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Pizza, cheese burgers, french fries, and ice cream all have something in common aside from being delicious. These foods are high in carbs and fat which can make them difficult to bolus for when you have type 1 diabetes. Here’s what you need to know about dosing for high carb/high fat meals:

How does fat affect blood sugar?

In general, fat will slow down the digestion of carbohydrates. Carbohydrates are usually digested rather quickly, but since fat takes longer to digest everything will get slowed down. In general, saturated fat found in animal-based meats, dairy products, and oils not only slows down digestion, but contributes to insulin resistance as well. Insulin resistance usually looks like having a stagnant blood sugar for hours on end despite giving additional insulin.

How to offset the blood sugar rise from fat

Since fat delays digestion, it is recommended to either start off with an extended bolus with an insulin pump or split bolus with insulin injections. These dosing strategies will provide a slower release of fast acting insulin over several hours rather than giving the complete dose upfront.

Making adjustments

Dosing for high carb/high fat meals can be frustrating and discouraging at times especially when you are faced with a high blood sugar for hours on end. If your last dosing strategy didn’t work, that doesn’t mean you need to swear that food off forever. You can make some adjustments to your approach the next time you eat the food until you find a strategy that works. When making adjustments here are a few questions to consider asking yourself:

• When did you give your initial dose?
• What percentage did you give upfront?
  • 50/50, 70/30, 60/40, 30/70, 40/60
• What time frame did you use?
  • 2, 3, or 4 hours
• Did you require any additional corrections?
• How long did your blood sugar stay high and out of range for?

Dosing for fat can be a headache especially when you are left with a stubborn high blood sugar for hours at a time. But now that you understand WHY your blood sugar responds that way, you can be proactive in your approach and make adjustments as needed until you find a strategy that works best for you.

First time hearing about dosing for fat? Jessica Hrdlicka, RD, CDCES will walk you through everything you need to know on Keeping it 100 Radio: Uncensored Diabetes Conversations Episode 56: T1D Tips: High Carb/High Fat. Available now on Spotify and Apple Podcasts.