Does this happen to anyone else? Any ideas? His carb ratio is 15:1
Pasta can take a lonnng time to get into the system. If I don’t do an extended bolus, my insulin gets ahead of the pasta and I go low.
Also, 10 grams of carb sounds a bit high for that much broccoli …
How was his BG at 2 hours? Sounds like his bolus hit before the food. Timing is just as hard to get right as dose. Agree with Heather about the broccoli. 1/2 cup is 2-3 carbs.
If his bl is normal before eating I would sugest that he gets a bolous after eating and count the broc as a free food
Only thing I count as a free food, other than glucose for corrections, is water:) Best to dose based on before meal reading & the meal.
I am not a huge fan of the extended boluses as I’m never quite sure what to do with them but I have noticed that it looks like pasta can take 4 hours to hit sometimes! I usually avoid it but had some hair-raising adventures due to a recent pasta “fail” and will certainly lobby to avoid it for a while. I agree the counting might be a bit odd, although this is another reason I am not a big pasta fan, since the box invariably has some type of useless measurement of what a “serving” is so it’s a total crapshoot. I would think that the 40 for the whole kit and kaboodle might have worked and, maybe next time try like a 2 hour extended bolus?
A careful extended bolus is the only way I can eat pasta. The pasta takes a long time to get into your system, so a traditional insulin bolus starts working long before you need it to. Back in the day of regular insulin, I had fewer issues with highs after eating pasta because regular insulin lasted longer in my system. Now, I do an extended bolus and check frequently if I eat something like pasta. But, to be honest, I really just try to avoid pasta because it’s always more hassle than it’s worth.
On a side note - I have found that Dreamfields pasta decreases the glucocoaster. Doesn’t eliminate it entirely, but makes it less dramatic.
counting green vegetables is a YMMV thing. I was taught not to, don’t and would get into trouble if I did. But as I eat large amounts of green vegetables as part of both lunch and dinner, I assume that they are built into my carb ratio.
Maurie
What type of pasta is that? Is that something I can get at a regular store or health food one?
In my area you can get Dreamfield’s at Safeway Stores. But do test ongoing if you try it. Some of us are able to eat Dreamfield’s successfully and others of us it spikes us but does so at 3-5 hour mark rather than 2. For me I found I could only successfully eat 1/2 cup of it which is no more than regular pasta, so why bother? It also affects bowel movements as the idea is that much of it isn’t digested. That’s getting too weird for this diabetic.
Bottom line is I only order pasta if I’m dragged to a restaurant where that’s all available for me to eat (I’m a vegetarian) and sometimes it works and sometimes not.
after two juices and a candy he went up to 91, an hour later shot back down to 55, then had a Greek yogurt with honey and some agave nectar. At the 3 hour mark he was at 111, with no active insulin. About 5 hours later he was at 202, gave a correction. At 3am, 9 hours later, he was at 267!!! Crazy, lesson learned, no pasta or extended bolus.
Why were you told not to? Never heard of this before or food being built into a carb ratio. I was told to count every carb.
As the OP was having problems with her son crashing early, I don’t think Dreamfields which tends to digest more slowly is going to help solve her problem.
Maurie
I was told not to bother to count up to 3 “portions” (1.5 cups) of green vegetables when calculating carbs at the DOIT program at the Joslin. When I asked if I had to count if I ate more than that the RD thought a bit and said something like “No - it’s mostly fiber anyway and you need something free”. The DOIT program teaches to back out 100% of fiber.
Unless you do TAG and weigh everything you are including protein and fat as overhead in your carb ratio anyway. When I eat a veggie burger on a small sandwich round with green beans and have an apple and a square of 70% chocolate for dessert, I’ll dose for the burger (10), roll (15), apple (20), chocolate (2) at a ratio of 1:11 or 4.3 units of Humalog. I know from experience that the dose will keep me in what I consider an acceptable range most of the time. It doesn’t matter if I add 5 grams of carb for the beans and use a ratio of 1:12, I’m still taking the same amount of insulin. As I eat a fairly stable diet and almost always include large amounts of green vegetables with dinner, the ratio ignoring the green vegetables works. On the other hand, I don’t eyeball anything if I can help it and take a gram scale with me to friends’ houses and restaurants.
Maurie
Interesting. Works with consistent meals like yours. Wish we were taught about bolusing for protein.
Agree. I had huge spikes 5 hours after eating Dreamfields. Ate it once, tossed it in the trash.
I’ve changed out pasta to Quinoa pasta which digests well, but does cause her to drop. Therefore, we have figured it out for her and she will get 20 extra grams of the Quinoa pasta without being bolused for it, so, one and-a-half cups of pasta for 40 grams (even though it is listed at slightly more than 60 grams) and we always give it with something high glycemic such fruit or a slice of bread and milk. We also will not give her pasta if she is going out afterwards; it’s for dinner when she is staying at home. So she gets a nice sized dish of pasta. I never give pizza or anything similar without fruit, or something similar because insulin does not match digestion of all foods and regular pasta will drop her low, then she will be high digesting that pasta for four hours at least. Hence, the switch to the Quinoa pasta which digests right away.