Hi guys,
I am a recent pump user and am going a nervous breakdown. I absolutely have no idea why my blood sugars respond so bad to bolus. If i do not eat anything at all sugal levels are fine, meaning basal rate does not need correction. However, if I eat and does not matter what I eat, my blood sugar levels spike.
Generally, when on shots I was only counting carbs, however I notice that my blood sugar raises even when I only eat protein like Chicken breast for example. Does anyone else have the same problem? And how are you counting your bolus units in case you are no eating any carbs, or eat very little carbs?
I donāt bolus for protein. However, 20 grams of protein will raise my blood sugar the same as 10 grams of carbs. Just not right away. I therefore wait until I see my blood sugar rise and then dial up my basal. I keep my basal rate high until the protein has been digested. For me, this typically takes 6 hours.
Yes, I find that when I eat no cabs or very little carbs with a protein-rich meal that I have to bolus for the protein - something on the order treating 2-3g of protein like 1g carbs. When I bolus for protein, because it digests slower, I take the bolus after I finish eating. I donāt seem to wait 6 hours like @Helmut. but definitely slower than carbs. When I eat sufficient carbs with the protein, I donāt see these spikes, generally.
I bolus half the grams of protein as though they were carbs that will be slowly digested. I would also remind you that our bodies are very complex. When you eat, particularly a large meal, your gut sends hormones to your pancreas that help signal the release of insulin AND glucagon. The glucagon in a non-diabetic helps buffer the insulin action, but if you have a poor pooped out pancreas you just get the glucagon release. The is the reason for the āchinese restaurant effectā where just eating iceberg lettuce or ice water can cause a disproportionate blood sugar response.
Frankly I bolus for every meal, even if it looks like I have just a couple grams of carbs.
ps. One of the actions of the T1 drug Smylin is to blunt the glucagon release at meals.
When my daughter first started using her pump, her glucose levels often went the haywire, while her levels were pretty stable when being injected . It will take some time before you get the pump properly setup.
We never bolus proteins, only carbs. Correction is rarely necessary, and if so, it is minimal.
If a meal contains significant carbs, only a very small portion of the accompanying protein is converted to glucose because there are carbs available. However, if the meal is all (or mostly) protein with little or no carb, the body converts a substantial part of the protein to get the glucose it needs (or thinks it needs).
Personally my experience is that for a high carb meal I donāt need to be concerned with the protein. But with a high protein/low carb meal (which is my norm), I need to factor in the protein and bolus for a certain percentage of it. For those meals, I also use R because its slower action matches the protein digestion more closely.
This answer is very helpful. Last night I had a high protein very low/no carb meal and thought I had covered it correctly until I woke up at 1am at 198. I now better understand what is happening. Thank you.
I never understood what was going on with protein until I got a CGM. I wanted to be a good diabetic and often chose a big steak with a no-carb side when I went out for dinner. The next morning my blood sugar was always high. My blood sugar before I went to bed was normal. Now I know that after a big steak dinner my blood sugar rises the same as if I ate a bagel at 1am. 16oz steak = 2oz carb.
This seems to be one of the many things that varies some by person and also within person. I find protein is hard to predictāI agree with folks that sometimes when it eaten in large quantity it raises blood sugar, but itās not as predictable for me as carbs in terms of if it will or how much. However, since any rise it does cause tends to be slower and blunter, itās easier to play it a bit by ear and see what happens and correct as needed, whereas with carbs, Iād be playing catch-up and seeing spikes if I did that.
One of the pumpers should be along to explain split bolus, where you cover the carbs and delay over time the bolus for protein. you can even do a pizza right.
Caveat: those numbers are averages. The actual response varies greatly from individual to individual. As with everything else about this beast, you have to measure your own individual responses to know how various foods will truly affect you.
Like Thas, I have noticed that no or low carbs still require some accommodation for protein. I solve this problem by the fact I was never low carb to begin with.
When I have a snack, I never have protein alone or carbs alone. I have a little of both. When I do that, I only have to account for the carbs insulin-wise.
It comes down to the fact that whatever in food gets turned into glucose has to use insulin to get into the cells. Carbs do that quickly, inside of 2 hours. Protein takes more like 3-4 hours and up depending on how much protein was in the meal. Fat takes the longest, 5-6 hours after eating. If you overeat, and food sits in your stomach undigested, the times are even longer. I find that a combo bolus, part instant bolus and part extended or square bolus, really tracks actual glucose release into the system better for most meals. But I count just the carbs to do it. how many carbs one unit of insulin can handle, is something needed to be figured out by your doctor, and then over time, years, you can adapt it based on your own read of the data. If I eat a lot of protein, say beef, I increase the extended bolus accordingly. To accommodate a lot of fat, I wait several hours and take a small bolus. WARNING: you should not treat fat or protein calories like carb calories. Fat and protein generate less glucose than carbs do. NOTE: this is not advice of a professional, just another Type 1 with 59 years of experience.
For me I bolus for both Carbs and protein on Pizza, for me 1 piece of pizza the size of my hand has about 20g of carbs and 10 of Protein. So I do a multi wave bolus take the majority of the bolus at first and the rest over 6 hours and It works for meā¦
That makes good sense. But knowing how much protein or fat per unit of insulin isnāt published. Apparently the amount of physical exercise has a large effect on the impact the two have on glucose levels.
