Splitting the bolus for fatty foods

12 posts, 5 contributors

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Gander 7 posts

Hello, I started on the Freestyle Libre system about 6 weeks ago and have found it very revealing, causing me to revise my opinions on how to deal with many foods.

I have found that fatty foods cause a delay in the effectiveness of the fast acting bolus and would appreciate some guidance on how to split the bolus so I don't end up taking extra CHO at bedtime! Are there any links to available articles on this subject?

novorapidboi26 DAFNE Graduate
NHS Lanarkshire
1,789 posts

As with everything DAFNE, trial and error is the best approach......

Before the pump, when I had pizza, I started by splitting the dose 50/50 and then taking the second dose 30 minutes after eating....

this stopped the high later but it wasn't perfect....

the truth is with all the other hidden variables it doesn't always work......

so to come back to first point, trial and error is best.....

what specific foods are you thinking about....?

are you DAFNE trained?

Gander 7 posts

Hi thanks for your early reply!

Yes I was DAFNE trained three or four years ago, but never paid much attention to the problem before I went on to the Libre system as it wasn't very obvious then what was happening.

I am thinking of things like pizzas, fish and chips and especially things like German Bratwurst sausages. I seem to react a lot slower than you do though as I would have to wait at least a couple of hours before taking the second part of the bolus - bed time even!

That's why I'd like to have a look at some official advice before I start experimenting on my own! :-)

novorapidboi26 DAFNE Graduate
NHS Lanarkshire
1,789 posts

I don't know if there is any official advice on this particular type of bolus.......

you will get valuable information from the trial and error approach...

see what your diabetic nurse/doctor has to say maybe...

Gander 7 posts

They did mention the subject very briefly in our Libre familiarisation talk but I think I'll take your advice as I was all over the place a couple of days ago when I tried 50/50! :-(

Warwick DAFNE Graduate
Diabetes Australia-Vic, Melbourne, Victoria
502 posts

I'm vegetarian, but I find that foods like lentils, chick peas and beans have a really low GI, and can spike my BGLs for hours afterwards. When I eat these, I inject Humalog NPH which has a much longer tail than my regular Humalog. There is hopefully a section in your manual about the different profiles of insulin or you could use this link as a guide to find an insulin that may be better for you when eating fatty foods. https://www.healthxchange.sg/diabetes/essential-guide-diabetes/diabetes-types-insulin-action-profiles It is a little inconvenient to have another pen, but it does tend to make my BGLs much flatter than if I try to split my dose.

Gander 7 posts

Thanks for your reply! I actually eat quite a lot of vegetarian meals myself and have noticed that effect with those high fibre foods too, particularly barley which always used to lead to hypos!

I am on fast acting insulin, Novorapid, and Lantus, which lasts for 24 hours and I can't see my GP prescribing a third one unfortunately!

I guess I'll just have to keep experimenting but I am getting there! :-)

Warwick DAFNE Graduate
Diabetes Australia-Vic, Melbourne, Victoria
502 posts

Nice. Experimentation is a good thing with T1D. Smile

kajobren DAFNE Graduate
Central Middlesex Hospital
4 posts

I have only just started using the libre sensor.I did the DAFNE course 14 years ago and have found it great with my h b 1 being good ever since,but I was having low blood sugars at times from over estimating c.ps,however Saturday morning I had two croissants for breakfast which I rarely eat,but was horrified to see my b.g go up to 15.7 I couldn’t resist taking some more quick acting humalogue which then resulted in a hypo.I feel the fat was probably the cause,I admit I also had jam on them ,very interested about the idea of splitting bolts and wondered how this is now working for people as the posted regarding this are awhile ago.

Gander 7 posts

I am not surprised! Shocked
One croissant is quite enough for me for breakfast normally, although you do get some very small ones occasionally! The jam must have put you well into the 100 CHO range. They are very moreish though... Wink