Question for the O.C.
I'm new to pumping and am realizing that my old insulin to carb ratios don't apply anymore. Thus, my new approach is to "trust the process" of the pump to see what new rules apply now.
Today my lunch was a Progresso Lentils bowl. The package said it contained "about" 2 servings. Each serving had 24 grams of carbohydrates with 3 grams of those as fiber.
My blood glucose was 101 mg/dl before lunch with 0.30 units on board from my post breakfast correction. My trusty pump factored all of that in, of course.
I programmed in a 48 carb meal and set an extended bolus over 30 minutes because of the slow response of the high fiber meal. The bolus came to 3.70 units.
Here I am, 2 hours later at 49 mg/dl with 1.85 units still on board!
I've already gobbled down half a Whatchmacallit bar before I posted this, so I'm on the upswing now... but what happened?!
Hmmm... I exercised this morning, so that might have helped me use my insulin more efficiently. I haven't determined a different basal rate for days I work out yet. But, this doesn't seem to be a basal issue... definitely an overdose on the meal bolus.
Here's the question: Should I have compensated for the high fiber content of my meal by lowering the total carb count? (I think I've heard this is the case for pumpers... but I haven't come across it myself yet.) OR Was the "about" 2 servings an inaccurate figured and I should have rethought my count? OR should I have set my extended bolus for a bit longer? I'm sure I'd still have gone low, but maybe not so quickly?
Thanks for any insight you might have guys!! Today I ordered the book "Pumping Insulin"- so help is on it's way!
Today my lunch was a Progresso Lentils bowl. The package said it contained "about" 2 servings. Each serving had 24 grams of carbohydrates with 3 grams of those as fiber.
My blood glucose was 101 mg/dl before lunch with 0.30 units on board from my post breakfast correction. My trusty pump factored all of that in, of course.
I programmed in a 48 carb meal and set an extended bolus over 30 minutes because of the slow response of the high fiber meal. The bolus came to 3.70 units.
Here I am, 2 hours later at 49 mg/dl with 1.85 units still on board!
I've already gobbled down half a Whatchmacallit bar before I posted this, so I'm on the upswing now... but what happened?!
Hmmm... I exercised this morning, so that might have helped me use my insulin more efficiently. I haven't determined a different basal rate for days I work out yet. But, this doesn't seem to be a basal issue... definitely an overdose on the meal bolus.
Here's the question: Should I have compensated for the high fiber content of my meal by lowering the total carb count? (I think I've heard this is the case for pumpers... but I haven't come across it myself yet.) OR Was the "about" 2 servings an inaccurate figured and I should have rethought my count? OR should I have set my extended bolus for a bit longer? I'm sure I'd still have gone low, but maybe not so quickly?
Thanks for any insight you might have guys!! Today I ordered the book "Pumping Insulin"- so help is on it's way!
posted by Kelsey @ 2:44 PM
6 Comments:
At 4:00 PM,
Felix Kasza said…
Hi!
(1) Servings: If the box lists the weight of the contents in grams, and the nutrition label lists the weight of a serving in grams (or oz, or what have you), that is usually more accurate. Keep in mind that the weight on the box is the minimum weight and not necessarily exact.
(2) Lentils: For me, lentils and beans are not only slow carbs, they are sort of not-really carbs; I have to reduce my bolus by about 30% for those, even after accounting for the fiber contents. An exception is when they have been cooked into oblivion, like the worse kinds of refried beans.
(3) Fiber: That depends. Insoluble (and thus indigestible) fiber must always be subtracted. Soluble fiber is slow to digest, but unless your digestive system is really fast in moving things along, it _will_ digest. (If it doesn't, colon bacteria finish the job, and you get gas.) When in soubt, underbolus (subtract fiber from carbs) and correct later.
YMMV.
Cheers,
Felix.
At 9:36 AM,
Johnboy said…
Hmm...doesn't sound like a lot of fiber to me. Did you ever encounter this issue with lentils on MDI?
How have your carb ratios been performing for you at other times?
It's funny how differently our bodies can react to the same foods! :s
At 10:57 AM,
Kerri. said…
Kelsey,
I'm a bit of a disaster when it comes to suggesting plans for other people, but the whole exercise-before-eating thing may have thrown you off. Also, my doctor at Joslin told me to subtract the fiber grams from the total carbohydrate count. If I were eating the soup you had, that would account for almost an entire unit over-bolused. Couple that with a target bloodsugar of 100 mg/dl and I could see a 49 mg/dl making an appearance.
What's your target blood sugar?
At 12:12 PM,
Kelsey said…
Thanks for the feedback everyone.
My target right now is 120 mg/dl. I think my trainer wanted me to start a littler higher since I'm new to the pump.
Yeah, it definitely looks like I should have subtracted the fiber from the total carb count. That would've helped.
Also, since I've only been pumping for 12 days now :) I may need to tweak my insulin to carb ratio a bit. I was using 1:15, but was running too high. So, I changed it to 1:13. I've had some luck with that, but now I'm experiencing some lows. Maybe 1:14 would be better.
Thanks again everyone!!
At 2:14 PM,
Sarah said…
I would have subtracted the fiber from the total carbs. Also, you might end up having different carb ratios for different times of the day, so that is something to watch out for. Good luck!
At 7:03 PM,
Christine said…
I agree Lentils aren't really carbs. I would have subtracted the fiber and bolused for 42 grams.
I noticed I needed a little less insulin with meals initially pumping, but I was also on R with MDI, so I was making the switch to an analog too.
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