Sunday, November 30, 2014

Bolusing: Chocolate Effect

Yesterday was my oldest sweetie's FOURTEENTH birthday!  He's been through a lot in his short life.  Four pounds, thirteen ounces and 18 inches to over 5'3' and 106 pounds.  Whew.  Over a year with diabetes..and every year it gets harder (especially when he wants cheesecake for dessert!).  It's totally worth every minute, and I love him so much.  I hate diabetes, and don't spend too much time writing about it..since I don't like to give it a minute more than it deserves.  But we can talk about chocolate, no?  Yum!

I don't know about you, but when we bolus (give insulin) for chocolate (even pure bars, no nuts), I have to multiply printed carbs x 1.5, then give a dual wave bolus (on the pump).  So, today his cheesecake said it was 33 grams (big fat HA!), I bolused him for 50 grams.  His bolus ratio is correct with other foods, so I've isolated it to just chocolate for both him AND his sister.  Chocolate is yummy..but it keeps coming back to bite you.  You just can't trust it.

So, I delivered a dual wave bolus for 50 grams, about 66% normal and about 34% over 4 hours.  (Have you ever checked your child/yourself an hour after eating to find you are perfect..but four hours later over 300?  We call that the Chocolate Effect.)  We'll check him in four hours to see how we did. : )

We do the same with chocolate chip cookies (anything with chocolate chips), chocolate fudge, Hershey's kisses (ANY pure chocolate candy/bar, nuts or not), brownies, chocolate pie, etc.  I have found that Oreos do not need increased insulin.  Huh.  Can't explain it.

BTW, we bolus other desserts (like chocolate chip cookies, fudge, candy bars) with a dual wave bolus.  We deliver 60-70% right away, and 30-40% over 30 minutes to an hour, depending on how much fat/protein is in the food.  (Do you know there is PROTEIN in chocolate?  yep, so you need more, haha!)  Then we pray and keep an eye on them hourly for at least three hours.  This is why we don't have rich desserts at night when we are super tired, ha!  ..We parents have to look at each other and agree to allow it if they want something rich after 8ish..it'll mean a (minimum) 1am night!

Do you know that if your child stays high during the (minimum) 8 hours they sleep, not only do they build up ketones, but their a1c will increase dramatically?!  It's like letting them go high for an eight hour stretch in the day.  You wouldn't dare do it then.  So..by staying on guard that extended time early on in their sleep (11pm to 2am), you protect that long stretch of time.  Therefore lowering a1c.  We all win, Hooray!  (..More protein-filled chocolate Reese's bells tomorrow!) (and of course, I order four bags at a time..is that not normal?)

How sweet are your words to my taste, sweeter than honey to my mouth!    Psalm 119: 103

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