2 4 6 8 10 12 2 4 6 8 10 12 2 4 6 8 10 12 2 4 6 8 10 12 AM PM AM PM

2 4 6 8 10 12 2 4 6 8 10 12 2 4 6 8 10 12 2 4 6 8 10 12 AM PM AM PM

Figure 7.6. Insulin curve is to help patients identify those times of the day or night when their BG is most likely to be too low or too high due to changes in the availability and intensity of insulin's action. Patients also plot curves to determine the effects on daily BG fluctuations when they change the timing and/or amount of their insulin dose. Patients often find the insulin chapter to be the most challenging, because it requires mathematical computations and the plotting of insulin curves can seem complex initially. However, after BGAT, many patients rate this material as one of the most valuable components of training.

In Chapter 6, patients learn about the impact of food on their BG and use carbohydrate counting to estimate the extent to which meals and snacks will increase glucose levels. Patients learn to monitor the fat content of their food, since high-fat foods can cause a significant increase in digestion time, which can dampen and/or delay BG increase. The implications of this for use of high-fat foods to treat hypoglycaemic episodes are emphasized; specifically, the danger of BG not increasing quickly enough. Patients plot the time course of their foods' effects on BG levels using 'food curves' such as the example one shown in Figure 7.7. They also keep a carbohydrate diary for several days to assess the extent to which the carbohydrate content of their meals and snacks varies from day to day, then plot these changes on food curves to determine the expected impact on BG. After plotting food curves for several days, patients compare these to their insulin curves to identify mismatches in the timing or intensity of food and insulin action; for example, a difference in the time of peak action for insulin and food. This type of mismatch is

0 0

Post a comment