I've done a few searches of the forums but haven't found anything on point, so am turning to you guys for advice on meal dosing (MDI) given a specific situation.
I'll be observing a landmark birthday with my three best buddies at Maggianno's. Most of the menu items I've chosen are reasonably low-carb -- Caesar salad, sausage and peppers, salmon, and chicken -- but one entree I won't pass up is the linguine with white clam sauce (which will be consumed with relative moderation). Cheesecake is also on my radar, although probably just a half-slice. The meal will probably extend over a couple of hours.
An equivalent scenario would be a holiday dinner (i.e., Thanksgiving or Christmas), where food is available and consumed all day long. Last year's holidays were my first as a T1, and I recall dosing for the initial serving; an hour or so later I ate again, dosing for that helping. I don't remember that there was any stacking effect.
The question is whether the entirety of the calculated dose should be administered at the beginning of the meal, or sporadically throughout since smaller doses absorb faster?
WHen I was on injections, and had a spread out meal such as Thanksgiving, or a multi course meal at a resturaunt, I would inject separately for each course I ate - I do not believe it is considered insulin stacking when you are injecting to cover carbs. I always though stacking was when you dosed insulin for corrections, without letting the insulin board do it’s job - or rage bolusing. Therefore - if I dosed for everything I though I was giong to eat in the beginning, and then didn’t feel like eating it all, I wouldn’t have to eat to just to match the insulin I injected. Also, some of these meals are spread out so much, that the total insulin dose would be ahead of any food I ate, making me go low.
Now that I pump, I do the same thing - multiple small boluses for each course I eat. I don’t want to be locked into eating to match insulin, so I just bolus as I go.
Jennifer, thanks for the input. I’ve tried the bolus-on-the-fly method with other extended meals, with mixed results (with the biggest failure being Chinese food). Other times it works great! Clearly, I don’t know enough about stacking, so you’re probably right about its relationship to corrections.
For meals like this, I inject as I go along making sure there’s an hour between shots. With small doses I haven’t had any problems with stacking.
I don’t think many people have luck with Chinese food. I didn’t have luck even trying it for the first time pumping and even dual wave bolused for it. Actually epic fail. Two hour PP of 297 - the highest number for me post diagnosis. Took 4 hours to come down that day and yes, rage bolusing occurred.
Heh… I have to stop myself from chortling out loud when I think of the irony of not being able to eat rice!
“an hour between shots” is exactly the sort of guideline I was looking for.
I have rice a lot. A serving size of boil in bag rice is 33 carbs. I have it often with dinner.
Not fair. Chortle loudly, Muragaki.