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September 13, 2001

Insulin Pumps, Meal Planning, Food and Diet

Question from DeKalb, Illinois, USA:

My 11 year old son has had type�1 diabetes for eight months and is using an insulin pump with good control in general, but we struggle to bolus correctly for high fat meals.Usually, we attempt to give one-half the coverage bolus up front and the other half over the next two hours. However, sometimes he will go low before the dual wave has finished. Generally though, he is high at four hours and even higher up to eight hour later. Any suggestions as to how to handle this situation? Can you please explain the effects of high fat on the body?

Answer:

Fat delays the absorption of glucose. The time of the delay is individual, and your son must have a longer curve during which his blood sugar is high. You might record the amount of fat eaten and share this with his diabetes team. Otherwise, you can either raise the square wave part of the dual wave bolus amount, or try a temporary increase in the basal rate.

LSF

[Editor’s comment: See a brief write up of a poster presented by Dr. Peter Chase on bolusing for high-fat meals at our review of the 2001 ADA conference.

JSH]