The U.S. celebrates Thanksgiving
November 24, 2022
This Quick Tip is prompted by Thanksgiving, but the tips here apply to all food-oriented holidays, and there aren’t that many holidays that aren’t focused on food!
LOTS OF FOOD! All kinds of food … all day! If you’re new to T1D or Looping, spend a little time before the festivities begin and create a ‘cheat sheet’ with the carb, fat and protein counts for the foods that you’ll most likely be eating (and eating again).
Here are some great tips on managing Loop so that you can eat, maintain great control and just enjoy the day.
These tips show the Loop interface, but the concepts can be translated to any closed-loop system.
Bolus Attack: Super Bolus and Pre-Bolus
The main idea is to get insulin moving before the food is eaten, or give the insulin a head start by giving insulin for both the food you are eating now and going to eat later.
It’s ok to manually bolus!
- Manually bolus some of your estimated insulin needs for the next hour or more of eating. You will see a low prediction in Loop since no carbs have been entered.
- Add carbs as you eat them (Loop’s predictions will rise as you enter carbs). Use pictures to remember what you have entered.
- If you end up high, it is often safe to use a super bolus, which is giving a few hours of your basal rate as a bolus. See DiabetesNet.com for more information.
Don’t get too crazy. Remember, fat and protein make some foods SLOW. But, if you’re high, just bolus for the next thing NOW and eat it later.
Basically, pre-bolus for the current food and the next food.
A few bonus tips:
- Expect a dramatic low prediction when manually bolusing until you enter enough carbs to cover the insulin or basal has been off long enough to reduce IOB to match the active carbs.
- Loop will shut off or reduce basal to balance out the extra insulin.
Override to Cover the Unknown
- Use an override for a slight increase in overall basal rate – remember this will cause a proportional increase in insulin for every food entry and increase the corrections offered when predictions are above target – so be cautious
Big Carb Entry
- Enter an estimate for how much you plan to eat with a time of when you plan to start eating but use a long absorption time (5 hours is not unreasonable)
- Edit the amount of the carb entry, or add a new one, to surf your way through the day (Sugar Surfing™)
There are lots of ways to do this; you make the choice. Remember that protein and fat contribute to a later rise in blood glucose – so enter slow-acting carbs to cover that based on your experience.
Disclaimer – These tips will not prevent you from gaining weight, but they might keep your blood sugar within goal.