Mealtime Insulin: Tips for Everyday Eating

Christen: I'm Dr. Christen Cooper and I'm pleased to meet you. Rochelle: My name is Rochelle. Pleasure is mine. New Speaker: So tell me about any adjustments that you've made in your diet since you started mealtime insulin. Rochelle: Once thing for sure is I had to deter my sugar. Sugar is found in most foods, so I really have to count carbs even if I have to have something that may be bland, I use other spices, in order to have the flavors maintained in the food. Dr. Messer: I'm Dr. Messer. Very nice to meet you. Len: Len. How are you? Dr. Messer: I'm fine. Thank you. How are you? Len: Not too bad. Not too bad. Dr. Messer: So I'm very curious to know, what kind of changes have you made to your diet? Len: Like if I have an apple, or maybe grapes, or fruit, it does tend to elevate my sugar, but a piece of cheese with that tends to counteract that and balance it out. Dr. Messer: So we do know that fat slows down the absorption of glucose. Dr. Mezitis: Hello, Jeffrey. I'm Dr. Mezitis. Nice to meet you. Jeffrey: Hey doc. Pleasure to meet you. Jeffrey: What is your suggestion for me to maintain the proper dosage? Dr. Mezitis: What I recommend is to have a structured meal, so that's pretty consistent, as opposed to trying to play with the amounts, and then you can adjust the mealtime insulin based on your finger stick. Take your blood sugar. Dr. Messer: I mean that's part of the beauty of mealtime insulin. It kind of frees you up in a way. If you want to eat a little less, you take a little less insulin, and if you want to eat more, you can take more. Jeffrey: Well, when you're at work, you know how that can be, you don't always and cannot always get the structured meals. Dr. Mezitis: You have to pack a meal. You have to have your lunchbox, and if you rely on whatever, whenever, then you're opened up to trouble. Len: So I ask all professionals, what is your advice for helping me deal with carbs? Dr. Messer: Try to avoid the bread basket, avoid the desserts, and then use the rule. You can use your fist. The fist is about 15 grams of carbs, or use the idea of a mouse, a computer mouse is about 15 grams of carbs. Rochelle: What happens when I go to a restaurant? New Speaker: Look, restaurants are tricky for everyone. Portions can be huge. Remember that portion size matters, okay? If you eat small portions of foods that you love, you'll be able to enjoy pretty much any food that you would like to enjoy. Adjust your insulin accordingly, because keeping that blood sugar stable is a really big part of managing diabetes. Jeffrey: What happens if I do miss my mealtime insulin injections? Dr. Mezitis: If you've missed a mealtime injection, you probably don't want to try to catch up later because that can cause a hypoglycemic episode. There has to be a rhythm, and usually I take a meal, there's a rise in blood sugar after the meal, and if I've timed it properly, the insulin matches up with that particular peak. Len: I have no problems talking about food. Dr. Messer: I think most of us like to discuss it, as well.