Mom Wants A Diabetes Cure

Friday, March 24, 2006

My Son, The Human Guinea Pig

Pizza. We have a love hate relationship. We love the way it tastes, but we hate the numbers Brendon gets from it five hours afterward.

We typically weigh the pizza that we happen to get from the same place every time, dose him for what he's eaten and extend the bolus for about 2 1/2 hours. We'll test him after a couple of hours and the number generally looks good, but Every. Single. Time we find the same pattern, a high of anywhere from the high 200's to the mid 300's about 5 hours afterward.

So I went searching for a dosing technique that would give us better results. Here's what I found: Diabetes and Pizza: Slow and Steady Wins the Race.

In the article, it states three ways researchers dosed for pizza to get optimal results. Mind you, this was done to react way differently. I won't get into all three, but the third had the most success, so I figured I'd follow what the researchers did for that.

Basically "half of the insulin was given in one dose immediately before the meal, and the other half was administered slowly via the pump over the following eight hours."

I figured I'd give it a shot. As soon as Brendon sat down to eat, I gave him a bolus for half the pizza plus his milk. As soon as he was finished eating, I dosed him for the pizza he ate (minus what he didn't) and extended his bolus for 8 hours. Here are the results:

6:30 p.m.: 264 (this was a result of a messy race to push his glucose up because he was low from playing outside...this is incidental)

8:30 p.m.: 170

9:30 p.m.: 209

11:45 p.m.: 218

12:45 p.m.: 142

2:30 a.m.(8 hours later): 77 (I pulled back his basal by 50% for 2 hrs to prevent a further drop. We tested at 7:25 a.m. this morning and he was a 137.

Those numbers sure beat the numbers that we usually get (not that we test him so often afterward on a typical day). So he peaked at 218 rather than what I had mentioned before which is a drastic improvement.

Next Time: If he starts off dinner as high as he did this time, I'll rearrange the dose percentage to be heavier at the first dose and less at the second dose (65/35?). If he starts off lower, then I'll do the 50/50.


  • Awesome info! For my first extended bolus pizza experiment I think I did 50% and the rest over 4 hours. Woke up a little higher than I'd like, but not much under 200. I'll try pushing the curve out a little next time.

    Please go find such excellent information on Chinese food :)

    By Blogger Kassie, at 3/24/2006 8:53 AM  

  • The article says that this technique can be used on foods that give the same glucose patterns as pizza.

    For Brendon these include, lo mein, Applebee's grilled cheese (and maybe more, but those stand out in my mind).

    You were the one who inspired me to find the perfect pizza dosage!! :)

    By Blogger Shannon, at 3/24/2006 9:01 AM  

  • Fabulous, Shannon. I love that you are so on top of finding the answers when they're not readily available. Brendon is a lucky boy! And he eats pizza. Yummy.


    By Blogger Nicole P, at 3/24/2006 12:08 PM  

  • Bravo Shannon!

    That worked out pretty darned nice! Good job!

    By Blogger Scott K. Johnson, at 3/24/2006 12:13 PM  

  • Nicole and Scott, thanks! I feel pretty good having gotten a grip on something that's given us stress for the past 3 years.

    We'll see how the next pizza episode goes when we order again.

    By Blogger Shannon, at 3/24/2006 12:58 PM  

  • Nice!

    I should really figure out my extended bolus feature one of these days - I'm kind of afraid of it!

    By Blogger Erica, at 3/24/2006 1:08 PM  

  • Very good information - but what is the formula when you don't have a pump?

    Our first experience happened last weekend, and I don't want to go through that again! LOL. That stuff is evil!

    By Blogger Jamie, at 3/24/2006 2:48 PM  

  • Hi Jamie,

    I printed the pizza info about using the pump and also another piece about shots for the support group I go to. Here's what I found for those using shots:

    Certain concepts about meals and carbohydrate should be discussed with patients. One of them is that a high-fat meal (eg, pizza, fettuccine Alfredo, steak with baked potato and lots of sour cream and butter) tends to slow the absorption of carbohydrate from the intestine. Consequently, the rapid-acting insulin given before the meal may peak relatively too soon, causing low blood glucose levels shortly after the meal or high blood glucose levels several hours later, or both. This situation can be avoided by taking the insulin soon after the meal rather than before it or even by giving the total rapid-acting dose in two separate injections a half hour to an hour apart.

    By Blogger Shannon, at 3/24/2006 3:23 PM  

  • Erica, I was intimidated by using the extended bolus and left it up to Jeff to deal with.

    I'm finally coming out of my shell as you can see. Extended bolus's are actually a really good tool to use for foods like pizza. Try it one day :)

    By Blogger Shannon, at 3/24/2006 3:25 PM  

  • Thanks Shannon :) I do give Danielle her shots after she eats, simply because she never eats everything I put in front of her, so we sit back and wait till she is done - then guesstimate how many carbs she's consumed (oh what fun that is!). I think dividing the bolus in half and giving the second portion an hour later would maybe work more for her - that's a helpful tip .... thanks for sharing!

    By Blogger Jamie, at 3/25/2006 2:15 PM  

  • Jamie,

    I'm curious to know how it works out. Please let me know :)

    By Blogger Shannon, at 3/25/2006 2:34 PM  

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