Fast acting dose

Hi group.
How do you handle slow rising blood sugar? I have been able to eat low carb meals (around <30 g) of unrefined, mostly, with no meal-time insulin and very little spike.
BUT when I eat refined carbs or carbs along with fat, it seems to take awhile for blood sugar to spike (taking 0 meal-time), as much as two hours. I will then inject when I notice it is on the rise. Is this an acceptable way to manage instead of injecting at mealtime, dropping a bit low, spiking later and injecting again?

P.S. after reading other similar posts, I saw a few answers that apply here. Thanks, @joe
I’ve been wondering why and am concerned when my numbers spike to about 190-200 long after a meal (with fat) and stay steady FOR a long time! ANIMAL FAT or olive oil!

Hi Cathy, I mean I think it’s acceptable it depends on your goals. If you wanted “really good blood sugars” then that after meal peak should stay under 140. That can be hard to do. I sometimes eat this Italian thing “Arancini” which is deep fried rice/egg/cheese/meat and I don’t use any insulin until about an hour after eating, and then it is a really long extended bolus. If I used any insulin before I would go low. So in my opinion it comes down to whatever works.

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Hi! If it works for you, I think it’s acceptable. High fat/carb meals IMO are the hardest to nail down. I sometimes can hit it right on the head but a lot of times still make mistakes with it. I think you commented on the pasta post I made yesterday as well.

I know some other t1d on MDI (assuming based off verbiage that you’re taking injections so I apologize if I’m wrong) who take half a dose in the beginning of a meal like pizza and then will take the additional half one to two hours later- I have not tried this and I do pump so I typically do an extended bolus. For me 50/50 split extended over 2 hours (pump) works really well for things like pizza, but if I have a cheeseburger I need to do less up front and more extended so my typical for that looks like 40/60 or sometimes 35/60 depending on toppings and sides

The other thing that I’ve noticed that controls spike time with high fat/carb options is serving size. So for example with something like ice cream if I just stick to a 1/3 cup or 2/3 cup and the fat content is less than 20 grams what works best for me is to just take my insulin. If I were to go larger and get a blizzard or something like that at DQ, I still need to take a decent chunk of insulin up front to help with the high carb high sugar, but still need insulin additional insulin 3-4 hours later.

Long rambling post here but there isn’t a true right way to handle those spikes other than what works best for you. Best advice is to just remember not to stack insulin!

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Thanks for the feedback!
I use flex pens, no pump. Right now I need very little to no insulin if I eat unrefined carbs/low fat. And I seem to do just fine as far as management with smaller portions of refined carbs/fat meals with no or very little insulin. I have my moments of overindulgence that have me on the roller coaster ride and many times it isn’t worth the effort to manage.

Thanks for the post. My experience is similar. I live on a whole foods plant based diet. Which is dominated by unrefined foods and has a limited fat content. I often get very slow blood sugar responses, and I use very little insulin (now on 6 units of toujeo per day and about 2.5 novorapid per meal).
I saw my diabetician recently and we are waiting for the results of blood tests as she thinks I may have an unusual form of diabetes, and insulin might not be ideal.
But for now I am happy with it so long as I stay on the straight and narrow in nutritional terms

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@jamesdb1 thanks for sharing.

My endo confirmed the other day that I do have C-Peptide present and that, based on my current insulin regimen, thinks I may have LADA or Type 1.5. Both are still treated with insulin but the loss of naturally produced insulin will fade much slower than with Type 1. My first three months after diagnosis I was using insulin regularly and she says that that was due to my hyperthyroidism. Now that that is regulated, I am not requiring much insulin. She is concerned that with NO insulin injected I may reach diabetic ketocidosis so I am using small amounts of slow-acting daily (or at night) and having blood drawn again to check C Peptide levels.