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    • 4 hours, 30 minutes ago
      ConnieT1D62 likes your comment at
      Does your T1D healthcare provider suggest new medications or devices that they think would be beneficial to your T1D management during your appointments?
      I’m almost always more informed of the reported advancements in T1 treatments than my doc. So I usually bounce ideas off the doc for his input.
    • 4 hours, 31 minutes ago
      ConnieT1D62 likes your comment at
      Does your T1D healthcare provider suggest new medications or devices that they think would be beneficial to your T1D management during your appointments?
      I am my own advocate. I read about new devices and always investigate side effects of any new medication before starting. I usually bring up but then have good discussion with Endo before making decisions.
    • 4 hours, 33 minutes ago
      ConnieT1D62 likes your comment at
      Does your T1D healthcare provider suggest new medications or devices that they think would be beneficial to your T1D management during your appointments?
      With my endo, I usually have to ask. With the Diabetes Educator, she'll make the suggestion first. They're both very aware that I'm dependent on insurance covering the majority of the cost.
    • 5 hours, 46 minutes ago
      Trina Blake likes your comment at
      Does your T1D healthcare provider suggest new medications or devices that they think would be beneficial to your T1D management during your appointments?
      I wouldn't say that my T1D healthcare provider OFTEN suggests medications or devices that they think would be beneficial to my diabetes management, but they do SOMETIMES suggest options available to me. (I was privileged to be the first person, in the area that I live, to be offered CSII (Continuous Subcutaneous Insulin Infusion, or pump technology) to help control my diabetes. This was after my endocrinologist attended a diabetes conference in the United States where a former Miss America, Nicole Johnson, was demonstrating a Medtronic/MiniMed insulin pump. He asked her for more information on how these pumps work, mentioning that I had extreme difficulty in controlling my diabetes, with me spending as much time in hospital as I was at home when I was taking multiple daily injections (MDI). On his return to the UK, he offered me the opportunity to 'trial' the pump, which I accepted. This was in 1989.)
    • 5 hours, 52 minutes ago
      beth nelson likes your comment at
      If you have T1D, have you ever dated or married someone who also has T1D?
      No, I was the one who had diabetes
    • 5 hours, 52 minutes ago
      beth nelson likes your comment at
      If you have T1D, have you ever dated or married someone who also has T1D?
      I fell in love with an insulin-dependent Type 2 20 years ago. There’s something terribly romantic about taking Lantus together at the end of the day.
    • 5 hours, 52 minutes ago
      beth nelson likes your comment at
      If you have T1D, have you ever dated or married someone who also has T1D?
      Already married over forty years when I was diagnosed.
    • 5 hours, 52 minutes ago
      beth nelson likes your comment at
      If you have T1D, have you ever dated or married someone who also has T1D?
      I never knew of anyone who had diabetes, type 1 or 2 before I was married. I became a T1D after I was married.
    • 5 hours, 57 minutes ago
      beth nelson likes your comment at
      If you have T1D, have you ever dated or married someone who also has T1D?
      I answered “no.” I don’t think my girlfriend at diabetes children’s camp when I was 13 counts. While I think there would be a lot I would have in common with a partner with T1D, I wouldn’t want that to be what brought us together, and I don’t think it would keep us together.
    • 5 hours, 57 minutes ago
      beth nelson likes your comment at
      If you have T1D, have you ever dated or married someone who also has T1D?
      went on one date with a T1D. she had been dx'd as a child (I was dx'd at 43) so she was very old school. she ragged on me during the entire date about my menu choices, my carbs estimation for my shot and she lost her mind when I ordered a Corona! punchline is that my sugar was less than 150 when I went to sleep.
    • 5 hours, 57 minutes ago
      beth nelson likes your comment at
      If you have T1D, have you ever dated or married someone who also has T1D?
      When I was married, diabetes was not in the picture at all. All I knew was an uncle who died in 1929 because he refused injections. I developed LADA in my 40's, followed by my husband with Type 2, then my two daughters who had PCOS and Type 2, then my son with Type 2. Enough.
    • 5 hours, 57 minutes ago
      beth nelson likes your comment at
      If you have T1D, have you ever dated or married someone who also has T1D?
      I am married to someone with Type 2.
    • 5 hours, 58 minutes ago
      beth nelson likes your comment at
      If you have T1D, have you ever dated or married someone who also has T1D?
      I have been married since 1985. My wife Susan does not have either type 1 or 2 diabetes, but rather type 3 diabetes- spouse or mate of someone with T1D...:) She has been my guardian for night lows, though she has rarely had to intervene since I started CGM in 8-2006.
    • 5 hours, 58 minutes ago
      beth nelson likes your comment at
      If you have T1D, have you ever dated or married someone who also has T1D?
      I dated someone, but I was/am not out of the closet about having T1 so he didn’t know that I have T1
    • 5 hours, 58 minutes ago
      beth nelson likes your comment at
      If you have T1D, have you ever dated or married someone who also has T1D?
      My husband was diagnosis at age 3 and I was diagnosed at age 4.
    • 6 hours, 18 minutes ago
      Janis Senungetuk likes your comment at
      Does your T1D healthcare provider suggest new medications or devices that they think would be beneficial to your T1D management during your appointments?
      I wouldn't say that my T1D healthcare provider OFTEN suggests medications or devices that they think would be beneficial to my diabetes management, but they do SOMETIMES suggest options available to me. (I was privileged to be the first person, in the area that I live, to be offered CSII (Continuous Subcutaneous Insulin Infusion, or pump technology) to help control my diabetes. This was after my endocrinologist attended a diabetes conference in the United States where a former Miss America, Nicole Johnson, was demonstrating a Medtronic/MiniMed insulin pump. He asked her for more information on how these pumps work, mentioning that I had extreme difficulty in controlling my diabetes, with me spending as much time in hospital as I was at home when I was taking multiple daily injections (MDI). On his return to the UK, he offered me the opportunity to 'trial' the pump, which I accepted. This was in 1989.)
    • 6 hours, 19 minutes ago
      Janis Senungetuk likes your comment at
      Does your T1D healthcare provider suggest new medications or devices that they think would be beneficial to your T1D management during your appointments?
      I think my healthcare providers learn about new medications and devices at about the same time that I do. This wasn't the case when I was first diagnosed, pre-internet. Back then, I always looked forward to seeing my CDE because I knew I'd come away with something to make my life easier/better.
    • 6 hours, 39 minutes ago
      Bonnie Lundblom likes your comment at
      If you have T1D, have you ever dated or married someone who also has T1D?
      I have been married since 1985. My wife Susan does not have either type 1 or 2 diabetes, but rather type 3 diabetes- spouse or mate of someone with T1D...:) She has been my guardian for night lows, though she has rarely had to intervene since I started CGM in 8-2006.
    • 6 hours, 48 minutes ago
      beth nelson likes your comment at
      Does your T1D healthcare provider suggest new medications or devices that they think would be beneficial to your T1D management during your appointments?
      I may already be on the best medications and devices available to me.
    • 6 hours, 48 minutes ago
      beth nelson likes your comment at
      Does your T1D healthcare provider suggest new medications or devices that they think would be beneficial to your T1D management during your appointments?
      I wouldn't say that my T1D healthcare provider OFTEN suggests medications or devices that they think would be beneficial to my diabetes management, but they do SOMETIMES suggest options available to me. (I was privileged to be the first person, in the area that I live, to be offered CSII (Continuous Subcutaneous Insulin Infusion, or pump technology) to help control my diabetes. This was after my endocrinologist attended a diabetes conference in the United States where a former Miss America, Nicole Johnson, was demonstrating a Medtronic/MiniMed insulin pump. He asked her for more information on how these pumps work, mentioning that I had extreme difficulty in controlling my diabetes, with me spending as much time in hospital as I was at home when I was taking multiple daily injections (MDI). On his return to the UK, he offered me the opportunity to 'trial' the pump, which I accepted. This was in 1989.)
    • 6 hours, 48 minutes ago
      beth nelson likes your comment at
      Does your T1D healthcare provider suggest new medications or devices that they think would be beneficial to your T1D management during your appointments?
      I think my healthcare providers learn about new medications and devices at about the same time that I do. This wasn't the case when I was first diagnosed, pre-internet. Back then, I always looked forward to seeing my CDE because I knew I'd come away with something to make my life easier/better.
    • 6 hours, 48 minutes ago
      beth nelson likes your comment at
      Does your T1D healthcare provider suggest new medications or devices that they think would be beneficial to your T1D management during your appointments?
      I had to answer “other” because I just got a new endo after my other one retired so I’ve only met with him once. Too early to discuss new technology or medications.
    • 6 hours, 48 minutes ago
      beth nelson likes your comment at
      Does your T1D healthcare provider suggest new medications or devices that they think would be beneficial to your T1D management during your appointments?
      Generally, no, my healthcare provider does not suggest new medications or devices. However, it is not often that new meds/devices become available. Most things are dependent upon my quarterly blood tests. Recently, my Endo put me on statin drugs when my bloodwork showed high cholesterol over a six month period. Otherwise, I am usually the one who asks about new devices about which I have heard or read.
    • 6 hours, 49 minutes ago
      beth nelson likes your comment at
      Does your T1D healthcare provider suggest new medications or devices that they think would be beneficial to your T1D management during your appointments?
      I’m almost always more informed of the reported advancements in T1 treatments than my doc. So I usually bounce ideas off the doc for his input.
    • 6 hours, 49 minutes ago
      beth nelson likes your comment at
      Does your T1D healthcare provider suggest new medications or devices that they think would be beneficial to your T1D management during your appointments?
      I am on the Dexcom, I’m not on a pump though. I am LADA so I have very high insulin resistance, so I use a lot of insulin & there’s just not a pump that would be efficient for my amount of insulin. I’ve tried to get Afrezza, but every Endoc I bring it up to won’t prescribe it. Even though I bring them evidence that it doesn’t cause lung cancer when you’re not a smoker. So frustrating that we can’t agree on that course of treatment.
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    When counting your carbs before bolusing, do you factor the amount of fat into your calculation at all?

    Home > LC Polls > When counting your carbs before bolusing, do you factor the amount of fat into your calculation at all?
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    When you are traveling away from home for a few days, do you typically take glucagon with you?

    Sarah Howard

    Sarah Howard (nee Tackett) has dedicated her career to supporting the T1D community ever since she was diagnosed with T1D while in college in May 2013. Since then, she has worked for various diabetes organizations, focusing on research, advocacy, and community-building efforts for people with T1D and their loved ones. Sarah is currently the Senior Marketing Manager at T1D Exchange. Sarah and her husband live in NYC with their cat Gracie. In her spare time, she enjoys doing comedy, taking dance classes, visiting art museums, and exploring different neighborhoods in NYC.

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    29 Comments

    1. AimmcG

      Since I use a closed loop system my accuracy in carb counting has gotten less accurate. I don’t have to be as precise

      8 months ago Log in to Reply
    2. Ms Cris

      Yes.
      Higher fat meal, longer extended bolus.
      Lower fat meal, shorter extender bolus.

      8 months ago Log in to Reply
    3. Lawrence S.

      Generally, I eat a low-fat diet. However, there may be occasions when I eat a high fat meal, and use an extended bolus. But, I don’t calculate for fats.

      8 months ago Log in to Reply
    4. Amanda Barras

      Not so much actually counting it, but being aware it’s there and is going to delay absorption. Changing a regular bolus to an extended bolus to cover high carb and fat food like pizza and Chinese food.

      4
      8 months ago Log in to Reply
      1. mojoseje

        I wish CGM paired with my pump allowed for dual and square-wave boluses.

        2
        8 months ago Log in to Reply
    5. Ahh Life

      In the good old days it would take 90 minutes for digestion on my low-fat diet. I would add 2-3 hours for pizza and high-fat food digestion with extended boluses.

      Then gastroparesis reared its ugly head. All bets were off. I now use the best artful artifice to finesse and approximate the equations diabetic educators recommend. Biology and faulty nerves often work at wicked purposes. 🙈

      6
      8 months ago Log in to Reply
      1. Lawrence S.

        Ditto

        8 months ago Log in to Reply
      2. Joan Fray

        Yes, delayed stomach emptying can be another monkey in the wrench!

        8 months ago Log in to Reply
    6. Sherolyn Newell

      I read that fat also inhibits the action of insulin. It also said how much is different for everyone, some need 10% more insulin, some need double. Seems risky to experiment much, but I usually increase the carb count by 10% and do the usual extended bolus.

      8 months ago Log in to Reply
    7. mbulzomi@optonline.net

      I have travelled extensively around the world. I never have taken my Gvoke HypoPen with me. Do you think everybody can read English to administer the glucagon injection?

      A never leave home without my Glucose tablets PERIOD!

      8 months ago Log in to Reply
      1. mbulzomi@optonline.net

        Answered in error.

        1
        8 months ago Log in to Reply
    8. mojoseje

      I only bolus for carbs and when my bg starts to rise later (after a couple of hours) I look at the upward trend and “correct” for the fats. I think I’m pretty successful at it since my endocrinologist says being in-range at 93% is really good.

      3
      8 months ago Log in to Reply
    9. Jane Cerullo

      For me fat usually requires a bolus a few hours after a meal. Tried keto but was not for me. BS all over the place. I’ll stick to low carb moderate fat.

      1
      8 months ago Log in to Reply
    10. Mick Martin

      I do factor in the amount of fat in a meal in order to administer a dual-wave bolus of insulin.

      With meals such as pizza or chips (French fries) I tend to give two thirds of my bolus immediately and the remaining third over a period of about 1.5 hours.

      2
      8 months ago Log in to Reply
    11. Bob Durstenfeld

      Pizza!
      It gets a delayed bolus.
      Other than that, not often. I stay away from fatty meals.

      1
      8 months ago Log in to Reply
    12. Sheldon Schwartz

      . Fat slows digestion so it will determine extended bolus or not.

      8 months ago Log in to Reply
    13. Janis Senungetuk

      I only consider the amount of fat if my meal is pizza or another meal with lots of cheese. If that’s the case then I extend the bolus delivery but I don’t increase the carb count.

      1
      8 months ago Log in to Reply
    14. Jeff Balbirnie

      If the food has a greater amount of fat/protein if may factor in the dosage, but there is no specific math for that I know of….

      Likely being attentive at the back end of that dosage ( I.e. 3-4 hours later.)

      1
      8 months ago Log in to Reply
    15. Becky Hertz

      I rarely eat high fat meals. I use extended bonus when I do

      8 months ago Log in to Reply
    16. Bonnie Lundblom

      Pizza is the meal that requires me to extend the bolus dose but doesn’t affect the amount of insulin bolus I use to cover the carbohydrate amount.

      8 months ago Log in to Reply
    17. Pauline M Reynolds

      I only take the fat into consideration if it is a high fat meal, like pizza. Then I use extended bolus.

      4
      8 months ago Log in to Reply
    18. Mitchell Ehrlich

      I consider the amount of fat to determine if, and how long, to set up an extended or dual-wave bolus. I do this to account for the effect of the fat slowing absorption of the carbs, and thus slowing of the rise of BG. For me, if I don’t do this I will end up with high BG much later than usual after the meal.

      1
      8 months ago Log in to Reply
    19. kflying1@yahoo.com

      Through experimentation for different foods, and limiting the varieties I’ve come to involuntarily account for fats, like with pizza or various meats.

      1
      8 months ago Log in to Reply
    20. Eve Rabbiner

      I try to avoid fat rich meals in the evening but when I don’t I increase my basal rate.

      8 months ago Log in to Reply
    21. KarenM6

      Just as an “extended” bolus.

      8 months ago Log in to Reply
    22. Nicholas Argento

      Fat clearly increases the need for insulin by making the person more insulin resistant for 6-12 or more hours, and also by a more direct mechanism. There really is no concensus on how to cover, and it does vary from person to person. As a rule of thumb, if there are carbs and fat, I increase carb counts by 30-50% and give the extra as a 2 hr delayed bolus w pump, or a second bolus at 1-2 hours for pizza. If fat alone like nuts, I don’t cover unless a large amount. I do cover cheese if a larger amount but no set way to do it. One suggestion is consider as 1 gram fat = 1/2 to 1/3 gram carb. Coverage for fat is needed, but it is highly varied based on individual experience.

      2
      8 months ago Log in to Reply
    23. Wanacure

      I try to eliminate variables by trying to maintain same doses of MDI at same times. I try for each breakfast to have same grams of fat, protein, and net carbs. Each lunch has the same food values as preceding day’s lunch. Each dinner has same value as preceding day’s dinner. If I deviate, I try to anticipate what effect it will have and lower or increase fast acting lispro, and/or plan on a snack. I try to be aware of and correct for unusual exercise, or poor sleep or unusual menu item if eat at a restaurant or taco truck.

      8 months ago Log in to Reply
    24. Katie King

      Pizza is the one food that I have to consider the fat with my calculations

      8 months ago Log in to Reply
    25. Cheryl Seibert

      In 22 years of pumping, I never counted Fat or protein. However, I do count fat and protein now. Recently, as I am getting older, I’ve had issues with spiking BGs after eating even with adjusting carb ratios, etc. Protein tends to affect the BG more than fat, but since I’ve starting counting fat, my Time In Range is much beter.

      8 months ago Log in to Reply

    When counting your carbs before bolusing, do you factor the amount of fat into your calculation at all? Cancel reply

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