Where does fat come from?
- Fat is found in almost all the food groups (excluding most vegetables and fruit)
- All meat contains natural fat (higher percent in fattier cuts)
- Processed snack foods (chips, etc)
- Candy and desserts (made with chocolate, butter, oils or nuts)
- Nuts, nut butters and seeds
- Added fats like oil, salad dressing, butter, half and half, cream cheese, sour cream
- All full fat dairy products (milk, yogurt, cheese, ice cream)
What effect does fat have?
- Fat will slow carb digestion at a meal; BG rises more slowly and over a longer time period. The more fat, the slower/longer the digestion
- Large amounts of fat can also cause a delayed BG rise in addition to the rise caused by carbs & protein
How does fat make BG rise?
- High fat meal/snack ⇒
- Raises triglycerides in bloodstream ⇒
- Causes temporary insulin resistance (8–10 hours post meal)⇒
- Causes liver to secrete more glucose than usual ⇒
- Higher BG
Free fatty acids induce insulin resistance, starting 3 hrs post-meal.
Effects of fat dissipate after about 6-8 hours.
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HOW TO BOLUS FOR A HIGH FAT MEAL (>25g fat) |
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Insulin Timing for Carbs (injections) |
Split the injection—half of meal dose at start of meal and half 30–60 minutes after the meal |
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Insulin Timing for Carbs (pump) |
Use dual wave/combo/extended bolus—start with 50% up-front, 50% over 1–2 hours |
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Offsetting the Delayed Rise (how much?) |
Set temp basal increase of 50% for 6–8 hours |
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Offsetting the Delayed Rise |
Start after completion of the high fat meal |
A Simple Guide to Counting Fat Grams
*A 3oz portion is about the size of a woman’s palm or a deck of cards
Reference ©Gary Scheiner MS, CDCES – Integrated Diabetes Services. May be reproduced and used for patient education, but not sold.
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