How to bolus for apple pie?

[GuitarManDave]

Hi -

I'm currently using the Novolog pen but I'll be "getting pumped" next Tuesday on a minimed 522.

Last night at a celebration I had apple pie and a little ice cream for dessert. I calculated the carbs and bolused accordingly and my 2-hour bg at 8:30pm was actually low (74) - I guess I overcompensated. However this morning my fasting bg was high at 133. Normally my fasting bg is 95-110 so this was quite a big change.

I'm guessing what happened is that the fat in the ice cream and pie crust slowed down the absorption which accounts for the 2-hour 74 and that my bg spiked later while I slept. Add the dawn effect and bingo I hit 133.

My question is - how would you bolus on the pump to handle this situation? I'm guessing a dual wave would be the right choice but what kind of ratio? And how long do I spread it out?

Bear in mind that I don't currently require basal insulin so that isn't a factor. I just need to understand how to bolus for a high fat/high carb meal regardless of when I eat it.

Thanks!
Dave

[morrisma]

Dual wave is the answer and the ratio depends on the amount of fat in the food. You will need to test foods to see how they affect you in particular.

A guess: I would have probably done 60% right away and 40% over an hour. YMMV - in fact it certainly will.

Good luck with the pump, I love mine.
Mike

[johgn]

I agree, experiment with the dual wave and test during hours 2-4 of the digestion process.

[xMenace]

You're spot on IMO.

This is something I need to work at too. My wife makes a killer apple pie, and it behaves similarly. I think next time I will have only pie for a meal and then test every hour for as much as 6 or 8 hours. You should have something to compare it to. Do you know if your fasting numbers stay flat? I assume so as you sound like you are honeymooning. You could run the same test with a simple whole wheat bread meal. Also guestimating the carbs is **** near impossible to do accurately.

[iDream]

Yeah, to me a 74 2 hour is perfect man.....I wouldn't stress the 133 morning either.

[Alice]

You could have easily been 133 the morning after without the pie...I don't think I would worry about it too much. Your two hour point was pretty good.