When you enjoy a high-fat, high-carb meal, what is the most likely outcome? If you are like me, you may see a prolonged increase in your blood sugar since it’s really hard to dose insulin for meals like these.
These types of blood sugar scenarios are what I often call “sticky blood sugars”. The ones where, even if you bolus correctly for the initial blood sugar spike, your blood sugar may rise up again a while later and you have to struggle to get it back down.
This happens because the high fat content in your meal delays the release of glucose into the bloodstream, and that’s why high-fat, high-carb meals are some of the hardest to get right from a blood sugar perspective.
To quote the experts from Joslin Diabetes Center:
“Unlike carbohydrate, which is digested fairly quickly, fat takes a long time to move through the gastrointestinal tract. It can take 4 to 6 hours and sometimes even longer to be fully metabolized. This can be a problem for someone taking insulin.
Rapid-acting insulins such as Novolog, Humalog or Apidra are active in the body for 3 to 5 hours. When you eat a high fat meal, the insulin may start working before a significant amount of glucose reaches the blood. The insulin often is finished working before the rest of the glucose makes an appearance.”1
Pump vs. Multiple Daily Injections
One of the most notable differences between insulin pump therapy and multiple daily injections is the ability to deliver an insulin bolus over an extended period of time. If you are using multiple daily injections, your option is to take small boluses continuously to cover the slow glucose release. However, if you are using a pump, you can set an amount and duration and have it deliver it for you over time.
As always, you should discuss the solution with your medical team, but using the Extended Bolus feature on your insulin pump may be a good option for solving crazy post-meal blood sugars.
What is an Extended Bolus?
An Extended Bolus can provide a great deal of flexibility and control when eating certain types of food, as well as when you’re eating over a longer period of time. By using an extended bolus, you can enter the total amount of carbohydrate you plan to eat, and have the option to choose to only take a certain percentage of your insulin up front and have the rest delivered over an extended period of time. This allows you to better match your insulin dose to your food intake.
Example: If you estimate that the high-carb, high-fat meal you are about to eat will affect your blood sugar for the next 3 hours, you can set your pump to give you 70 percent of your bolus now and the remaining 30 percent over the next 3 hours (these bolus numbers are examples, NOT recommendations.)
This can help avoid high blood sugar when eating high-carb and/or high-fat meals. I like to have the occasional slice of pizza or ice cream too! 😀
In addition, if once the bolus has started, you decide not to eat as much as you planned, you can cancel the undelivered portion of the bolus. If you decide to eat more, you can take an additional standard bolus without interrupting your extended bolus.
How to set an Extended Bolus on the Tandem Insulin Pumps
This part was written in collaboration with Tandem Diabetes Care as part of their sponsorship of the Healthy With Diabetes Challenge.
Where to Learn More About Insulin Pump Therapy
To learn more about pump therapy, call (877) 801-6901 to speak to an insulin pump specialist or visit: Tandemdiabetes.com.
1 Joslin Diabetes Center Blog: http://blog.joslin.org/2011/09/why-does-fat-increase-blood-glucose/
Medical Disclaimer: All information provided on Diabetes Strong is based on my own and our expert’s personal experience. We are not medical professionals and no adjustments to care should be made without consulting your medical team. If you are new to exercise, haven’t exercised in a while and/or haven’t seen your medical team in the last 3 months, it is advised to do so before engaging in any kind of physical activities. You must not rely on the information on Diabetes Strong as an alternative to medical advice from your doctor or other professional healthcare provider. If you have any specific questions about any medical matter, you should consult your doctor or other professional healthcare provider. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website.
From time to time, we may pass along: suggestions, tips, or information about other Tandem Insulin Pump user experiences or approaches to the management of diabetes. However, please note individual symptoms, situations, circumstances and results may vary. Please consult your physician or qualified health care provider regarding your condition and appropriate medical treatment. Please read this Important Safety Information [https://www.tandemdiabetes.com/important-safety-information] before using a Tandem Diabetes Care product.