Sushi Night (it's not really an official event, but more of an "Ooooh, you know what sounds really good?" spontaneous sort of thing) happens about once a month, so I've gotten some degree of practice with the art of the Sushi Bolus. And it really is an art, not a science - who knows what is in those sauces? Whatever it is, it's delicious, and when in doubt on carb counts I go with my stand-by strategy* of:
Throw a bucket of insulin at it and stalk your blood sugar for the next several hours.
A pain? Yes. Worth it? Also yes.
Every situation and PWD are going to be different, but here's what worked for me in the instance above: I ordered two "cooked rolls" (think California or Philadelphia rolls) and ate 14 pieces, plus some soy sauce, wasabi, and ginger. 6 of those were also covered in some sort of sweet sauce and I have no idea what it was made of. I set up an extended bolus on my pump to cover 85g of carbs over 3 hours, with a 65/35 split, and ended up with the results above.
If you've never programmed an extended bolus on your pump before, 1. consult with your CDE/endo (and also, this DiabetesMine article from 2011 does a nice job of explaining what this type of bolus is all about), and 2. here's what I mean by the above: what happens is that of the total amount of insulin I'm programming for this meal, 65% of it was administered up front as a normal bolus. The remaining 35% was spread out over a 3-hour period. This helps me because for whatever reason, sushi digests kind of slowly for me and using this technique helps me avoid a spike later. In fact, in this case I seem to have overdone it a bit, so I had to (at the end of that 3 hour bolus period) set a temp rate of 10% for an hour to even things out.
It takes some practice, but having the ability to bolus in more advanced ways like this is so valuable to me. It's one of the reasons I stick with using an insulin pump.
If you've never programmed an extended bolus on your pump before, 1. consult with your CDE/endo (and also, this DiabetesMine article from 2011 does a nice job of explaining what this type of bolus is all about), and 2. here's what I mean by the above: what happens is that of the total amount of insulin I'm programming for this meal, 65% of it was administered up front as a normal bolus. The remaining 35% was spread out over a 3-hour period. This helps me because for whatever reason, sushi digests kind of slowly for me and using this technique helps me avoid a spike later. In fact, in this case I seem to have overdone it a bit, so I had to (at the end of that 3 hour bolus period) set a temp rate of 10% for an hour to even things out.
It takes some practice, but having the ability to bolus in more advanced ways like this is so valuable to me. It's one of the reasons I stick with using an insulin pump.
*As always, this is not medical advice.
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