[Eddy]

Forking a thread so as not to hijack it...

Originally Posted by xMenace

I haven't read through all your posts, but are the R & N part of your boluses more accurately described as basal, to address gaps?

No. I did that with Lantus, requiring N to cover gaps. It was a royal pain, as it required eating at specific times. Now, my 0630, 1530, and 2030 shots are entirely decoupled from meals.

Originally Posted by xMenace

Or are they intricately designed to cover complex meals? It's an intriguing way to dual wave.

Yes, "dual-wave" or "square-wave" boluses for complex meals... even individual foods. Insulin activity length in me (sub-Q):

1h:15m aspart
2h:00m human R
6h:00m human N

I mix based on how much insulin I want how soon.

Kashi cookies? Straight R.

My pancakes? Between 30% and 40% aspart with the remainder R, depending how much agave syrup I use.

Tinkyada rice noodles cooked al dente with EVOO and pesto flavoring (i.e., no marinara or alfredo)? 1:2:9 aspart:human-R:human-N.

Dates? Straight aspart about ten minutes after eating.

Bananas or raisins? Pre-bolus using aspart and wait 15-20 minutes. (I'll have to try IMs...)

When I make tangy wild rice -- which contains raisins, agave syrup, and balsamic vinegar -- I use separate aspart and human-N shots. Sometimes I want the aspart/human to blend with and "share" the isophane; for that dish, I do not.

With really large meals, my basal requirements increase for a spell afterward, and my insulin need is elevated well after digestion is through. Thus, when I'm being a pig, I do this:

Levemir bolus (deliberate!)

[xMenace]

I'd be very hesitant to try N as a bolus. It lasts too long for me. I've never had the need.

With really large meals, my basal requirements increase for a spell afterward,

Interesting theory, but it's likely fat and protein at work.

............

I suspect your N and Levemir levels are so low that they get used up long before the charts say they should. I believe those charts are optimized for a daily dosage level. Smaller doses will last for shorter periods.

............

This is cool stuff, but beware of some old lady swinging a chicken over your head. There's not much room for error in your regimen.

[Eddy]

Originally Posted by xMenace

I'd be very hesitant to try N as a bolus. It lasts too long for me. I've never had the need.

Well... considering how quickly aspart, human R, and lispro clear... yeah, rapid human N clearance is par for the course.

Originally Posted by xMenace

Interesting theory, but it's likely fat and protein at work.

Perhaps to a certain extent. However, I've tried eating large quantities of fat and protein, with lower carbohydrate... and not observed the same magnitude of insulin need.

Needs further study? Probably. But I doubt it's exclusively latent fat/protein effects. Even if it is... at least I know how to handle it. I'm still interested in the underlying mechanism, though.

Originally Posted by xMenace

I suspect your N and Levemir levels are so low that they get used up long before the charts say they should. I believe those charts are optimized for a daily dosage level. Smaller doses will last for shorter periods.

N, probably. Levemir? I'm not that low of a dose. Lantus didn't last, either, when I was doing 32-ish U/day in a single shot.

Originally Posted by xMenace

This is cool stuff, but beware of some old lady swinging a chicken over your head. There's not much room for error in your regimen.

(Old lady swinging a chicken over my head? )

Interestingly, control is easier than Lantus ever was.

[xMenace]

Originally Posted by Eddy

Perhaps to a certain extent. However, I've tried eating large quantities of fat and protein, with lower carbohydrate... and not observed the same magnitude of insulin need.

Needs further study? Probably. But I doubt it's exclusively latent fat/protein effects. Even if it is... at least I know how to handle it. I'm still interested in the underlying mechanism, though.

You've accounted for your shifting basal rates? You have to have them as Lantus alone doesn't work. My I:Cs follow my basals almost perfectly. Changing sensitivity is easily overlooked when assessing behavior.

I too experience effects my endo can't explain. I think I'd believe just about any repeatable behavior.

(Old lady swinging a chicken over my head? )

Ask Owlyn

There are times when things just don't work as you expect. It's as good an explanation as any.

Unfortunately, those times tend to show up with no warning. And they can slam you pretty hard.

Interestingly, control is easier than Lantus ever was.

The bottom line.