Big meals on closed loop

[SB2015]

Just wondering if anyone else finds big meals cause an issue for their closed loop.

In manual mode if I ate around 60g of carbs I upped my quick acting by 20% and also did a split bolus.

I have had two much bigger meals recently over 90g (the crepe brûlée was too tempting and the cocktail ...). I inevitably spiked but then plummeted a while later into hypo land!!! Same happened last time.

Does anyone find it better to switch back to manual for big big meals (or are you all much more strong willed then me!!!)

 

[trophywench]

She asked with a huge grin, why would anyone ever opt for a burnt pancake? Then added I opted for a creme brulee somewhere about three years ago cos it had been so long since I had the chance of one - and it was just so sweet I actually didn't like it. Massive disappointment, so I hope you loved it to make it worthwhile?

I've never ever added extra insulin for a carb fest, only time I add on is when my BG is over 10-ish to start with, probably means I have an iffy site, but I'm not letting my dinner go cold while I mess about doing whatever I need to. I would consider a split or extended bolus though, depending on what's in the meal - defo split for pizza, probably pasta too cos I do like a lot of cheese with pasta so much like pizza really. There again, don't have that many carb fest meals in my life!

 

[SB2015]

It was a perfect crème brûlée, nothing mass produced. Worth every mouthful.

Thanks @trophywench . In closed loop these variations should be dealt with automatically but I think I overloaded it!!! These events happen rarely which is why I haven’t found a strategy. Tends to be when we are away. A more restrained meal this evening, served by a waitress who when I asked how long the meal might be to be served, when I explained why, said oh you want pre-bolus! it was very quiet so we set a 20 min lead in. Perfect.

 

[Inka]

I was never a fan of Creme Brulee at all but I had one at a smart restaurant flavoured with the slightest hint of Rosemary and it was absolutely divine…..

Back to your question: I don’t loop but I know someone who does and they use manual for big meals eg meals out or whatever. Perhaps you could eat the same again and experiment? 😉

 

[SB2015]

Thanks @Ink

I was never a fan of Creme Brulee at all but I had one at a smart restaurant flavoured with the slightest hint of Rosemary and it was absolutely divine…..

Back to your question: I don’t loop but I know someone who does and they use manual for big meals eg meals out or whatever. Perhaps you could eat the same again and experiment? 😉

Thanks Inka. I had a feeling I was asking too much of the loop to deal with all of that

I like your thinking. It is always important to experiment!

 

[everydayupsanddowns]

I guess this may be a difference between the different closed loops? I don’t know what options you still have with the MM780?

I discovered early on in my T1 career that bigger meals seemed to need a different ratio to regular meals, and the value of splitting the dose to spread the insulin action over the longer digestion time. I think John ’Pumping Insulin’ Walsh suggests that if a meal’s grams of carb is a bigger number than your weight in kilos, you may need to add more insulin/adjust ratio and timing?

I‘ve refined my guesswork while on insulin pumps with the benefit of dual wave boluses, and the Tandem tSlim allows me to still use Dual Waves even while Control IQ is active, so I can add the extra insulin (generally best done by overestimating the carbs in the meal for me), and DW the dose over a suitable timeframe, with the benefit that Dex and Control IQ will keep an eye on things and can make adjustments if I’ve undercooked it.

 

[SB2015]

I guess this may be a difference between the different closed loops? I don’t know what options you still have with the MM780?

I discovered early on in my T1 career that bigger meals seemed to need a different ratio to regular meals, and the value of splitting the dose to spread the insulin action over the longer digestion time. I think John ’Pumping Insulin’ Walsh suggests that if a meal’s grams of carb is a bigger number than your weight in kilos, you may need to add more insulin/adjust ratio and timing?

I‘ve refined my guesswork while on insulin pumps with the benefit of dual wave boluses, and the Tandem tSlim allows me to still use Dual Waves even while Control IQ is active, so I can add the extra insulin (generally best done by overestimating the carbs in the meal for me), and DW the dose over a suitable timeframe, with the benefit that Dex and Control IQ will keep an eye on things and can make adjustments if I’ve undercooked it.

I guess I was hoping that the loop would deal with these, especially as on the 780 there is no option to do extended bolus, so my only other option is to do two separate bits of info to the pump. However as I have tried and tested systems in manual, similar to yours, that I know work on these very rare occasions I think that is the easiest option.

I shall probably have forgotten by the time this happens again, and it will just end up as another yo yo day , but so be it.

 

[everydayupsanddowns]

However as I have tried and tested systems in manual, similar to yours, that I know work on these very rare occasions I think that is the easiest option.

Sounds like it. They aren’t common and I assume you can dip in and out of auto mode pretty easily?