[sam2006]

I'm a type 1 diabetic that feels much better on a low carb diet, but none of my diabetes providers can tell me how much insulin to take. Basically what I do is use my square wave bolus on my pump and give myself 2 units over 2 hrs, but bs are still in the 160-200 range after. Does someone have a formula? Thank you. Sam

[dano]

Hopefully you are counting carbs. I don't have any pump information, I have seen some of the information that you requested on some of the pump websites. This is the best that I can do for now: ICR (Insulin to Carb Ratio) . Good Luck.

[sam2006]

of course I count carbs I am a type I diabetic and have been for 14 yrs. I was asking about protein and insulin and what the bolus is. That was the whole point if the post.

[dano]

Originally Posted by sam2006

of course I count carbs I am a type I diabetic and have been for 14 yrs. I was asking about protein and insulin and what the bolus is. That was the whole point if the post.

I don't remember you saying that in the first post. Apparently the ICR link was of little use to you. I did say that I don't have any pump information, hopefully someone can help you. Sorry!

[type1rachelle]

hey Sam - fat and protein DEFINITELY slow the absorption of carbs so the square wave bolus is a good idea. sounds like either your IC ratio might need some tweaking (you should even be able to set this by time of day on your pump, like, 1u:10g in the AM, and 1u:15g in the PM) or you need to extend the bolus even more (say, two hours instead of one hour).

everyone is different in this regard, unfortunately, and the only way to really get it right is trial and error.

as far as I know, there is no set formula for, say, x grams of protein = x hours of extended bolus... just know that the higher the protein and/or fat content, the longer your bolus should be spread out.

if you're STILL having postprandial highs, you might want to look into a drug called Symlin - it's helped me, but I'm an endurance athlete and low carb just doesn't work for me.

good luck!

[sam2006]

Thank you! I will try your suggestions. I'm a runner and do to my extreme morn highs because of hormone changes I had to relax my runs from 6 miles down to 3 miles adding 60 min eliptical after or before runs. (doc said my body was getting really inflamed. On off days I take a cycle or strictly strength class. Im feeling much better now that I started taking a few Bayer asprin at night, which has helped bs come down in the am. So hopefully by spring I can push my runs with faster recovery. Anyway do you have any advice for a diabetic that has high bs during exercise? Thanks

[type1rachelle]

if you're having extreme morning highs consistently, have you thought about adjusting your insulin dosages? have you heard of Dawn Phenomenon? many people with diabetes have higher BGs in the mornings because of this - usually you can account for it with a little extra insulin - talk to your Dr about it.

as for high BGs during exercise - this happens because of stress hormones being released. I'm not sure how fast you run, but would recommend longer slower efforts to start out with. 6 miles is fine if that's what you're used to, but maybe slow the pace way down to a conversational pace/jog to reduce the cortisol release. giving yourself insulin for highs before/during/after exercise is fine, but make sure you give yourself a reduced bolus (same with meal boluses) because your insulin sensitivity will be higher. there's no set formula for this as it greatly depends on the workout activity, intensity, the last time you worked out, how much sleep you got, etc.... but I typically cut my boluses in half generally speaking, and go from there. I don't work out if my BG is above 300 (the stress hormones that are released can cause it to go higher - not good) and I will correct with 30g of carbs if I'm below 70, and wait about 15-30mins before exercise.

if your Dr is saying you're having issues with inflammation, I would take an NSAID (Aleve, Motrin, Advil) over aspirin (Bayer) as these are anti inflammatory. The aspirin will help with pain, but will not reduce inflammation. There is evidence against taking NSAIDs long term or even on a prophylactic basis before runs, since they inhibit the formation of osteoblasts and can therefore increase your risk of stress fractures. also, they are harsh on the stomach (so is aspirin), so always take with food (if you're used to taking at night, take after dinner).

just a few suggestions.