Please help! Just screwed up cake bolus - crappy math

@both cgms 206 and 205 respectively and straight arrow.

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A quick update: :grinning:

I just talked to @Quadgirl. All good. A little more insulin, a walk, and frequent BG checks with cake ready in reserve for when it is needed. :ok_hand:

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I just got here and am happy to see that others have already helped.

Here are my spectator’s comments.

First, nothing bad actually happened. The excitement was about what could have gone wrong if no actions had been taken and BG trends were not managed, but the actual actions Quadgirl took make sense: measure to see what the BG is doing, use insulin or exercise if it’s going too high, and use carbs if it’s going too low. For myself, I prefer insulin to exercise, because moderate exercise tends to increase the power of the insulin already in the body (insulin sensitivity increases) but physical and emotional stress can raise the BG instead.

Second, it looks like a successful first go at dosing insulin for cake, even though it was scary because it was new and unfamiliar. With additional practice and familiarity it should become more graceful. Pretty much what Quadgirl did and it was right is: Watch the BG. If it’s going up too much or too fast, use insulin or exercise to fix that. If it’s falling too far too fast, eat fast carbs. If it looks like it will eventually fall too far but there’s no immediate issue, eat anything tasty.

Second, it looks like taking the whole bolus up front was right: the BG rose, it didn’t crash. If the drama was too unsettling, take a smaller portion of cake to start, and after an hour or two when things are under control, go back for seconds.

Third comment, I don’t understand the benefit of eating egg salad. Protein and fat can slow the absorption of carbs, but it’s not so helpful after the BG has already risen, and if the BG turns forcefully downwards, the protein and fat would slow the response to glucose (in an emergency) or more cake (if there was plenty of time to prevent a low.) I could see the argument for egg salad followed a little while later by the cake, as the spike would be slower.

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Plus, egg salad is kind of gross…

:joy:

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@Quadgirl,
Give us an update please! Don’t vanish after you have reported taking a million units.

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Hi, all. Update: I took 1 unit of insulin at 10:30 and went on a slow dog walk of about half a mile. BG was 184. By 11:07 finger stick was 131. Feeling punky at noon and Dex reading 83 and falling, drank 4 carbs of apple juice. 12:10 did finger stick and was 75. Drank 12 carbs more of apple juice at 12:17 (do not want to not like cake by association, so doing juice) as dex reading 67 and don;t feel great. But I am hanging in. My graphs from cgms will be attached here. I think I should have paid attention that so much momentum was down. Now I just want to get level for a while and eat my regular lunch, but that could be a while. Depends on apple juice. Anyway, thanks for helping! Any further advice on seeing the graphs is going to be well-taken! I am learning, but ready to feel good now. Sharing specifics in case helpful to someone. Never did so many finger sticks in a day, and that alone makes me sort of sick. But onward! Thanks to all!


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@bkh Thanks for your help analyzing! My pea brain thought that fat and protein in egg salad would kind of short out the rise in bg. Also, I tend to like to act and will probably always need to learn to slow down and wait. Anyhoo - that was the “reasoning” - I could talk myself into anything!:crazy_face:

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I read your previous post about the cake. I’ve gotta say - IMHO, you are way overthinking and over-worrying. Eat the cake. Take insulin. You’ll survive!

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@Quadgirl, I know it was scary for you but to me, you did great on your first cake experience! For me, it is nearly impossible to not spike eating such treats, and then, as you found out, the next several hours are spent trying to prevent another latent spike while not introducing a hypo at the same same by over correcting. You escaped both of these, so pat yourself on the back!!

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And hopefully made a great memory or two!

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@Trying @ClaudnDaye
Thank you, both! Alas, the whole story was not a success. My insulin correction while in the 150s was too much for my system. I had to nudge and nudge trying to find what would bring sugar up. After lunch I did not feel too well and 90s a few hours after lunch truly felt like 60s. It was so much work trying to navigate both highs and lows all day and last night. Sips of apple juice, 1/2 a banana, and such, and short walks which became hard to do. I felt shaky and nauseous and ill. I have low sodium sometimes and wonder if my sodium went low in addition to all the rest. Also, I usually have 8 units of bolus Humalog or so on average days, so that 14 may have thrown me for a loop, too. By supper time, I felt like crap, had my salad, chicken, yogurt and Dave;s toast ready, but sugar was gradually coming down still after 5 hours since last bolus. Was scared to eat and scared to not eat. Did not want to be up all night with lows. So, decided to eat the 8 carb yogurt and then bolus. But then was rising, so decided to bolus for my little bit of chicken and the piece of toast and plan was to walk after eating it. I did that and brought sugar down, still feeling so ill. Had pedialyte as part of pre-supper nudge lows and hoped to balance electrolytes. Ended up getting to about 130 by bedtime, but by midnight sugar went up to 160s, so took a full unit correction only to have it high all night. I was able to walk this morning, but still feel crappy and sugars are running high. For me personally, I hate to feel this scared and sick. No food on Earth is worth it. I got too brave for my particular britches. The rest of the cake is being given to mom and friends. It is not a failure for me, but a painful lesson. My ordinary managed life allows me a sort of freedom I enjoy so much, and took for granted, and I don;t care if it is regimented. It leaves me worry-free the rest of the time. I love my breakfast and my lunch and just fake and make supper. Big deal. I eat ghirardelli;s 72% and 86% chocolate squares every day. I love my coffee with sugar free delight. I guess I just need to be honest with myself and know I feel safer and happier not managing highs and lows. Looking at my weekly Clarity report this morning has been awful. Worst 2-day in every category and also 7 day, ever. I found a pattern that works for me and I am not apologetic about being a wuss about not doing this again. It just isn;t my lane right now. I will experiment with pumping some more and mdi and will work with all that, but I simply don’t have the inclination to have another 24 hours like this.

And, I do so appreciate all the help, but ultimately we all know that it is alone where the knowing and learning and dealing with t1d is. The cake puzzle for me will just be a puzzle. I will experiment with supper meals, but no more big tries. So, no reflection on anyone who lended such great support. I needed it. Today, I am still fighting highs - getting beeped at right now with a friggin’ 178. Not happy at all. Hopefully I can get it ironed out soon. Rollercoasters are not my thing. So, it could be considered a dismal failure, but learning is occurring. Sorry to report all this, but I know this forum appreciates diversity, and this is just my experience. Thanks again for the support and kind words throughout. Have a wonderful weekend.
Laura

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Oh, sorry you feel it was not a success. I totally understand, no one wants to feel lousy and I sure know the feeling!!. To be honest, it doesn’t take much to get into a roller-coaster that you just went through. That’s why t1 is so difficult :tired_face: A few bites of the wrong thing can do it. Sugar surfing, nudging as you described, helps but it does require a big effort. DIY loop algorithms help, too, but still requires, for me, constant monitoring for these situations. That is why so many of us mostly forego treats. Or, for me, know ahead of time to be ready to monitor!!! For me, too, it can take a few days to get back to “normal”.

Big tries. Maybe that’s the key right there. I believe it would have been a drastically happier experience if you had started cake training with about 2 bites rather than a jumbo slice. And after 2 bites is figured out and working, increase to a 4-bite slice, ramping up gradually as you gain experience until you find the point where it’s too big to be worth the effort. Right now, all we know is that today, a 248g slice of cake isn’t worth it. Maybe a 30g or 40g slice would have been well worth it. Then go to 60…

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@Trying Thanks for that! I am glad to know I am not the only one. I appreciate this. :grinning:. I am still having bigger magnitude changes than expected. Low alarms after lunch and very high after breakfast, but I am today able to just sit tight and wait for more normalcy. Just glad to be feeling better. Thanks again for the empathy!

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@bkh Amen to that! You are so right. Can’t use the go big or go home - I need to try little experiments. Thanks for that. It is intuitively right. I just jumped in, got lost in details and then was careless. But, yes. Your way is perfect and eases the learning curve. :grin:

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Exactly! :arrow_up:

:heavy_plus_sign: :100: @bkh :exclamation:

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Start with….cake pops! 25-30 grams of carb deliciousness! Very manageable. :yum::partying_face::innocent:

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Milk will raise it faster than cake!!! My go to when it’s very low

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