# all you can eat **** up.....



## bev (Jan 30, 2010)

Hi all,
Update on our 'eat all you can' meal last night.

Dual Wave for 30cho (50/50) over 4 hours to start us off - he had rice - then we added each item as he went - sausages - prawn toasts - crisp duck pancakes - etc....

Then after half an hour - he was 3.7!? So was forced to eat a pot of chocolate from the chocolate fountain! Got up to 4.5 and carried on eating - all same food as before and counted and added as we went.

Anyway, the following 3 hours tests were 4 5 4 6 4 etc - so gave him a tiny biscuit before bed.

1am - 25.8!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Corrected - then 1 hour later - 22.5!!!!!!!!!!!!!!!!!!

Gave another small correction and put temp basal on of 130% for 3 hours. He was 7 at 6am and stayed like that until 9am.

Not sure what i did wrong - advice welcome! He hasnt eaten so much food since diagnosis or such greasy type food - so not used to dealing with it!Bev


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## Freddie99 (Jan 30, 2010)

Bev,

If A had greasy food the fat content delays the release of food from the stomach into the small intestine. What that means is the insulin is absorbed and out of the body so there is no insulin to cover the food that has moved into the small intestine after a longer than usual period in the stomach. Perhaps a dual wave at a later period, if you use the CGM sensors that come with the Veo perhaps you could use tehm to spot when rises occure after a greasy meal and then act appropriately?

Tom


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## am64 (Jan 30, 2010)

All i know bev is when i told my DSN that i had some crap chocolate once cos i was low for me, she said the problem is the fat level makes it work slower thats why its a myth to give a diabetic chocolate for hypo....so it sounds like you had a build up ....poor ole A  and you hope you had fun anyway xx


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## randomange (Jan 30, 2010)

Hi Bev

I wonder if he's having a similar problem to me?  When I have high fat, high carb meals like chinese or pizza, I get a peak about six hours after I've eaten, and this peak seems to require more insulin than my ratio would suggest (about 25% extra in my case).  Unfortunately I think sussing these things out is pretty much trial and error!


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## Northerner (Jan 30, 2010)

Bev, I can't comment on the pump aspects, but it sounds to me like all that was a pretty complex experience and actually you coped very well on the whole. A bit more experience to consider, scratch your head about and try a slightly different tack next time. Imagine how much harder it might have been (if not impossible) on MDI! 

I think that you did well, and hopeflly Alex enjoyed it and didn't suffer because of the late high.


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## Adrienne (Jan 30, 2010)

Hiya

When Jessica just has rice she has to have 30/70 dual.   With rice in some people it doesn't start working very quickly so the insulin could well have kicked in way before the rice even thought about it, hence the first hypo.

You could well have over bolused on the individual things which is why I never do that.   I would have started eating and then once some rice is in, bolused but I would have done the same as you ie 50/50 but I would have done a bigger amount than 30, perhaps 50 to cover all that food.   I would have done it over 5 hours.    I would have then maybe bolused extra for a pudding.

You have done nothing wrong, this is very very typical for chinesey style food.  It is sooooo unpredictable that it has to be a treat food.   Don't let that stop you going as you can deal with it after, especially on a pump.

What you have proved with Alex is he can't have a 50/50 on a chinese, he needs a 30/70 perhaps but spread over maybe 6 or 7 hours.   Then you could have bolused for a pudding extra but not the other bits.  

It is so hard to guesstimate Chinese you just need to take a stab at an overall guess.

I think the lows were too much insulin all at once and the highs were not enough insulin spread out.

Again you have done nothing wrong, this is normal.    

Hope he (and you all) had a good time and that the highs didn't spoil it for him.

You need to have Chinese take away and experiment !!


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## Adrienne (Jan 30, 2010)

randomange said:


> Hi Bev
> 
> I wonder if he's having a similar problem to me?  When I have high fat, high carb meals like chinese or pizza, I get a peak about six hours after I've eaten, and this peak seems to require more insulin than my ratio would suggest (about 25% extra in my case).  Unfortunately I think sussing these things out is pretty much trial and error!



Hi

This is very very normal in all this sort of food, pizzas and chinese being the very worst.   People can peak 6 to even 8 or 9 hours later.   Lots of people do their normal bolus or injection and yes, like you, need it all again when you peak.  On a pump you can set a bolus of insulin to carry on drizzling out over those hours to hopefully stop the spike but believe me it is a nightmare to actually know when that spike it going to happen, it differs each time.


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## Adrienne (Jan 30, 2010)

Forgot to mention but after you (Bev) saying about this restaurant I googled it and we are off there tomorrow lunch time after the cinema with friends so we will see what happens as well and your experience will help me tomorrow.   Believe me, I'm no expert with this and find it very hard to get right, it really is hit and miss and you either chase hypos or hypers................


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## bev (Jan 30, 2010)

Thanks all!

Adrienne, if you have one of these restaurants near you - GO! On a sunday they do half price ?6.50 all you can eat and the food is gorgeous. You go and choose which piece of meat/fish etc you would like and they cook it for you to your liking while you wait. There is so much healthy stuff too! I didnt manage to taste everything - but i had sushi salmon dim sum prawns and all sorts of fresh fish - GORGEOUS! I defy anyone not to get their monies worth though as there is so much food to choose from and you are given a 2 hour slot! Highly recommended!Bev


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## bev (Jan 30, 2010)

Wooops! I must have been typing as you were replying! Have a lovely time tomorrow and do let me know how you get the dual wave right! I think i will have to go back again to 'practice'!Bev xx


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## Adrienne (Jan 31, 2010)

Thanks for text earlier Bev, sorry didn't reply was in the cinema seeing the flipping chipmunks the Squeakwell !  

Anyway Jessica was skyhigh before she started eating at COSMO.  We had had popcorn and I had miscalculated and she was 20.7 when we started at the restaurant, whoops.

She had a plate of rice and other bits and she started eating and halfway through we bolused.   We guessed 80 cho and did a 70/30 dual wave over 6 hours.  This included the correction for the 20.7 which is why I did 70/30 rather than maybe 55/45 or 60/40 which was in my head to do before I found out she was 20.7.

I then let her have exactly what she liked including puddings.  Oh boy, chocolate fountain and marshmallows and other stuff.  The only thing I said no to was jelly !    

So during then and now (we ate at 1 pm) I have overridden the correction factor twice but only by 0.3 and 0.5.   These are her numbers :

10.31   12.8
12.28   20.7
15.03   16.9   overriden by 0.3
16.33   17.3    overriden by 0.5
18.18   10.9
19.13   12.4    Soup and yoghurt for tea so bolus and no correction as active
20.33   7.4


So I'm actually quite pleased seeing as how she was so flipping high to start with.    However knowing Jessica the 7.4 will continue going down, I wait with bated breath.

It will be interesting to see what happens next time as we will  go back but will go to the Hastings one as it is huge, whereas Eastbourne's one is tiny.  

I would have done the 55/45 or 60/40 if levels ok and again just let her eat whatever.

Oh well we shall see.


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## Kei (Feb 1, 2010)

Yikes!  All those numbers look scary!  I do fine with carb-counting, Mixtard and Novorapid, but I'm worried that if F ever goes on a pump I'll struggle with the calculations.  I have a slight number-blindness thing, where I can get totally confused with numbers...

I hope her numbers stayed fairly regular and didn't keep dropping.

Kei
xx


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## Steff (Feb 1, 2010)

Adrienne said:


> Thanks for text earlier Bev, sorry didn't reply was in the cinema seeing the flipping chipmunks the Squeakwell !
> 
> Anyway Jessica was skyhigh before she started eating at COSMO.  We had had popcorn and I had miscalculated and she was 20.7 when we started at the restaurant, whoops.
> 
> ...



Off topic but Adrienne you should come here for the night lol, my son had watched that chipmunks film every night since last wednesday it is driving me and his dad mad


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## Adrienne (Feb 1, 2010)

Kei said:


> Yikes!  All those numbers look scary!  I do fine with carb-counting, Mixtard and Novorapid, but I'm worried that if F ever goes on a pump I'll struggle with the calculations.  I have a slight number-blindness thing, where I can get totally confused with numbers...
> 
> I hope her numbers stayed fairly regular and didn't keep dropping.
> 
> ...



Believe me those numbers are great when you through a chinese into the mix.   I think the problem I had was that she started so high but that was my fault for under estimating the pop corn at the cinema.

She went up again to 13.0 but I corrected that at midnight and she woke up at 5.8 so all worked out fine in the end.


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## bev (Feb 1, 2010)

Adrienne,
Considering the level was at 20 to start with i think you did brilliantly! Wow! I am a bit jealous of the way you got her down to 7.4! I will just have to go back and try all over again. By the way - did you both like it there?Bev


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## Adrienne (Feb 1, 2010)

Yes loved it and are going to go back but need to go to the bigger one in Hastings next time as Eastbourne is the flagship restaurant so the smallest.  

Please don't be jealous at all.   It was pure guesswork.   I just kept an extra eye on levels and decided whenever it was too high to override the pump but only with small amounts like the 0.3 and 0.5 and just keep testing.  There was no science behind it, just guessing and luck, that is all.

No idea what will happen next time.  Sheer fluke thats all that happened.


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## Patricia (Feb 1, 2010)

I think you did well too, starting at 20! Yipes. It's exactly that which is so nightmarish for us....

Bev you did well too -- we have yet to try anything like this with E, on pump or not...The one time we tried eating lots over a period of time, we did separate boluses and it was pretty disastrous, like Adrienne says, way over-estimating...it's easy to do.

We have had enchiladas tonight. Lots of cheese. Think of us! No idea what will happen...


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## Icey (Feb 1, 2010)

Must be the weekend for Cosmos and all you can eat  

I went on Sunday - I was very surprised to see that my test was 20.something, however I didn't get to test until around 3ish hours later, so it could have been higher.

I'm guessing you went to the Swindon one Bev? 

(Sorry for crashing in the pumping section :">)


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## bev (Feb 1, 2010)

Icey said:


> Must be the weekend for Cosmos and all you can eat
> 
> I went on Sunday - I was very surprised to see that my test was 20.something, however I didn't get to test until around 3ish hours later, so it could have been higher.
> 
> ...



Hi Icey,

Yes we went to the Swindon one!Which one did you go to? I am sorry that you were 20. something - but also feel slightly heartenend that someone else found it hard to keep on top of an 'all you can eat'! It is so hard with fatty foods isnt it? I think we will be going again though - I am envious of Adrienne's results!Bev


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## Adrienne (Feb 1, 2010)

Bev, seriously it was sheer fluke.  You can never be sure in these places.  I was dealing with a high as well as food so had room to play around with insulin whereas you didn't.

Next time it will never be the same.

Tonight I have over estimated and she has been hypo since 9.15 pm.  She started at 3.9, coke down to 2.8  any only now just come up to 3.9.  She had two cokes, a hypo fit and two glucose tabs and an hour of 0% basal so goodness knows what will happen later !


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