One packet of instant maple-and-brown-sugar oatmeal: 33 carbs, and a third of them are added sugar. Scott, who has never eaten oatmeal in his life, reads the label; Jenny explains why a slow food with a fast sugar on top is exactly the wrong thing to under-pre-bolus at breakfast.
The standing Bolus 4 example, set here for the first time: one unit covers 10 carbs, one unit moves you 100 points, so the math stays simple. Jenny adds the rest: stable, in target, a blood sugar of 100, not rising, no low treated. Nothing to correct. A packet of oatmeal has almost no fat or protein, so the fat-protein side of the estimator never comes into play. 8:48
The first Bolus 4 they recorded — Scott says you'll be able to tell. The plan: simple single foods first, then menu items, because people keep asking how to bolus for the rolls at Texas Roadhouse.
Jenny's first move when Scott says oatmeal: which one? The little flavored packets of quick oats, or old-fashioned thick rolled oats? There's a difference, and it matters to the bolus. Scott picks what people probably eat — the instant packets.
A variety box off Amazon — maple and brown sugar, cinnamon and spice, apples and cinnamon, peaches and cream. Scott reads the maple and brown sugar label.
A third of the carbs are sugar, and it's added sugar. Jenny's math on the recording: 12 of the 33 grams. That is the number that changes the bolus — not the oats.
The more processed the oat, the faster it cooks — and the faster it hits.
The practice person gets set up for the first time — one unit for 10 carbs, one unit moves 100 points — and Scott does the packet's math. Twice.
Scott read 18 carbs first and said 1.8 units; Jenny caught it — “there are only 18 carbs in that little packet, really?” — and he corrected to 33 and 3.3 units. Four grams of protein and a gram of fat are a quarter of a fat-protein unit, far below the estimator's cutoff, so there is nothing to extend.
Oats on their own break down slowly. Flavored quick oats put a third of their carbohydrate on top as added sugar, so you get a heavier glycemic impact than the oats alone would give. Not terribly different on the index — but the index isn't what you did to them.
“They're not terribly different, but it's what you end up doing to them that can make the difference.”
A slow-digesting material with a quick spike on top, eaten at the hardest hour of the day to bolus. Scott's phrase for the result: a 320 that lasts three hours.
Scott's picture of it: the oats take forever to digest, the sugar hits right away, and it all lands at breakfast — feet on the floor, adrenaline about the day, a lower overnight basal, more resistance and less insulin working. Throw a packet of sweetened oatmeal at that and you get a 320 blood sugar that lasts for three hours.
Stable at 100, nothing else on the plate — no eggs first, no butter in the bowl. Just the oats, and out the door.
Does it need an extended bolus or a follow-up? Not if you're really on top of the pre-bolus, Jenny says. There is nothing sticky here, not much fiber, no fat or protein to linger past three hours — an in-and-out carbohydrate that clears the way rapid insulin clears. Get the timing right and the meal and the insulin coincide.
The numbers that transfer to the next breakfast.
“There's really nothing that's going to hold this food for a long time.”
“So that's where you get a 320 blood sugar that lasts for three hours.”
“It's what you end up doing to them that can make the difference.”
“Try your oatmeal again.”
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