I was diagnosed last year as Type 1/LADA and am trying to get better control of my blood glucose AND gain back some of the weight I lost. I do MDIs basal/bolus plus 1500 mg Metformin (a decrease from 2000 mg to see if that was contributing to the weight loss). In looking over my meal and insulin records, I think part of the problem is just not getting enough calories. If I increase my protein and/or fat intake without reducing my carbs, will I need to bolus for either the fat or protein since I am also insulin resistant? Thanks in advance for help with this!
Kind of a complicated question, one that really needs an endo and/or nutritionist familiar with your case to dig into. But FWIW, in general I find I have to add an extra bolus when I’m having something with a lot of fat. But it’s tricky because you don’t really have a number to work with like you do with grams of carbs, and the effect tends to lag quite a bit after the actual meal. With a pump I can set a second bolus to fire off like two hours after eating pizza, say, or the BLT I sometimes treat myself to on Fridays. But I just have a experience-based rule of thumb for it, not an algorithm anyone else could apply.
Great question… large amounts of fat in a meal ( fatty meals) can decrease gastric emptying hence a possible low after a bolus for the carbs in that meal and subsequent high once the food actually leaves the stomach and the carbs begin to get absorbed … I never dose for protein or fat itself but do take into account the delayed carb absorption.
Thanks, Tony and DrBB, for your thoughtful replies. I think I have a better handle on this now.