How To Bolus for Ice Cream

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I often get asked how I bolus for ice cream, which I definitely eat more than a normal person, T1D, or not.

First thing's first: ice cream is a carb. A very high fat, high carb kind of carb. And, as a person with diabetes, I know all too well that all those rollercoaster highs and lows can always (re: in most cases) be avoided by... avoiding carbs. 

But sometimes the ice cream monster in me needs taming.

And let's be real for a very quick sec: everyone gives in to their ice cream urge from time to time. But that's just it -- it's a time to time sort of occurrence. 

When those times do come around, I've learned (and am still learning) a few things about how to handle blood sugars upon ice cream consumption.  

What is High Blood Sugar vs. Healthy Blood Sugar?

Why Is It So Hard? 

Ice cream is a tricky food, as it’s higher in fat and carbs (versus a high carb, low-fat kind of food or liquid like juice, which spikes immediately with no aftermath). 

But I actually find ice cream easier to bolus for than other high carb desserts, like cake or cookies.

Both cake and cookies (and the like) have less fat and, therefore, almost always send me into a fast BG (blood glucose) spike, which later turns into a crash-collision low for me, even with a very aggressive pre-bolus. 

That being said, ice cream is still a tough one!

Figuring out the fat-to-carb ratio for a given scoop (or pint) and the effect it has on your body (because everybody's different!) can be tough.

But I've got a few tricks up my own sleeve that I use to keep my BG levels steady. Here are a few tricks of the T1D trade when it comes to those ice cream splurges.

4 Low-Carb Frozen Dessert Recipes

Don’t Get a Massive Scoop*

But hey, that is so much easier said than done. And if you’re like me — indecisive, want strawberry, mint, salted caramel and peanut butter swirl flavors, plus get told by scoopers “we don’t do multiple flavors in a small”—then medium is really the only choice.

*But here's the thing. And, truly, the pro tip #1. Don’t eat it all!

Stick to about 30g worth of carbs (which also translates to a kiddie/small size). That way, you get your ice cream fix plus a ridiculous amount of world's most marvelous flavors, but you don't get that insane HIGH after the fact. 

You can justify being wasteful because it is good for the shugs. Or, if you simply cannot let that sweet cream go to waste (I get it), pass on the leftovers to a friend in need. 

Avoid Having Ice Cream After Eating Out

Or after any complicated meal with lots of insulin-on-board (IOB), varied absorption rates, weird sauces, or sneaky carbs, for that matter.

Basically, save it when you don't have any other insulin or blood sugar weirdness in your peripheral. 

I usually have my ice cream on its own, as an isolated treat, to keep things simple.

I also avoid fudge, toppings, cone, sundaes, and all those add-ons that can and will add extra carbs. Gotta pick my battles! 

Incorporate Light Cardio Before and After

My husband & I usually walk to get ice cream, then walk back. It's so simple! But it really helps minimize spikes & increase the effectiveness of the insulin.

Don’t do hard cardio, though, which can actually spike BG due to increased amounts of adrenaline and cortisol.

(You know that feeling you get when you're running on the treadmill and your fave workout song comes on and you go so hard? Hello, adrenaline running through your veins!) 

5 No-Equipment Exercises for a Quick Total-Body Workout

Extended Bolus

This is best done with (and, frankly, really can only be done properly) with a pump.

So if you wear an insulin pump, here's how it's done (AKA how I do it). 

I don’t give all my insulin up front. Instead, I bolus about 25% initially, then extend the rest over 2-3 hours.

If I find I am dropping, I can cancel the remaining insulin. 

And, if I do drop, I don’t get too worried. Almost always, that drop turns right around and rises later because of the delayed insulin absorption from the fat. Remember that!  

If you use pens, you can probably do a similar strategy (you'll just need to keep up with your doses yourself, not your pump). Take a small bolus upfront, and micro-doses to follow.

Practice Makes Perfect

I figured most of this out by actually eating ice cream! It's all about trial and error. You’ll never know what works and how it works unless you keep trying! 

Our bodies are all so different -- so different, in fact, that no one body is the same. So the way one person reacts to ice cream and a set amount of insulin is going to be very different from another!

Always keep in mind that, although you're given your "set" insulin:carb ratio and you have your sliding scale for counts, those are only meant to guide.

You can (and should!) learn how your body works in given situations, and tweak as needed.

You do you, better than anyone else. 

Follow Heather at @doctordiabeatit for more diabetes musings, advice, and all the goodness! 
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Heather Lampert
Jun 26, 2019

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