For me, it is impossible to determine carbs for a chines restaurant / take away dish, or shell I say I can not guess it within 50 carbs. It’s all the sauces, weird noodles and white rice too.
Last night we had:
- Prawn cocktail chips (oily) with sweet sauce (sweet, of course)
- vegetable spring rolls (oily)
- fried rice (not soooo oily, but still oily)
- sweet and sour chicken (sweet, of course)
And now for the million dollar question: How many carbs shall I bolus for?
Needless to say I was VERY, VERY proud of my guestimate when 2 hours later Mr T’s BG was 6.4 and then 4.8 a further hour later.
Unfortunately, that was already pass my bed time and Mt T was sound asleep, so I had to treat it as potential borderline low (there was no insulin on board left according to the pump). I gave him 2 tiny gummy teddies (3 carbs in total which normally just bring him up by 1 mmol), aiming at around 6 for the start of the night. Just to be sure I pinched it a bit from next hour basal, using temporary basal rate (-50%). I predicted his BG would go up to between 7 and 8 and all will be well until the morning.
Only 3 hours later Mr T woke me up saying he is sooooooo thirsty! Sure enough his BG was 20 mmol/l. Quick re-check of BG in a toe – 18 mmol/l. Not far off, but too high anyway!
WHY, I wondered? The detective in me started analyzing the situation while I was trying to assure irritated Mr T that his BG will come down soon after the correction dose of insulin kicks in. Poor thing, his mood was foul and I do not blame him: so high, thirsty and awake in the middle of the night!
My mind was busy thinking about two possibilities:
ONE – the BG continued dropping from 4.8, it hit the low in early hours of Mr T’s sleep, did not wake him but, luckily caused the natural Glucogen response by his liver, shooting his BG in to the 20ties.
TWO – insulin given for dinner was just right during the three hours of insulin action time, but as soon as that wore off, the rest of carbs in an oily combination of dishes kicked in, providing enough glucose for BG to rise to 20 in such a short time.
The truth is, I will never know for sure but the second option sounds more probable (many more oily carbs were still coming). Regardless, I had to do something to correct it and bring it back to the range, fast.
I decided to give the correction dose via needle – at least I knew it was going to be absorbed properly. It took 5 hours and two corrections (each time increased by 50%) to get the beautiful reading of 6.4 at 7am.
In the morning we talked about what has happened over night.
Mr T came to the conclusion, all by himself (?), that heavy meal with unknown loads of carbs should be eaten earlier in the day. He suggested we eat it for lunch instead, so that we have the time to correct high or low well before we all need to go to sleep.
Pretty good for a Junior Detective, I say!