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a general diabetes question...

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markk:
Do you eat according to the Glycemic Index? i.e Low GI food? if yes, what kind of insulin do you use? i am on humalog and lantus now, and humalog i take before each meal and when neccesary. I would like some advice, but first need to know if you eat low GI... :mahl:

Alf:
Yes, allthough the American Diabetes Association (in example) is telling "their" diabetics that the GI isn't that important for a well driven diabetes.
Of course it makes sense to take care of nutritions which will not raise the bg level very quick, especially if the diabetic is using analogue insulins like Humalog because then the lowering effect of the insulin could be much faster than the increase thru the food and this can cause dangerous situations... ;)

markk:
That's my thaught exactly, eating low GI to me means not having constant up and downs in blood sugar level, and has ed to a reduction in insulin required. But Low GI foods take a while to get converted into glucose, that's thier whole point, and that's where my question stems from: If the food is slowly converted to glucose, while my humalog gets to work so rapidly, should I be timing my injections more appropriately? for example, if I eat and inject 20 minutes later, will I be closer to matching my insulin peak to the peak rate of glucose conversion?  :balla:

Joerg Moeller:

--- Zitat von: markk am Februar 15, 2005, 13:33 ---If the food is slowly converted to glucose, while my humalog gets to work so rapidly, should I be timing my injections more appropriately? for example, if I eat and inject 20 minutes later, will I be closer to matching my insulin peak to the peak rate of glucose conversion?  :balla:

--- Ende Zitat ---

Yes, you got it! :super:

I use Humalog in my insulin-pump and eat every sort of carbs (with different GI's)

What we try to reach is that glucose and insulin reach the blood-system at the same time. And as you surely know: if you have two runners with different speeds and you want them to pass the goal line at the same time, then you have to start them at different times. That's what we called "SEA; Spritz-Ess-Abstand = Injection-Eat-Distance.
This value can be positive, zero or negative.

If I eat meals with high GI, then I pump my insulin and wait 10-15 minutes before I start eating. (positive SEA)
If the GI of my meal is medium, then I pump and eat immediately. (zero SEA)
If the GI is low, then I eat first and pump after a few minutes. (negative SEA)

If I follow this rules, my BG isn't higher than 140 mg/dl at any time!

E.g: Usually I eat carbs with middle-high GI. Then I don't need a SEA.
But one of my favourite meals is called "Reibekuchen". It´s a type of pancakes made of potatoes, onions and flour, baked in a lot of oil.
As you know: fat can decrease the GI of a meal. And this meal is so fatty, that I have to pump only the half of my Insulin-dose 30 minutes after meal is finished.

Sorry for my poor english :rotwerd:

reschmieba:
Hi Markk,

you are right. You could use the GI as a hint for the time lag between injection and food intake. E.g. Pizza: Some of us take half of the required dose before eating, the other half after a while. The same applies to Fondue (Bread dipped in melted cheese, high fat) or fried things with a lot of oil/fat. Some of us take the (reduced) injection afterwards.

So: First of all it is important to calculate your bolus correctly. Therefore you should know/test your sensitivity of blood glucose on insuline/carbs. To be safe when using analogue insulines or to smoothen blood glucose values you can consider GI in a second step. A control indicator is the blood glucose value 1-1.5 hours after eating carbs. Values not over 150mg/dl are fine. 3-4h you should have reached the target value of glucose. Compare with the profile of your insuline.

I built a excel tool to visualize profiles of insulines (curves), blood glucose and carbs. This helped me for my first steps. Contact me, if you are interested.

Cheers,
reschmieba

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