How do people using Humalog/Novalog handle high protein/high fat meals? Novalog keeps my numbers good for the first 3 hours or so but then I spike, I am guessing it’s because after 3 hours most of the Novalog has been used up and the meal hasn’t fully digested. Then I spend the next 2 hours taking multiple injections to get it down and it’s starting to irritate the hell out of me. Never had this problem when I was using R. Does anyone else experience this?
My guess without seeing actual numbers is the ratio of carbs to high protein/high fats. Can you cut a few of those meal carbs in 1/2 (while on high fats) and see to what extend that solves this issue? Protein converts to energy after carbohydrates so taking High Protein and High Carbohydrates out of the equation should give you pretty good insight for future adjustments.
Why not use Regular for slow digesting, and Novolog for others.
Or switch to pump, with novolog, where many options are available to match up with various meals.
There is no reason to give up R. You can learn to combine small amounts of it with Novolog through trial and error for exactly the problem you are describing.
I split it into a couple different doses on mdi… there’s always some guess work involved but you can get the hang of it
On a pump, I run a 110 to 115 pct temp rate for 4 to 5 hours in addition to my regular bolus
I agree with El_Ver.
You can also use ‘total available glucose’ TAG for dose and splitting, if it’s a regular thing like low carb.
The bolus will vary per individual, but it’s basically a percent of your I:C
carbs 100% per G
protein 50% per G
fats 10% per G
I get similar result with extended bolus, and then reflects as bolus in data. Will cancel if BG starts dropping too fast.
@El_Ver I often boost basal, as well as doing extended bolus.
Just to clarify, on my Animas pump basal @ 110% = 2.1 x normal rate. Is this what you’re running on yours (a little more than double the regular rate)?
@Jimi63 2.1 x normal rate would be a temp basal of 210 pct on my Tandem. I rarely unless sick go past a 50 pct increase in basal rates (1.5 x normal).