Bagels- combo blus?

colleen · #1 (**permalink**) 06-27-2008, 12:33 PM

Does anyone on the pump know if a bagel with cream cheese is better dealt with using a combnation bolus b/c the high carb count plus the fat from teh cream cheese?
I never see a bagel listed as an example combo-bolus food, but whenever I eat one (even those in a package with a carb count on the nutrition label) my BG is high (200-300) later.

Penny · #2 (**permalink**) 06-27-2008, 12:51 PM

Years ago, a DE told me to have a bagel and cream for beakfast, as it was perfect for a Diabetic. She didn't tell me what to do about the high I got from it! When I figured it out, I cut bagels out of my diet. I use cream cheese with celery for a snack, and it does nothing to my BS, I do not even use any Novolog for it.

Eddy · #3 (**permalink**) 06-27-2008, 02:02 PM

How much later is your spike? What sort of bagel?

I find that cream cheese is higher-glycemic than whole-grain bagels. i.e., I use faster-acting insulin for the cheese than the bread.

Others have reported significant BG spikes due to fat/protein being converted to glucose. I've not really observed this, so I'll refrain from commenting... other than to say "see what happens if you have a nice, big chunk of CHO-free cheese".

Gary_W · #4 (**permalink**) 06-27-2008, 03:48 PM

Bagels have a very high glycemic index (at least the ones I've had over this side of the pond do) and (due to being very dense and heavy) have an awful lot of carbs for their size relative to other breads. So they are a double whammy. Couple this with the fact that I like them for breakfast (always the most difficult meal of the day due to DP etc) and you're up to 3 strikes.

Cream cheese or not, I certainly wouldn't combo bolus for a bagal; it is such a formidable beast that I don't think the cream cheese would touch it. If anything, I'd consider a super bolus to help with the spike. I've only been pumping for a 2 1/2 months and I've not had a bagal in that time.

Gary

Subby · #5 (**permalink**) 06-28-2008, 09:20 AM

I too found bagels a real problem food, very carby and high GI, some years ago, and have mainly avoided them since. Haven't had one since pumping.

But - If you are on the pump, Colleen, there will probably be a way to deal with it. I don't know these combo bolus lists you speak of, but I wouldn't treat them anything like bible, people can be so varied in their insulin and food response. The answer is to collect info on your own response, and then modify your bolus based on that.

So, to profile what a bagel does for colleen. Here's something that would fit the bill... next time, take a normal bolus, test right before, then 1 hour after, then 2, then 4.

The 1 hour might inform you if it's outshooting your insulin action straight up, in which case a general rethink of bagels as an appropriate food for you, is in order. (Or, start looking at significant pre-bolusing so your insulin is firing right up as the bagel hits, if that is an option for you).

The 2 hour likewise, but it'll give a better indication if the spike is dealt with in the good fight, or if you get resistance kicking in due to the spike. This would be borne out by your insulin not being as "effective" in the medium-long run, and leaving you higher.

The 4 or 3 hour, for same reasons, and to see if the fat content of your meal might be extending the carb action. As well as the cheese I assume bagels can vary a bit between makers on fat content too, watch that, and stick to low-fat and carb-accounted for.

As Eddy said split the food up and see what happens, and if you feel the cream cheese is a problem you can't deal with in the end even with a combo, what about low-fat cream cheese?

Hey, I just read over that and realised it could all be a bit much if you want easy answers. You know you also could just go ahead with a combo bolus and see what happens!