Easter means chocolate eggs – but for my type 1 diabetes, this can be hard to insulin dose for

JDRF volunteer Melissa on her type 1 diabetes insulin dosing

The fat in chocolate can mean blood glucose levels take longer to rise than you would expect in a sweet treat, making it difficult for people with type 1 diabetes to calculate insulin dosages.

Here Melissa Blaik, a JDRF volunteer who was diagnosed aged 14, talks about how she finds the process a tricky business…

“To date there’s been an emphasis on carbs when calculating dosages for food, especially with the excellent DAFNE NHS course.

However, with the popularity of low carb, and even ketogenic diets on the rise, what about the other main food groups – protein and fat?

There have been times when I’ve calculated the carb content for a plate of food, then wondered why my blood sugar has crept up hours later.

I’m still learning how to calculate for meals that are high in protein and fat.

Previously, I would look at a large sirloin steak with steamed veggies (maybe covered in butter) and inject too much insulin beforehand – because it looked like a big plate food – only to hypo within 45 minutes.

My sugars would then creep up steadily into the early hours leaving me bewildered and tired the following day.

Trial and error

It seems to me there is a lack of information and advice available from health professionals about the varying food groups of meals.

Evidence suggests that both protein and fat above a certain level need to be covered by insulin as they will raise glucose levels gradually – protein around 1.5 hours and fat 3-5 hours after eating.

So if you eat an evening meal with a higher protein or fat content, this could mean you need to stagger injections, or use a setting such as dual wave if using a pump to cover a longer period, so that your blood glucose level doesn’t creep up.

Hopefully algorithms are being developed to catch up with the technology, and information about this will become more accessible to support people to achieve tighter glycaemic control.

For now though, it will have to remain trial and error for me to get my calculations right.”