Pasta bolus help

How would I bolus for pasta? Seems like it doesn’t raise BG until 5 hours after consuming. If we bolus for it when we eat it, a big low happens. So if we have pasta for dinner, I see the spike happen around 2 am. I can’t see how using an extended bolus would help. The only solution is to get up at the 5 hour post-prandial and correct. Suggestions? Pasta isn’t something we eat all the time, but sometimes we just want it. I know everyone’s different…but the 5 hour spike happens every time.

As a substitute for pasta, have you tried the low carb noodles? Really, if you eat pasta you are only supposed to have half a cup, so I choose not to eat pasta or rice dishes.

Are you sure it’s the pasta that causes the 2:00 a.m. spike? Are you eating any fat or protein with the pasta?

Nope. Absolutely certain no fat or protein. Happens every time with pasta for the last 5 years. We don’t eat it often, but sometime we just want it, or we are invited somewhere and that’s what they are having.

Hi sweetmom, I think you have the solution in your topic. That is what I would suggest, and what I do when I eat a big plate of spaghetti. Ours is without meat but I will tell you that there is some protein in pasta, just so ya know.

One solution is to just consider it a lunch food…I only eat pasta, steak, BQ, pizza, and foods that cause what I call slow long lasting High BG for lunch or breakfast. If you don’t want to deal with it in the middle of the night just don’t eat it,
or consider it breakfast or lunch food.

Some foods are just not night time friendly foods.

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Ya I know…but it’s not an extreme amount. So do you bolus upfront at all? I guess I’m wondering if I should not bolus for the past at all until 5hr mark. Maybe give a little upfront? What do you do?

I bolus before the meal, and then do a correction if necessary. If I happen to know about a pasta meal before hand, I often will add some steps to my workout to increase my metabolism or even walk after the meal if that can work.

I think it’s just something you need to trial and error. Caleb would be about 40% upfront and the rest over an eight hour period - it just releases and releases and releases. But we’ve also chosen to use alternative pastas - tinkyada and ronzoni gluten free - which for Caleb, have no delay and we just bolus up front.

I actually think I’ll try the 40% upfront and extend the rest for 8 hrs. Seems crazy long…but pasta just digests so dang slow! I’ll try that.

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Are you on a pump? I assume from your last post that you are. I also consistently experienced the 4-5 hour rise post-pasta, particularly if I was eating a late dinner. I now routinely use a combo bolus with around 50% upfront and the remainder extended over 2 hours. You are going to have to work out the exact details yourself by trial and error. However, I would be surprised if you need to extend by 8 hours. For Humalog or Novorapid (Novolog) the duration of insulin action is at least 5 hours. You therefore need to add 5 hours onto the time you extended to work out the extent of insulin action.

Pasta (and other low GI meals e.g. pizza) seem daunting at first and require a lot of effort to figure out the extended bolus split and timing. However, once you get it figured out it will work consistently. Paradoxically I now find these “difficult” foods easier to deal with than some of the higher GI stuff (like a lunchtime sandwich or a dessert) where the insulin simply isn’t fast enough to deal with the spike.

Joel

Pasta, pizza, chinese - all these foods require an 8 hour extension for Caleb.

You could try setting a temp basil just before you go to bed, even after initial carb bolus when eating, stretch that out for 3 hours (or closer to 2am as you said.)

i experience the exact same thing when i try and eat any simple carbs. english muffin, oatmeal, pasta, etc.

because of my CGM, i have been able to track my BGs over the period of time in which i spike and/or go low. usually, my BGs drop after my bolus, and then go up after about 2 hours until over 200. my cgm has helped me tremendously to track this trend. my CDE suggested i try a dual bolus based on at what time i start to spike. yesterday, i tried a 70/30 % split over a 1 1/2 hour period. it almost worked. today i am going to try a 60/40% split over a 2 hour period.

my suggestion is this: try out the dual bolus; experiment. especially if you rarely eat pasta, at least you will know how to handle it when its whats on your plate.

good luck.

i have incredible challenges w/ starchy food like pasta. i have found that even eating something so benign as an english muffin is quite the challenge. what i recently have done, over a months period of time, is experiment w/ the dual bolus feature on the pump (is your child on the pump?) my final successful solution was doing a dual bolus of 50% up front and 50% over 2.5 hours which covers 4 hours of mini boluses, which keeps me steady; not lows, no spikes, just a relatively successful BG. have you tried this yet?