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April 13, 2003

Meal Planning, Food and Diet

Question from Valparaiso, Indiana, USA:

I take Lantus at 9:00 am and 9:00 pm, and a sliding scale using carb counting, and the other night I ate a large order of french fries and three fish sandwiches from White Castle. I took the correct amount insulin for the carbs along with some NPH to try to compensate for all the fat I ate. I was monitoring my blood with the Glucowatch, and, for the first two hours my sugars were good, but about five hours later, my sugars started to rise to about 200 mg/dl [11.1mmol/L]. Is there a way to help determine the effect of fat and when it turn into sugar?

Answer:

Fat does not turn into sugar. However, sugar can turn into fat. The reason fat influences glucose levels is because the fat content of a meal impacts the rate of gastric emptying into the small intestine. I am not sure the NPH is helpful here as there is no real way to calculate how much to take, other than with trial and error. Lastly, fat can change the body’s utilization of glucose and decrease its uptake.

I think your questions are great and would make for a good patient education program. If you have local diettcians, I would consult them further about the effect of fat on glucose metabolism.

JMS