I ate a pizza today for lunch (it was only a medium pizza, 132 grams of carbs total).
For reference, I set the “high” number on the Dexcom to 120, just to give a good visual of it.
A good downward slope before I started, an aggressive bolus, and a little extra insulin pop an hour later, and I never got above 114 and didn’t need any sugar correction. (The low looks worse than it actually was. For me, Dex always lingers on the low number much longer than in reality.)
I think it’s just my Italian heritage that lets me eat pizza with no worries…
I love the curve.
When I used the Dexcom, that type of dip would drive me insane…it frightened me. So I’m DXCM free and have been dealing with pizza ok. As you stated, an aggressive bolus and a little extra insulin pop, depending on the individual.
For me, perhaps, too type A, just seeing a dip below 60 may concern me too much. The DXCM delay also would mean that I would want to fingerstick anyway.
Pizza is a challenging meal, so is “burger and fries”.
No worries, my son can’t even come close, even with prebolusing and being aggressive, 100+ carbs would be a bear to handle. He’s hoping that as he gets older his carb sensitivity goes down.
Could be either, probably both. He reminds of my co-worker with Type 1.5, he can get lines like that, but he does take a bunch of insulin due to his resistance. He never seems to have as many lows/highs as we experience. However, I hold out hope that as my son becomes an adult his experience smooths out.
I’d have needed over 20u of novolog to eat that… maybe 30+ with afrezza … and could have kept it reasonably under control if using a cgm… but it’d have been a ton of insulin… type 1.5 basically just means LADA, in my vernacular anyway… that’s what I consider myself… it seems nearly unanimous that kids have more erratic blood sugars than adults…
When we have our Real Man Triathlon, we don’t need to worry about blood sugar. Just pizza, beer, and I was going to say running, but what do you want the 3rd event to be? More beer?
I am sure that his being an experimenter is important. But my guess is that the critical factor with him is that, with the amount of sports he does, he is extremely insulin sensitive.
We should discuss this some time. I need to create a post and talk about some of these things. Part of it is understanding the release curve of the insulin, and how it’s not a straight line. Carb counts and insulin:carb ratios are based on the full duration of the insulin. I do it a bit differently. We can chat about these things, I can put together some sketches of the idea.
which is a parallel concept to why an ultra rapid like afrezza seems to play by different rules in terms of carb ratios etc… I’m all for thinking outside the linear boxes they teach us… I have my own small little lens through which to view these things I’ve learned myself, not sure how much of it I could even explain, but am all for exachanging such concepts to whatever extent possible
My approach is a bit like the Afrezza approach. But with advantages and disadvantages. Injectables give you more precise dosing options, i.e. fractions of units, but they also have the longer lag time, the tail that Afrezza does not have.
You’ve done a helluva job with Aftezza so far, and you’ve only played the game a few years. Have you posted yet on how you started with it, why you started it, whether it was an Endo or who got you going with it? Do you combine Afrezza with an injectable to cover the slower carbs? There is a lot to learn about it. My use of Afrezza has been very minimal.
I think that [quote=“Eric, post:14, topic:376”]
We should discuss this some time. I need to create a post and talk about some of these things. Part of it is understanding the release curve of the insulin, and how it’s not a straight line. Carb counts and insulin:carb ratios are based on the full duration of the insulin. I do it a bit differently. We can chat about these things, I can put together some sketches of the idea.
[/quote]
would be a great thread for discussion.
Like kenrick, I too, get nervous bolusing for more than 60 g. If I’m having a long extended meal like over holidays, weekends, social stuff, I do keep bolusing a little to match of keep up with the carb intake. But I don’t like to be “wrong” if all of the insulin were to peak at the same time. I tend to spread the insulin out 45 minutes to about 1 hour apart even if the whole carb intake for the long meal may be well over 100+. For whatever reason, I can handle one slice of pizza with acceptable post meal BG. Two slices, forget it, BG over 180.
for our local pizza joint (bklyn nyc, the best pizza in the world), i currently bolus for 75gms 50% / 50% over a 2 1/2 hours. this affords me 1 1/2 slices. but if my post meal bg were in the 180s, i would consider that a major success.
PS: but i’ve got our local burger joint down to a science (Bare Burger).
for 1 hamburger on a brioch bun with a large plate of guacamole/chips and some french fries, i bolus for 75 gms carbs with 25/75% dual bolus over 3 hours. post meal bg is usually around 120, give or take. but it took me over a year to figure out this formula. i was very persistent.
we went for pizza this afternoon. i wanted 1.5 slices. i decided on covering 75gms. i spilt the dosage using the dual bolus. 25/75 % over 2.5 hours.
2 hours later i spiked from 90 to 175. i probably could have given myself more insulin up front. we’ll see how it works out. i really wish i had a cgm at this point…at least while experimenting. (and when i had my dexcom, i hated it. )
