We have had this discussion on a few different threads here. If you search for the word “Thanksgiving” you can find some of the previous discussions.
But since the day is coming up soon, we (@CatLady) wanted to bring it back up as a topic and make it easy for some of the new members to see.
Personally, I don’t get too deep into any fancy calculations or formulas. I don’t count carbs and bolus for them specifically. I don’t do that for meals in general anyway. But I think that would be even harder for Thanksgiving. (Maybe even more so if you are a guest at someone’s house and don’t really know about the food.)
My strategy is simply to over-bolus for the meal. And then if I trend low I can eat more or eat some of the pumpkin pie.
So for me, I would look at what I might normally bolus, and then add some to it. And there is not much downside to this strategy.
Oh no! I took too much insulin and have to eat more of this delicious Thanksgiving dinner.
Oh no! I took too much insulin and need to eat some pumpkin pie for dessert!
For me, there is no real problem with that.
As long as you know there will be plenty of food, and are not worried about gaining too much weight, I think this is a pretty easy way of dealing with it. And if you have an issue with fat slowing your digestion, and having the food come in later, having extra insulin can help with this too.
So this might not seem sophisticated or elegant. Like it isn’t all fancy with X% extended or this or that. It’s just a brute-force clobber it all with a bunch of insulin, and eat more later.
Please share your strategies for the meal. Just wanted to open up the discussion for anyone who has a particular way of addressing Thanksgiving.
I agree with the overbolus strategy, provided that (a) I trust my CGM, and (b) I have plenty of glucose in case my BG is plummeting and the available food is too slow.
Totally agree but I wouldn’t do it unless I had a CGM. It’s part of my strategy to make sure I never go too high. And the bonus is I can have a snack when or if it starts trending too low. I do this for every meal.
This is our method also. For kids it can be trickier since they sometimes say i want this and this and this and this but end up eating only a fraction of it. In our house at least we have lots of Thanksgiving “sweets” that they never get enough of… So if i overbolus I just make up the missing carbs in sweets. . As long as he’s made an attempt at putting down the good food, we just make it work.
I’m usually the primary cook in our house so after prepping all the meals I’m tired and not wanting to individually count carbs. A lot of “best guessing” goes on during T-Giving and then just monitoring the trends and adjusting insulin or carbs as necessary.
For me, estimating carbs isn’t generally that hard – eyeball 1/2 cup or a cup of mashed potatoes or squash or stuffing, or a couple tablespoons cranberry relish, whatever, that’s easy, and automatic, and not likely to result in wild BG swings. When it’s just the two of us at home I prefer to overbolus, because I’d rather be at the low end of my range, but when I’m eating out or entertaining, I prefer to run a little high. Going low in those situations just wipes me out mentally – I can’t focus on the cooking, I can’t converse. Also, I don’t eat as much now I’m getting older, so having to force down juice or glucose tabs or extra dessert just ruins the meal for me. When I’m back home or once the guests leave, if I’m trending high I can aggressively correct and be back in normal range fairly soon.
In my case we have bought several Tofurky’s so I am making one every 1-2 weeks lol with various fixings. You can usually only get the whole roast this time of year and we don’t have the freezer space here to freeze a bunch so that’s our excuse!
But I take a full dose in my pump before and then I take more when I eat and I take more over the next couple of hours in increments as it never seems like enough. One of my problems is I just put a bunch on my plate and eyeball it, I am pretty good about that, but then I have seconds, some of it is higher fat, plus I’m cooking and tasting so…it always takes more insulin than I ever predicted!
If my BG is in a normal place, I do it when I am done carving because I know it will be several minutes before we eat.
If my BG is low or trending low, I do it right before we eat.
In general, the only time I pre-bolus with any significant amount of time is if I am high, or I am eating sweet stuff before the meal. Insulin works pretty quick for me.
BTW, when I am a guest, I bolus right when they put the food in front of me. Because when you are a guest, you never really know when you are going to eat!
OK, Dexcom just reported my TIR for the day at 74% (YAY!!); particularly since I’ve adjusted my TIR to 70-160 from 7am-10pm. Not nearly as good a many of you “flat liners” out there. On the not so good side, I got behind the power curve and had a sharp peak over 300 for half an hour (inadequate bolus estimates)…despite cautions from many of you. For a first Thanksgiving with T1D, I’m counting it a draw with the dragon and lessons learned for future holiday meals! I hoped for better, but figured significant improvement would be needed, so not disappointed. On the good side, I had a great time with friends and family and hope you all did as well!
. As long as he’s made an attempt at putting down the good food, we just make it work.
it is!
