I remember starting off on vague insulin doses of 5 to 10 units at every meal instructed to me by the hospital. Then I saw a diabetes educator, and learned to carb count. Adding up every gram of carb on worksheets supplied by my dietician only led to frustration over why logic was not translating into steady blood sugars. (Of course, little did I know about the gazillion other factors that could affect my blood sugar back then…)
For a few years in the middle, I just swaggered by and thankfully lived to tell the tale.
Fast forward to today where I’m using an insulin pump, carb count nearly everything I eat at home and have a pretty good idea of what most foods that I eat will do to my blood sugars. I know exactly why my blood sugar is high as I’m typing this right now (hello, potato bake with no pre-bolus). Overall, I feel pretty comfortable with being able to eat, give insulin and manage my blood sugar levels today.
That being said, there are still a few select foods that I cannot bolus insulin for if my life depended on it.
If there’s one food that confuses the life out of me, it’s Pasta. You can’t go by what’s on the packet, because most packets only refer to the uncooked weight. Seriously – who in the world eats dry pasta? If you were to make that mistake, I‘d be surprised if you weren’t chugging down litres of coke or making a dash to the emergency room.
Logic tells me that Pasta has around 28% carbs in it. The carb counts in our plates of pasta at home would be huge, because who on earth can only eat 1 cup of pasta? But if I were to give a massive insulin dose for all that carby goodness, I’d be eating glucose tabs for dessert.
All the extended boluses in the world can’t keep me from the Pasta lows, which can only mean that Pasta must be a really really really slowly digested food. These days I tend to settle for bolusing for 50 to 60% of the carbs at the time of the meal, accepting that the remaining 40% of the carbs that have absolutely no effect on my blood sugar whatsoever must be magic.
If there’s one meal that I despise purely for diabetes reasons, it’s soup. Who on earth can count the carbs in all those lentils, veggies and pastina that have been sitting there in the pot stewing all afternoon?
Then there’s the hassle of attempting to drain all of the liquidy goodness from the soup ladle for the purposes of weighing my plate, and then scooping up only liquid from the pot to add to my dry plate.
Add to this the same principles as pasta – all of those lentils and pastina are really slowly digested and would send me low quite easily. With carb free veggies and meat in the mix, I’ve sort of settled on bolusing for about half the number of carbs I would with Pasta.
Fun fact: I cannot eat a Banana without going low. Which is shit, because I actually happen to like them a lot. I very much look forward to my mid morning coffee and banana, while other times I slice it up to mix in with my Overnight Oats.
Logic tells me that a Banana with skin intact has around 13% carbs in it. But if I were to weigh my banana and bolus that much, I would be low within the hour. I’ve sort of settled on bolusing for around 50 to 60% of the carbs in my bananas, and some days this does the trick while other days it does not.
Steak and chips. Or Pizza. Or any kind of restaurant meal, really…
I have a love hate relationship with pub meals. I love how delicious and mouth watering and salty a steak and chips are, but I absolutely hate the night sweats and resilient high blood sugars that follow in the aftermath.
After learning that restaurant meals tend to be higher in fat to make them more delicious, I tend to set a temporary basal rate increase of 50% on my pump for 8 hours to combat the insulin resistance. I don’t prebolus for anything, given that fat slows down the digestion. I might also bolus for 40 to 50% of the protein in my steak after the meal is over, using a extended bolus over 2 to 3 hours.
Get the insulin in too early, and you go low. Get it in too late, and my blood sugars go up, up, up. It’s definitely a case of hitting the sweet spot.
Ahh, food and insulin…if only it were as easy as counting the carbs, giving an insulin dose and catching a unicorn 2 hours later.