And again

[Elizabethe]

Me again needing advice, today I was out for lunch, my BS were 6.2, I ordered penne chicken pasta with tomato, garlic and cream sauce, washed down with a glass of white wine. When the meal arrived I took 2 units of my Fiasp, about one and half hours later my BS were 3.1 the finger prick showed 4.2. I took 5 jelly babies and a coffee . The rest of the day my BS have been between 6 and 8. They are currently 6.7 and I will have an egg salad and not take insulin due to very low cards in that meal. My question should I have taken one unit of the Fiasp, ( it was my first pasta dish since being type 1). I think pasta is perhaps slow release carbs.
please advise

Elizabeth

 

[PattiEvans]

Hi @Elizabethe between 6 and 8 looks fine to me. In answer to your question, it's not the pasta which is slow-release, but more the creamy sauce which will slow down absorption of the carbs. You may find that some hours later the BGs will rise. When I have a fatty sauce on pasta I tend to takemy insulin in two "installments" which is easy on a pump, but it would mean two injections for you. One upfront and one later when BGs started to rise (if they do).

 

[Elizabethe]

Hi @Elizabethe between 6 and 8 looks fine to me. In answer to your question, it's not the pasta which is slow-release, but more the creamy sauce which will slow down absorption of the carbs. You may find that some hours later the BGs will rise. When I have a fatty sauce on pasta I tend to takemy insulin in two "installments" which is easy on a pump, but it would mean two injections for you. One upfront and one later when BGs started to rise (if they do).

That sounds sensible, I just never anticipated it being this difficult and no breaks.

 

[Elizabethe]

Hi @Elizabethe between 6 and 8 looks fine to me. In answer to your question, it's not the pasta which is slow-release, but more the creamy sauce which will slow down absorption of the carbs. You may find that some hours later the BGs will rise. When I have a fatty sauce on pasta I tend to takemy insulin in two "installments" which is easy on a pump, but it would mean two injections for you. One upfront and one later when BGs started to rise (if they do).

Can I also ask what is the difference between a pump and injections?

 

[PattiEvans]

Can I also ask what is the difference between a pump and injections?

Ahh, a pump continuously infuses rapid acting insulin drip by drip all the time in the place of your basal insulin. It's attached to you either via a cannula and some tubing, or a patch pump is stuck directly to your skin. However if you wish to do a bolus before a meal you can either do a "standard bolus" which is like doing one injection, or you can programme the pump to give you an "extended bolus" where you have say 50% of the bolus up front and the rest dripped in over some hours... or you can do a dual wave bolus where you can give 50% now and schedule the other 50% to be done later at some point. If you are on injections you are limited to what you inject immediately and then what you can inject later to cover the same meal if it is one which absorbs slowly. Hope this makes sense.

 

[SB2015]

Hi Elizabeth

As you are on tiny doses of bolus insulin at present with your meals, you might find it useful to talk to your DSN about switching to a half unit pen. This way you can make finer adjustments to your doses.

Having said that, as @Pattidevans has said a pasta meal with a cream sauce is a mix which is likely to release the glucose more slowly so a split dose is one solution for that. With all the dose up front your glucose did not keep up.

I know that it will seem so complex that present and lots to get your head round, but IT DOES GET EASIER. Do you remember learning to drive. It all seemed a lot to think about at the start but then most of it becomes automatic, and you are just watching out for the unexpected along the way.

You are already doing very well.

 

[PattiEvans]

@Elizabethe I do apologise, I hadn't realised how new you are at this and I certainly didn't intend to be in any way confusing. As SB2015 says, it is like learning to drive, it seems very complicated at first but does indeed get easier as you go along. Plus there's a whole new language to learn in relation to different diabetes related stuff. It sounds to me as though you are doing a darn sight better than I did at the beginning though!

 

[Elizabethe]

Hi Elizabeth

As you are on tiny doses of bolus insulin at present with your meals, you might find it useful to talk to your DSN about switching to a half unit pen. This way you can make finer adjustments to your doses.

Having said that, as @Pattidevans has said a pasta meal with a cream sauce is a mix which is likely to release the glucose more slowly so a split dose is one solution for that. With all the dose up front your glucose did not keep up.

I know that it will seem so complex that present and lots to get your head round, but IT DOES GET EASIER. Do you remember learning to drive. It all seemed a lot to think about at the start but then most of it becomes automatic, and you are just watching out for the unexpected along the way.

You are already doing very well.

I take 4 units of the long lasting insulin once per day and two units of the Fiasp three times per day, ( I skip a doze if no carbs in meal), I have the Libre 2 which I have on a 14 day trial period. My time in target was 91%, which I am well pleased about, I checked on average 90 times per day, but it’s a novelty just now. I do a module on Thursday then my GP should order my Libre if acceptable.

 

[Inka]

I take 4 units of the long lasting insulin once per day and two units of the Fiasp three times per day, ( I skip a doze if no carbs in meal), I have the Libre 2 which I have on a 14 day trial period. My time in target was 91%, which I am well pleased about, I checked on average 90 times per day, but it’s a novelty just now. I do a module on Thursday then my GP should order my Libre if acceptable.

If you’re on fixed doses of the Fiasp you’ll need to eat the same amount of carbs for each meal. I can see you’ve been given some help to adjust that as you don’t take Fiasp for egg salad, etc. That’s good, but do push for more help on adjusting your mealtime insulin according to the carbs in what you’re about to eat.

I also second the advice about getting a half unit pen. That’s incredibly useful.

Yes, Type 1 is very hard to start with. The important thing to understand is sadly it’s not.ike many other conditions where the doctor tells you your doses, you take them and then get on with things. In Type 1 we’re trying to do the job of our pancreas. This is very hard and nobody will manage to get perfect blood sugars all the time. You’ll be adjusting, amending frequently.

You’re right about pasta being a slower form of carbs for many people (even without a fatty sauce). I split my insulin dose for it. Again, there’s no magic formula - just something you have to experiment with.

 

[Inka]

In case these haven’t already been mentioned to you, two books much recommended for Type 1 are:


Think Like a Pancreas’ by Gary Scheiner.

And Type 1 Diabetes in Children Adolescents and Young People by Ragnar Hanas (ignore the title - it’s great for adults too)

.

 

[SB2015]

I take 4 units of the long lasting insulin once per day and two units of the Fiasp three times per day, ( I skip a doze if no carbs in meal), I have the Libre 2 which I have on a 14 day trial period. My time in target was 91%, which I am well pleased about, I checked on average 90 times per day, but it’s a novelty just now. I do a module on Thursday then my GP should order my Libre if acceptable.

Hi Elizabeth, good to know that you have the Libre2, and to read just how quickly you have got the hang of this all. Apologies if I have missed this in other posts, but are you under the care of a specialist team, or your GP.

It would be well worth enquiring about a carb counting course. I did Dose Adjustment For Normal Eating (DAFNE) which gave me a chance to learn loads more about managing my diabetes, but also a chance to chat with others learning to manage their T1. From them I picked up practical tips. There are other similar courses in different areas.

Keep the questions coming.

 

[Elizabethe]

Hi Elizabeth, good to know that you have the Libre2, and to read just how quickly you have got the hang of this all. Apologies if I have missed this in other posts, but are you under the care of a specialist team, or your GP.

It would be well worth enquiring about a carb counting course. I did Dose Adjustment For Normal Eating (DAFNE) which gave me a chance to learn loads more about managing my diabetes, but also a chance to chat with others learning to manage their T1. From them I picked up practical tips. There are other similar courses in different areas.

Keep the questions coming.

I am under the care of the diabetic nurse
at the hospital. I will ask about courses as I am sure they will now be beginning to start again. I would love to meet other type 1 diabetics to just chat. I do enjoy the forum though. It is really informative.

 

[SB2015]

Glad that you are enjoying forum, and I hope that you can get registered on a course. I had to wait quite a while, but my DSN was happy to get me started with carb counting, as like you I worked out that I needed less insulin for smaller meals, so I was too impatient to wait for the course. It might be worth asking your DSN.