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VALERIE1619's Photo VALERIE1619 Posts: 1,084
4/1/11 11:38 A

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Carey, how often do you test?

I have a book on TAG but don't know if I want to get into restructuring everything I've been doing...

My A1C has always been in the 5.4-5.6% range but results earlier this week show it at 6.0%.

I'm having lots of challenges with peri-menopause screwing with my "near perfect" routine!

Valerie


Valerie

Sh*t is hard. Do it anyway.



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4/1/11 9:12 A

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Yep the fat content in meals as well as protein effect your bg. Fat delays the digestion so therefor you need to extend a bolus for longer than say a salad or cereal. and protien getting factored in is a big deal too my A1C is so much better now that I use the TAG method!

"you CAN do ALL things through Christ which STRENGTHENS you"
phil 4:13


I don't believe in failure.

( this includes getting healthy!!)


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SHORTYGETFIT's Photo SHORTYGETFIT Posts: 477
3/26/11 12:36 A

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Hello Ladies,

I just wanted to say that this thread is very interesting, I will have to come back and read over it again. I remember when I was first diagnosed, the Nutritionist told me that I would count carbs in all foods, but later wonder why my reading and others told me that most protein did not have a carb count. I am sleepy, so I will review and probably come back with more questions/comments.

" Sometimes God places people in your life who help and encourage you even when they don't know it"


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3/24/11 5:37 P

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No problem! I love it! yes it takes a little more calculating but so work it when I get the results!

"you CAN do ALL things through Christ which STRENGTHENS you"
phil 4:13


I don't believe in failure.

( this includes getting healthy!!)


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3/24/11 2:21 P

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THANK YOU! I am so grateful to have this information to start off with. I'll give it a shot next week and see if it improves over what I'm doing now.

THANK YOU THANK YOU THANK YOU!!!

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3/23/11 11:55 P

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I have found through trial and error that for my metabolism, approximately 40% of ingested protein and fats are eventually converted to carbs (my percentages have changed over time as I played with the technique). I total the grams of protein and fat and multiply by 40%. As an example, if the protein and fat total to 80 grams, I would multiply by .40 and come up with 32 grams. With an i:c ratio of 1:10, this 32 grams of protein and fat carb loading would need to be covered by 3.2 units of insulin, in addition to the carbs in the meal. Since proteins and fats are digested more slowly than carbs, the 3.2 units have to be delivered using a square wave/ extended bolus to prevent a person from dropping too low.

How do I time the square wave/ extended bolus? Again, through much trial and error I find that a delivery rate of approximately 1 - 1.2 units of insulin per hour delivery rate for the square wave/ extended bolus keeps me from dropping too low or spiking too high. So in this example, I would deliver the 3.2 units over a time span of 3 hours (3.2 units per hr/ 3 hrs = delivery rate of 1.06 units per hr, which is within the 1 - 1.2 target delivery rate. The 1 - 1.2 delivery rate is used assuming I was in BG target range to begin with. If my BG is above target, I would use a delivery rate higher than this range or transfer part of the protein/ fat bolus to the carb bolus for immediate delivery. If my BG is below range, I would use a delivery rate which is lower.

As you can tell, I also experience a much smaller spike after eating a meal when using this technique. Typically, I see my BG spike as little as 20 - 30 points after eating a pasta meal which will have over 100 grams of carbs. After such meals it is common to see 1 hr post prandials of 100 - 120 and 2 hr post prandials of less than 100. If I delivered the insulin correctly, I will be at or near target several hours after the meal, without ever going low.

For starters most people start with a 70/30 dosing and move the percentages up or down depending on their body and diabetes. This is what I do with every meal now and have essentially minimize my spikes.

"you CAN do ALL things through Christ which STRENGTHENS you"
phil 4:13


I don't believe in failure.

( this includes getting healthy!!)


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3/22/11 7:00 P

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Valerie - thanks so much for the info. I'm equally annoyed that Dr. B doesn't talk about pumping!! I'm re-reading Gary Scheiner's "Think Like a Pancreas" to get me back on track.

Carey - I looked around tudiabetes for awhile and was completely overwhelmed with information (which is why I deleted my account there in the first place). Can YOU tell me how this works for you? (Like how much you take for however many grams of fat/protein/carbs you eat, etc...)

Thanks so much ladies!

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3/22/11 5:53 P

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I use tag myself as well and my Spikes have been minimal since this I also cover fat with it as well and use a square wave bolus or dual wave depending on the meal. My last A1C was 5.9 and I am in love with that number! To find more about the TAG method you can visit tudiabetes.org and look up Tag group. We have people with stellar info on this subject. Tudiabetes is like facebook for diabetics if you have never been to this site I highly recommend it as the support and diabetes news is just woderful!

"you CAN do ALL things through Christ which STRENGTHENS you"
phil 4:13


I don't believe in failure.

( this includes getting healthy!!)


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VALERIE1619's Photo VALERIE1619 Posts: 1,084
3/22/11 4:30 P

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There's also a system called TAG (Total Available Glucose) which factors in protein.

I don't count protein because I never eat GIANT amounts. Most I eat is about 6 ounces at a time, max.

The only thing I don't like about Bernstein is his inability to embrace pumping. He's an old dog who prefers injections.


Valerie

Sh*t is hard. Do it anyway.



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3/22/11 3:56 P

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Hey everyone -

I recently read through Dr. Bernstein's Diabetes Solution and am IN LOVE. www.amazon.com/Dr-Bernsteins-Diabete
s-
Solution-Achieving/dp/0316167169/refR>=sr_1_1?ie=UTF8&qid=1300823488&sr=8-1
(get it from the library now, but check out the new edition coming out this fall)

He talks about covering protein with insulin and I've done the calculations as an Apidra pumper. I think I need 1 unit to cover 12g of carbohydrates and 1 unit per 2.3 oz of protein (or 1 unit per 14 grams?). This is very interesting to me because I've never counted protein into my insulin dose.

Do any of you do this?? If so, please tell me how you do it! Thanks!

Allison

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