Wednesday, January 26, 2011
PPS (Post Pasta Spike)
What is it about pasta?? I am getting close to getting pizza down to a science but pasta still has me beat.
Yesterday was my sweet Bekah-boo's 1/2 birthday. We don't eat out often but decided that 1/2 birthdays were something to celebrate and an excuse to splurge on eating out. The birthday or 1/2 birthday person in this case gets to pick the place. We ate at a local restaurant where you throw the peanut shells on the ground. Bekah loves that part and that she gets a pre-dinner treat as we don't bolus for peanuts. Mac-n-cheese is her dream food so that is of course what she ordered with fruit on the side. I am getting pretty good at restaurant swagging even though I don't do it often. I did a combo bolus of 60% upfront and 40% extended over an hour and a half.
Once home we did chores, homework, played a quick game and then baths. After her bath we did a BG check and got a 70 and she wasn't feeling low at all. 70 to her is low because we treat everything under 80 as a low BG. I didn't want to confuse her but my instinct said to wait it out, the PPS (post pasta spike) was coming. I let her have 20g of cookies that they gave her at the end of her meal and she was too full at the time to eat. I thought at this point it is probably better to correct later than to confuse her as to what I was up to.
At 12:00 I got a 212 and gave a correction and at 3:00, Jason got a 319. As we all know that fasting BG that our kiddos wake up at has a huge effect on the numbers for the rest of the day. By wake up her BG was only down to 245.
I am going to do some basal testing this weekend to make sure that is not the problem but darn that pasta anyway! She LOVES it so I have got to figure this out. She does have mac-n-cheese almost everyday at lunch but that body in motion keeps the PPS away.
I would love to hear your tips and tricks for pasta. I promise to seek my medical team for their advice before trying your ideas. Thanks!
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Pasta is a slow acting carb, so you should do an extended bolus on it. Give 30% of the bolus now, then extended 70% of it for the next 4-5 hours.
ReplyDeleteYou can also raise the temp basal for 4-5 hours. For pizza, I do a +50% for 2 hours for every slice that she eats. (2 slices would be 4 hours of +50%) As always, I am not a doctor and I don't even play one on tv!!!
We eat whole wheat past for everything other than mac-n-cheese so that doesn't seem to cause as much as a spike.
ReplyDeleteAs for mac-n-cheese I usually do a combo bolus of 40/60 with the 60 over two hours. I am a bit aggressive with it as it seems that even five carbs too few with mac-n-cheese cause a big issue, so when in question I round up.
Also, if he starts going low with the combo part I don't usually give him free carbs right away but rather I lower his basal for an hour and check him again(fifteen minutes into the lower basal) to make sure he's either stayed or isn't going lower. If he goes lower at the second check I give him fast acting sugar but only four or less carbs worth so that it doesn't cause more trouble with that two hours worth of bolus still working to combat the fatty mac-n-cheese.
If he says he's starving for food at this point I make sure to bolus for the whole amount of snack without taking into account his low BG.
Not sure if that makes sense, but we eat mac-n-cheese at least three times a week for lunchtime and he has nap right afterwards so I've been able to combat it pretty well as he's not being active and really spikes unless we dose perfectly. Hope that helps :)
Pasta can SUCK IT! Joe's favorite is Mac and Cheese too and I find that it requires an extended increased basal for 6 to 8 hours after consumption...only at night. During the day I can bolus straight up for pasta and his numbers are fine and we don't have any issues. At night I need to extend the bolus (a 50/50% combo over 4 hours...) and bump up the basal by 40% or so from hour 2 to 6...I won't do it at night without a "good" Dexter on board...I would rather correct as I go and be "safe". I hate pasta...Mac and Cheese especially.
ReplyDeleteHappy 1/2 Birthday to Bekah!
First that restaurant sounds awesome!
ReplyDeleteNormal foods spike in an hour so pasta is usually delayed by 3 to 5 hours. Id try a combo/extended bolus over a longer period of time and give more towards the end.
For example we do 40% upfront 60 % over 3.5 hours. Yesterday he ended at 200. Started at 150 so it wasnt too bad. Next time Im going for 4.5 hours.
Idk f this helped or made it more confusing lol good luck!
I can't be any help as we are still new to this and on MDI, but I want to say that spaghetti is killing me. Low before bed and then sure to spike overnight everytime, and that's for both my T1 boys.
ReplyDeleteAnd hey, if anyone has any suggestions on what to do when using MDI for pasta, let me know!