[Eddy]

My usual spaghetti routine:

• 1 package Tinkyada whole-grain rice pasta (258 g net CHO)
• 1 jar Kroger pasta sauce (45 g net CHO)
• 1 pound ground buffalo
• "that looks about right" olive oil with the noodles

Cook meat. Add sauce. Set aside. Cook noodles with olive oil. Mix pasta and meat/sauce.

I'll eat it in three or four sittings, meaning 75g to 100g CHO per serving. My usual insulin mix for this dish:

• 20% rapid
• 20% R
• 60% N

I also seemed to need approximately 80% as much insulin as calculated. Yet I've had postprandial hyperglycemia the past few times I've made spaghetti, with the highest numbers at two hours postprandial.

After some experimentation, I've determined that the proper mix now is:

• 20% rapid
• 35% R
• 45% N

...and I need the full 100% of calculated.

What am I doing differently?

To give the spaghetti a little kick, I've started adding balsamic vinegar to the meat/sauce. I don't know exactly how much; probably between two tablespoons and a fourth of a cup. (The added CHO is negligible, so I don't worry.)

I now wonder if the vinegar catalyzed complex-CHO breakdown. It's very interesting that the change in preparation correlates with both increased insulin need and proportionately less NPH.

Hmmmm....

[Lizzie G]

Originally Posted by Eddy

My usual spaghetti routine:

• 1 package Tinkyada whole-grain rice pasta (258 g net CHO)
• 1 jar Kroger pasta sauce (45 g net CHO)
• 1 pound ground buffalo
• "that looks about right" olive oil with the noodles

Cook meat. Add sauce. Set aside. Cook noodles with olive oil. Mix pasta and meat/sauce.

I'll eat it in three or four sittings, meaning 75g to 100g CHO per serving. My usual insulin mix for this dish:

• 20% rapid
• 20% R
• 60% N

I also seemed to need approximately 80% as much insulin as calculated. Yet I've had postprandial hyperglycemia the past few times I've made spaghetti, with the highest numbers at two hours postprandial.

After some experimentation, I've determined that the proper mix now is:

• 20% rapid
• 35% R
• 45% N

...and I need the full 100% of calculated.

What am I doing differently?

To give the spaghetti a little kick, I've started adding balsamic vinegar to the meat/sauce. I don't know exactly how much; probably between two tablespoons and a fourth of a cup. (The added CHO is negligible, so I don't worry.)

I now wonder if the vinegar catalyzed complex-CHO breakdown. It's very interesting that the change in preparation correlates with both increased insulin need and proportionately less NPH.

Hmmmm....

Hi Eddy, just a guess based on very old and half forgotten knowledge of Chemistry (!). Balsamic Vinegar is pretty acidic (as well as very tasty in spaghetti sauce). As the various digestive organs tend to function in an acidic environment (and thus catalyse the various reactions by suppling H+ ions into the mix) I guess its plausible that the acidity of the food itself further promotes breakdown of carbs....but i am probably completely wrong so dont laugh too hard at me!

[Mich]

Hi Eddy,

I'm Thuthpithious about the sugar content of the balsamic.
My meter wouldn't test it. When balsamic vinegar dries, it's sticky.
When I eat a caprese (lots of balsamic) I have to take a little extra insulin.It's worth every extra extra tenth of a unit in taste!

Mich

[Eddy]

Originally Posted by Lizzie G

Hi Eddy, just a guess based on very old and half forgotten knowledge of Chemistry (!).

If you forget chemistry, you have an excuse. Once upon a time, I majored in it... so memory lapses make me look bad.

Originally Posted by Lizzie G

Balsamic Vinegar is pretty acidic (as well as very tasty in spaghetti sauce). As the various digestive organs tend to function in an acidic environment (and thus catalyse the various reactions by suppling H+ ions into the mix) I guess its plausible that the acidity of the food itself further promotes breakdown of carbs....but i am probably completely wrong so dont laugh too hard at me!

Well, if you're completely wrong, then that makes two of us. My thoughts were the exact same.

Interesting side note: Pre-DX, I noticed that I felt much better after eating acidic foods... which adds to my wondering how long I was undiagnosed. (I'd had the three polys for a while.)

I've used acid (vinegar, orange, lemon) when boiling poultry into broth. Yes, the acid definitely seems to help break down protein; I presume complex CHO is much the same.

I'm just surprised at how little vinegar apparently has a substantial effect on the spaghetti. When one is used to holding a ~25 mg/dL range after eating, and suddenly ends up 60-120 mg/dL off, it catches one's attention...

I hope it's the vinegar. I can't think of anything else that has changed... and I like my spaghetti, and the good postprandial BG numbers that I usually can turn in.

Mich, the bottle claims 2g CHO per tablespoon. Even if I used 1/4 cup (4 Tbsp.), that would be 8 g... which, for an otherwise-300 g batch, amounts to an error of less than 3%. If I could guesstimate portions and insulin dosing with such precision, I'd be very happy indeed.

[Eddy]

Broth. *smacks head*

I should have thought of something sooner...

A few days ago, I made some taco meat. Half buffalo, half turkey, and (you guessed it) some balsamic vinegar. The broth didn't have the normal taste, but rather was more like soup... like it had been cooked longer and broken down more.

I think I need a pH meter.

[BlueSky]

Originally Posted by Eddy

My usual insulin mix for this dish:

• 20% rapid
• 20% R
• 60% N

Eddy,

I am curious. Why are you injecting Novolin N before meals? I see you are using Levemir too. Isophane is an intermediate acting insulin and acts over 22 hours. Your stomach empties in 4 hours max. Below is an action profle chart for similar insulins to what you are using to cover meals. Wouldn't it be simpler to increase the levemir and drop the N from your boluses?

[Eddy]

Originally Posted by BlueSky

Isophane is an intermediate acting insulin and acts over 22 hours.

I've seen the charts... but... for whatever reason, NPH acts faster in me. Maybe it's [at least partly] because I use so little; I think that my record was something like 6U, when I had a gigantic 15U meal including lots of black beans. (My I:C ratio = 1U:15g)

The insulin menage a troi also means that some of the isophane interacts with the rapid... i.e., I end up with rapid, rapid+isophane, regular, regular+isophane.

I've done NPH at various times of day, various times relative to Lantus and Levemir. The activity does not change. I get the full effect within 5.5 hr. R = 2 hr. Rapid = 1.5 hr.

If I eat dates and inject Novolog at the same time, I'll go hypo 50-55 minutes post. Dates aren't exactly low-glycemic, either. (Well-chewed raisins, however, work faster than Novolog.)

Originally Posted by BlueSky

Your stomach empties in 4 hours max.

Yes, the stomach empties.. but how long do things take in the small intestines? Chyme is not instantly absorbed.

Originally Posted by BlueSky

Wouldn't it be simpler to increase the levemir and drop the N from your boluses?

Presently, I only use N for foods that require it. I recently went several days without, as I was eating foods that digested in 1-2 hours.

When I used Lantus, that was another story. I'd have notable drops a couple hours after injection... then begin creeping up 18 hours later. Lantus @ 1730, 1U extra NPH with breakfast, 2U extra NPH with lunch. The inflexible lunchtime (or need for a separate teeny supplemental basal) was annoying. the Lantus variability.

I set my evening basal to give me a 5-10 mg/dL drop overnight. Ideally, I go to bed in the low 90s, and awaken in the high 80s. BG declines linearly during the night.

I currently set my morning basal to match my evening basal's 1-ish mg/dL hourly decline. Once I catch up on work, I want to start doing some serious exercise... at which point I'll _decrease_ morning basal, and use shorter-acting insulins (primarily N) to cover "spots" when I'm not exercising.

I know it sounds wacky. When I first started shooting NPH, I was worried about hypos significantly later in the day. I was surprised when I consistently went hypo 4-5 hr postprandial. The activity is consistent, though.

The reason people choose Lantus/Levemir over NPH is for greater predictability, and for a longer, smoother, less-peaky insulin curve.

I mix my boluses for the same reason. My choices are:

• brutal hypos (40s or 30s) at one-hour post;
• wait to shoot a bolus (BG rises, then falls rapidly);
• split the bolus (multiple "peaky" shots, a la NPH basal on a shorter timescale);
• pump (see some of my other recent threads);
• mix.

If I live on processed food (readily-available CHO numbers) and fruit, and run my BG high, rapid works great. I was doing just that for the month after DX.

When I quit the junk food and cut back on the fruit, the 2x/3x-day hypos were just too much. I started mixing R with my boluses.

Then I found a few foods where even straight R gave a 2-hr hypo, followed by a rise during hours 3-4. I started mixing in N for those few foods.

I'm well aware that all this flies in the face of published charts. I'm just going on what I've determined empirically.

[markr]

Speaking from past experiences, vinegar can be extremely dangerous for me. There are so many different types available, make sure you read the ingredients before using it. When I eat out, I no longer use vinegar as part of a salad dressing, only olive oil.

[ant hill]

This is so interesting to see that what you think that Vinigar is none or very little carbs in it. Whell are we wrong!!
I don't know if this is of the same idea but buy having watermelon has an effect on BG's as I have lerned this from a type 2 that I know of, Is this true??

[Lizzie G]

Originally Posted by Eddy

If you forget chemistry, you have an excuse. Once upon a time, I majored in it... so memory lapses make me look bad.



Well, if you're completely wrong, then that makes two of us. My thoughts were the exact same.

Interesting side note: Pre-DX, I noticed that I felt much better after eating acidic foods... which adds to my wondering how long I was undiagnosed. (I'd had the three polys for a while.)

I've used acid (vinegar, orange, lemon) when boiling poultry into broth. Yes, the acid definitely seems to help break down protein; I presume complex CHO is much the same.

I'm just surprised at how little vinegar apparently has a substantial effect on the spaghetti. When one is used to holding a ~25 mg/dL range after eating, and suddenly ends up 60-120 mg/dL off, it catches one's attention...

I hope it's the vinegar. I can't think of anything else that has changed... and I like my spaghetti, and the good postprandial BG numbers that I usually can turn in.

Mich, the bottle claims 2g CHO per tablespoon. Even if I used 1/4 cup (4 Tbsp.), that would be 8 g... which, for an otherwise-300 g batch, amounts to an error of less than 3%. If I could guesstimate portions and insulin dosing with such precision, I'd be very happy indeed.

LOL - my uni degree was in chemistry...but it was so long ago now (graduated 99) and havent done it since - its kind of shameful how little i remember.

i agree its unlikely that the minimal sugar content of the balsamic has anything to do with it.

one thing you just said that makes me think it could be something different than just providing an acidic environment - you said very small quantities have a pronounced effect - this could indicate that something else present is involved as a catalyst (im fairly convinced that my memory serves correctly that minute concentration of catalytic substances do the job).

i have to say, the diagnosis with diabetes does tempt me to dig out some of my old books! currently i take a kind of 'semi scientific' approach but im sure if i went back through a lot of my old biochem and organic chemistry notes it would help...

[markr]

What I was talking about had to do with vinegar that contained wine, sugar, etc. which I wasn't aware of before I added it to my salad. Later when I checked my blood sugar, it was of course sky high.

[Lizzie G]

Originally Posted by markr

What I was talking about had to do with vinegar that contained wine, sugar, etc. which I wasn't aware of before I added it to my salad. Later when I checked my blood sugar, it was of course sky high.

are you talking about a balsamic glaze or dressing rather than striaght balsamic or white wine vinegar? the carb content of all the vinegars is pretty low (balsamic being the highest at around 3g per tablespoon, the rest are traces) so it is surprising that you would get a noticeable effect. also, the term wine vinegar is quite misleading as all the alcohol is distilled off in it's preparation so you are just left with the flavour, hence v low carb.

[markr]

[quote=Lizzie G;318824]are you talking about a balsamic glaze or dressing rather than straight balsamic or white wine vinegar?

I don't remember. I guess I'm just a sensitive guy.

[Lizzie G]

[quote=markr;318828]

Originally Posted by Lizzie G

are you talking about a balsamic glaze or dressing rather than straight balsamic or white wine vinegar?

I don't remember. I guess I'm just a sensitive guy.

i know the feeling! its hard work....at the moment im being really obsessive about everything, testing every variable as separately as i can, noting down the results, re-testing, so that it becomes less labour intensive....obviously what will happen then will something else will change and i'll be back to square one - LOL!

[George83]

Maybe the rice pasta has something to do with it, it has a Glycemic Index rating of 92, which is at the big end of the scale, any other spaghetti not made from rice will have a lower GI rating so maybe give that a try next time.