# Bolus for cottage cheese?!



## Jeanne (Oct 2, 2011)

Hi all, I'm new to the forum and to pumping! I got my pump on Tuesday and have so many questions that I don't know where to start! But I'll start with bolusing issues. 

I was taught at DAFNE that some foods are so low GI or minimal carbs that there is no need to take insulin to cover them - things like vegetables and lentils. I just ate cottage cheese on toast for lunch and would not normally count the cheese! But I'm kind of obsessing over grams of carbs at the mo and noticed that the amount I ate was 5.6g! After agonising over this for a bit (really!) I didn't include this in my bolus as I wouldn't normally have counted cottage cheese, but I'm wondering if I should have, or if there are other foods which could be having an impact on my BG, like some vegetables etc? I know everyone's different but what do other people do? 

Thanks, looking forward to hearing from you!

Jeanne.


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## HOBIE (Oct 2, 2011)

Hi Jeanne i dont normally have cottage cheese but it does take time to get used to your new pump. Carb counting becomes much less of guess work with a pump & you can plan things much better. Things that you have eatern for years show how they effect you in different ways when on a pump. Good luck sussing new pump.


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## Ellie Jones (Oct 2, 2011)

I actually don't like cottage cheese..  Does cottage chese have carbs in it or is this dependant to whether it has something such a pineapple added?

But something like cheese on toast, I would add about 0.5-1 unit of insulin dependant on how much cheese I was having, then I use a multiwave bolus, so have about 75% (some of this will be dependant on my starting BG) of the dose on the first wave, and then the rest over about 30 minutes on the second wave, don't forget with the multi-wave that the first part goes in like a standard jab, then the time of the second wave which is extended starts it's from when the first wave is injected...

If I was having something like a cheese omellet, then I would use and extended wave..  Normal going for me is about 1 unit of insulin over 15 minutes.. does the trick for me


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## Northerner (Oct 2, 2011)

Well, I'm not a pumper so you can probably ignore this, but I would imagine that because you can set your basals more accurately, and have different ones, then it is a much different proposition when it comes to carb counting than MDI. If you have your basals correct on a pump then you can be sure that any bolus is applied to your carb intake, so there's none of this 'taking from one to cover the other' business (if you see what I mean. For example, I know that my once a day lantus helps cover my food later in the day to some extent, and is therefore a factor to be taken into account when calculating my bolus - so in your case I wouldn't bolus for the cottage cheese.

Hope that makes sense, I'll get me coat!


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## Hanmillmum (Oct 2, 2011)

Hi, i cover every carb where possible for my daughter and that extra 5g of

the cottage cheese would have made quite a difference had I not covered it

with the pump being so finely tuned. Not sure how this differs in others. I 

would think it quite important if you are establishing your carb ratios to cover 

everything with the bolus then it narrows down the other variables if your 

numbers are a bit out when you next check your bgs


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## HOBIE (Oct 2, 2011)

Dont get ya coat Northy (dont no why but made sence to me).            Every bod different & what you have been up to !


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## shiv (Oct 2, 2011)

I would agree with Northe and bolus for it. Your pump is much more accurate than MDI


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## Jeanne (Oct 2, 2011)

Thanks folks, very helpful and confirmed what I thought too! Erring on side of caution at the mo, but feeling quite ill due to being so high - due to being cautious! And what about vegetables? Leafy greens I know are probably tiny amounts but what about stuff like carrots, butternut squash, peas? And having just checked my spinach packet, 80g is 1g carbs. Dietician in new pumper group says don't bolus for veggies but I don't really see why, since I can now take 0.1 unit?


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## novorapidboi26 (Oct 2, 2011)

I discovered on here that some pumpers, through lack of a slower acting insulin, find they do need to bolus for things that myself and others on MDI wouldn't consider, as we have our background insulins, Levemir, Lantus, Humulin I, to mop up those slower absorbed carbs like pulses, nuts etc..........

I suppose you just need to test and record the results to see what's best for you........


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## Phil65 (Oct 3, 2011)

Ellie Jones said:


> I actually don't like cottage cheese..  Does cottage chese have carbs in it or is this dependant to whether it has something such a pineapple added?
> 
> But something like cheese on toast, I would add about 0.5-1 unit of insulin dependant on how much cheese I was having, then I use a multiwave bolus, so have about 75% (some of this will be dependant on my starting BG) of the dose on the first wave, and then the rest over about 30 minutes on the second wave, don't forget with the multi-wave that the first part goes in like a standard jab, then the time of the second wave which is extended starts it's from when the first wave is injected...
> 
> If I was having something like a cheese omellet, then I would use and extended wave..  Normal going for me is about 1 unit of insulin over 15 minutes.. does the trick for me



Surprised you bolus at all for a cheese omelette...zero Carbs in an omelette


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## Phil65 (Oct 3, 2011)

Jeanne said:


> Thanks folks, very helpful and confirmed what I thought too! Erring on side of caution at the mo, but feeling quite ill due to being so high - due to being cautious! And what about vegetables? Leafy greens I know are probably tiny amounts but what about stuff like carrots, butternut squash, peas? And having just checked my spinach packet, 80g is 1g carbs. Dietician in new pumper group says don't bolus for veggies but I don't really see why, since I can now take 0.1 unit?



Jeanne I don't count carbs in salads apart from tomatoes, there is hardly any carbs in green leafy veg either....have you got the book Carbs and Cals?  I used this a lot when I started pumping.  Good luck with your pump


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## shiv (Oct 3, 2011)

Phil65 said:


> Surprised you bolus at all for a cheese omelette...zero Carbs in an omelette



I'm guessing it's the protein - with no carbs, protein turns to glucose in some magical way.

At the FFL conference last year, Gary Scheiner reckoned a big helping of salad was like 5g carbs...I don't tend to count it unless it makes up the main portion of my meal.


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## Unicornz (Oct 6, 2011)

Phil65 said:


> Surprised you bolus at all for a cheese omelette...zero Carbs in an omelette



I have to bolus for carb free meals as well - only a tiny one though, but they make my BG rise if I don't do it. I think it's because of the protein and the lactose, both of which will be converted to glucose if you don't eat any carbs so the body gets its energy. 

I know Jeanne's question has already been answered, but I also agree with what Northerner said. I would also bolus for it, but that's because out of experience I know that if I don't my BG will rise. I think it's because - if your basal is set right - it will only give you precisely the amount you need for the liver glucose dumps and so doesn't cover you for the tiny snacks that long acting insulin might do (because long acting insulin will never be precisely tailored to your body's needs). So yes, a pump is much more accurate than MDI in that respect and I have found from my personal experience that the tiniest snacks will need a bolus. The only way to be sure though is to try it


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## tracey w (Oct 8, 2011)

shiv said:


> I'm guessing it's the protein - with no carbs, protein turns to glucose in some magical way.
> 
> At the FFL conference last year, Gary Scheiner reckoned a big helping of salad was like 5g carbs...I don't tend to count it unless it makes up the main portion of my meal.



Absolutely Shiv! Before the pump i did not have to bolus for things like eggs or veg. But bolus for everything now. I count a medium egg as 6g of cho, cottage cheese does have cho value and is written on the tub. And veg does have carbs i usually count as 5 - 10 depending on my portion. if i have eggs for breakfast i dual wave as they will spike me after about 1 hour 30.


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## Jeanne (Oct 10, 2011)

Thank you everyone. My post lunch BGs have been much more normal since I started bolusing for all carbs; but I still have lots of work to do with basal rates.

Jeanne


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