April 14, 2007
Insulin Pumps, Meal Planning, Food and Diet
Question from San Gabriel, California, USA:
I am trying to find a good resource for how to bolus most effectively for those “stubborn foods,” such as pizza, pasta, rice, cake, etc. I understand that the dual wave is the best way to do it, but at what ratio and for how long? Is there a comprehensive list of research done in this area? Or, is there a book about this?
Answer:
According to a 2005 article Optimal Insulin Pump Dosing and Postprandial Glycemia Following a Pizza Meal Using the Continuous Glucose Monitoring System, the best postprandial blood glucose values were achieved when 50% was given up front and the remaining 50% was given over an eight hour dual wave bolus. This is much longer than what we usually recommend, but we don’t have any good data that we go off of either. I think three to four hours works for some and others need a longer time period. It may be one of those things that kids have to “trial and error” to figure out their optimum time.
LAD