Bolus Corrections....

[Stuboy]

Ok, So tonight i miss judged my chinese take out carbs. i guessed at around 100, which i now know was very low, and bolused 5units, i checked my bg 2 hours after my meal and it jumped from 4.9 (before meal) to 13.3!!! Dissapointed... i bolused another 3 units in an attempt to bring it down, checked an hour later and it had gone UP to 15.1!!

What the?? Please help, very confused!!

Bolus is Novorapid.

[Stumpkins]

This happens to me ALL THE TIME. If I go to the gym, I take off my pump, and let my sugar get up to like 200...

Get back from the gym, sugar is always around 75 -- 1 hr. later, it's up to 250..take correction...300...take ANOTHER correction, and I'm good!

[spike]

Ok, So tonight i miss judged my chinese take out carbs. i guessed at around 100, which i now know was very low, and bolused 5units, i checked my bg 2 hours after my meal and it jumped from 4.9 (before meal) to 13.3!!! Dissapointed... i bolused another 3 units in an attempt to bring it down, checked an hour later and it had gone UP to 15.1!!

What the?? Please help, very confused!!

Bolus is Novorapid.


this is what happens, Stu! I had an In & Out burger and a few potao chips. My bg was on target, I bolused 5U, ate and figured I'd be ok. Just a second ago, I've taken my 12th Unit--I'm now over 225.. Other days I can take 5-6 units with the same burger and be fine... go figure.

[rzrbks]

It depends on the different types of foods you had. The more protein and fat, the longer it takes your body to incorporate the food and longer you have to check yourself.

What you talk about is the very reason some people have just taken certain foods off their acceptable list.

I don't eat potato chips/crisps or French Fries any more, I just cannot figure out how to bolus for them.

For Chinese, I bolu at 1:10, then check at 1 1/2 hours, knowing that I'll have to bolus again, and every once in a while I have to bolus a third time.


This is part of the Interesting Charm of Diabetes. You'll have to figure out the bolus ratio for different foods for YOUR body/system.

[spike]

I don't eat potato chips/crisps or French Fries any more, I just cannot figure out how to bolus for them.



.


You'll need a combo bolus to cover fries. don't think too many people can get adequate control with a normal bolus when eating fries. U ever tried?

[Emm]

Ah the pleasure & pain of junk food!

I find chinese *very* hard to bolus for - pizza too. All take-out foods affect me horribly but they're the worst (of course, because they're my favourites - you bastard, Murphy!!)

I can't say I have it sussed, but I'm getting there. What I do now is inject just a couple of units before eating - I mean 20 - 30 minutes before, so that my blood sugar is already dropping by the time I eat. Then I jab the 'usual' 3 - 4 units for the meal as I start eating, and I'll still need a 'top-up' jab about an hour & a half later, another 2 or so units.

So, all in all, to cover a junkie food meal, I have twice the usual amount of insulin than I'd usually have for most high carb meals, and 3 jabs over the space of a few hours.

I'm really not sure it's worth it! But at least it's a step forward in discovering what I can & can't do. As far as I'm concerned, I want to avoid anything that'll cause me damage. If I can find away around the damaging stuff, then I'm happy :D After all, a gal's gotta have her treats :)

[DeusXM]

So tonight i miss judged my chinese take out carbs

There's your answer. I usually triple my insulin dose for Chinese - for a variety of reasons, they'll rocket your sugar and just keep pumping the stuff into your blood. Don't worry, it happens to 'normal' people too - I've seen a LOT of people get a bit hyperactive after eating Chinese food, because it's causing their BG to rocket up too, although they're quicker at bringing it down again than we are.

Don't beat yourself up about it - just think how much worse you'd have been on Mixtard in this situation.

[Cyborg]

Chinese food is hard to bolus for... I usually guess about 100g for Chinese (depending on what I eat), but I do have my insulin to carb ratio pretty fine tuned. I also take Symlin whenever possible if eating over 30g of carbs.

One of the ways I found easiest to fine tune that ratio is to eat pre-packaged meals that do not have a lot of protein or fat. An accurate carb count can help you nail down the insulin to carb ratio, which may be different at different parts of the day. The closer you get to the correct ratio, the more carbs you can eat without skyrocketing.

Then there is also the trick of taking your insulin about 10-20 minutes before you eat. That can help with the post meal bg spikes.

[BlueSky]

..... i checked my bg 2 hours after my meal and it jumped from 4.9 (before meal) to 13.3!!! Dissapointed... i bolused another 3 units in an attempt to bring it down, checked an hour later and it had gone UP to 15.1!! ....

Bear in mind that you become more insulin resistant as your BG rises. Something to do with insulin receptors shutting down to protect cells from excess glucose. Which means that you have to load your correction bolus. And the higher your BG is, the bigger the loading needs to be.

I need to load correction boluses as soon as my BG goes over 10. And if it goes over 15, I have great difficulty getting my BG down again. Several overlapping corrections later, the BG plummets. So I have to watch the BG level very carefully.

My decision to keep away from the carbs that cause these extreme post-prandial hyperglycemic excursions has simplified my life enormously. The best part is that, after breaking the carb addiction, I don't miss them anymore. :)

[Cyborg]

Bear in mind that you become more insulin resistant as your BG rises. Something to do with insulin receptors shutting down to protect cells from excess glucose. Which means that you have to load your correction bolus. And the higher your BG is, the bigger the loading needs to be.


One of the features that I look forward to in some of the up and coming pumps is the ability to have a correction factor based on current bg...

[kgm0612]

Any time I eat Chinese, Pizza, or foods high in fat or protein, I use the Dual Wave feature on the pump. I give half the amount upfront and the other half over 3 or 4 hours.

Karen

[It Ain't Over]

Any time I eat Chinese, Pizza, or foods high in fat or protein, I use the Dual Wave feature on the pump. I give half the amount upfront and the other half over 3 or 4 hours.

Karen

Same here, and I add about 35% more per carb even then. I do notice that the 3-4 hours are about right with Chinese. Pizza is tougher to evaluate. Seems it is even more unpredictable and can raise the sugar levels for a very long time after eating. Best to check every hour after eating pizza, or better yet, order something else.

[Tokyo Cate]

I had a Chinese food blood sugar disaster last night, too. It is just too difficult to get the right amount of insulin to cover Chinese food without correcting. Good thing I am not so crazy about Chinese food.

[Stuboy]

what about chinese diabetics... how do they cope!?

[It Ain't Over]

what about chinese diabetics... how do they cope!?

I would hope they don't have the same diet we see coming from Chinese restaraunts.

[Stuboy]

that's true, but i was thinkin perhaps that if any members on here are chinese, they could enlighten us as to how many carbs are likely to be in the food we do get from take outs... ?

[Cyborg]

I would hope they don't have the same diet we see coming from Chinese restaraunts.

They don't from what I understand. They tend to eat real Chinese food with more rice and vegetables. I had a good friend that lived in Tiawan.

[poobear]

what about chinese diabetics... how do they cope!? ROFL, no kidding. I can't imagine how they cope with all the rice they eat. I have friends that have rice three-four times a day every day.
Anyway, thanks for the giggle. I know it was a serious question, but all the same, it made me laugh.

I'm a type 2, newly on insulin, so if you don't mind, I'm going to hang around you guys a bit a try to learn from you. :) :)

[seacomp]

what about chinese diabetics... how do they cope!?
We recently had a post from a new member asking the same thing, she is Chinese.

[LiveNormal]

that's true, but i was thinkin perhaps that if any members on here are chinese, they could enlighten us as to how many carbs are likely to be in the food we do get from take outs... ?

Hi, I hope I can help some of you with eating Chinese food.

To be able to control it, you need to understand the Chinese food are made out of.

Let me try to define what is in there in the typical Chinese food that you will order and in how many ways they can be prepared that will affect us the most.

Main dish:
1. Plain cooked rice (15g carb for 1/3 bowl of rice, a bowl is about 1.5 cup). Again white rice will have higher GI than brown rice but the carb content should be the same
2. Dumplings, the kind with meat stuffed inside (need to watch out the thinkness of the skin). I usually count 3~4 dumplings skin as 15g carb. Remember, rice and flour are about the same thing. If you were to mash the skin of the dumplings and find that 5 of such skin will fill the 1/3 bowl, then that is about 15g carb
3. Fried rice. The carb content is the same with the white rice but need to be very careful in asking the chef to prepare it with less oil. This may not sound possible for a take out, but if they do take special order than that is great

Other dishes:
1. sweet and sour pork ribs. In this dish, you need to watch out the level of sweetness and the level of stickiness of the gravy. They use corn flour to make this gravy. Plus, the pork rib is always coated with a layer of flour for deep fried first. So you need to take that into account also. I normally avoided this disk unless it is my super good day (meaning no PMS, good BG before meal), which I will try in moderation (about 3 pieces and accounting that for 15g carb)
2. For vegetables, I like it stir fried too. But I will ask them to prepare in less oil. You can ask for “BaiZhuo” which mean they will boil the vege add season it with some soya sauce. Again, make sure they are not pouring sticky gravy over it

Soup:
1. Unless they are clear soup (meaning watery), if not, the sticky gravy in them will definitely kill me instantly. I will bolus same amount of insulin to cover 15g carb for 1/3 bowl.


Preparation types:
1. Steam. I like it best since there will not be any added oil
2. Fried. They tends to be oily and the food is normally coated with flour. So I normally avoid.
3. Stir fry. Ask for less oil
4. Braised. Need to watch out on the gravy see if they are sticky.

Desert:
1. They are typically made out of flour, rice cake. Don’t be deceived when they told you that they are saltish. Many times, there are added sugar and it is just that the amount of salt outweighs the amount of sugar, so they just call them saltish.

When I dine in Chinese restaurant, I go by the above rule. Very often, as I know how the dishes are prepared, I will double check with them and make sure they eliminate or use in moderation those ingredients that are not so diabetic friendly. Besides going less oily, I almost always ask them to eliminate msg totally. Eating food with msg always makes me feel thirsty even a few hours later.

Another point is that I am using regular insulin for my bolus. The longer effect of it seems to be a plus point for me when come to eating Chinese food. I guess you pumpers can do the same in the combo bolus mode for this. Exactly how, you will need to do some experiments on it. Also, I eat them slowly and eat them in moderation amount. To date, the most rice that I have eaten in a meal is about ½ a bowl. Another point is that the flour, corn starch and white rice all have higher GI than whole wheat toast, so I always eat them 20~30 min before my insulin will work the hardest.

Maybe you can let me know what kind of Chinese food you eat that makes your BG go whacky. I will try to find out the possible ingredients used and what you need to watch out for in that dish.

The above is just my personal experience. If there is something that I claimed wrongly, do feel free to correct me anytime.

[CycloneKitty]

Great reply there LiveNormal. I knew i needed to have double my usual dosage of insulin when i ate chinese food - and always wondered why it ran havok with me. Now I know. My usual chinese meal is sweet corn soup, maybe a couple of dim sims or mini spring rolls, the main meal is usually chicken with mixed vegetables ( i learnt to give up sweet n sour dishes), and sometimes a pineapple fritter ... not good i know ..... but i love chinese food. Oh - lets not forget the fried rice too. Yum!!!!

[LiveNormal]

My usual chinese meal is sweet corn soup, maybe a couple of dim sims or mini spring rolls, the main meal is usually chicken with mixed vegetables ( i learnt to give up sweet n sour dishes), and sometimes a pineapple fritter ... not good i know ..... but i love chinese food. Oh - lets not forget the fried rice too. Yum!!!!
As mentioned, if the soup is gluey with corn-starch, then you need to treat it like real carb, depending on the level of stickiness. I love dim sum too, especially the ChaSieuPau. I treat 1 small ChaSieuPau as 1 carb equiv. For other dim sum like SiewMai or meat roll with DouFu skin, I can often handle them without compensating with more insulin. Deep fried spring rolls can be very oily and I treat 2 mini rolls as 1 carb. equiv. I find myself quite able to take protein rich food without giving more insulin, unless they are deep fried and coated with a layer of flour.
Once in a while, I also indulge myself into the sweet and sour pork. Can't resist the hot sour and sweet taste of the chunky pineapple which give you that salivory sensation when given it a big bite, and also the crispy pork ribs hmm...so yummy.