Protein high?

Type 1 and LADA
#1

Before dinner I tested 200! It couldn't have been from eating too much carbs. I went out to lunch with my boyfriend and since I am on a 60g carb diet I decided to eat a lot of meat. We went to a yakiniku house where you cook your own meat on a brazier then dip it in a sauce before eating with rice or wrapped in lettuce leaves. I only had one small bowl of rice, about 40 carbs, and ordered ponzu sauce because it is very low in carbs. I ate 4 orders of meat, about half a kilo, and some lettuce leaves for wrapping the meat. I'm sure I injected my 5 units of humolog and sure I only ate 60g carbs or a little less. It had to be all that meat that caused the high.

I thought that only carbs would raise my glucose so what happened here?

#2

Protein can also raise your blood sugar. A good rule of thumb is that half the protein converts to blood sugar and it does so over a time period of 3-5 hours. If I recall a half kilo of beef contains about 100g of protein. That is a large amount. It would be equivalent of eating another 50g of carbs of 3-5 hours.

In addition when you eat large amounts of food your body can itself release blood sugar even if the meal contains no carbs (this is sometimes called the Chinese Restaurant Effect).

Diabetes can get complicated but you will figure this out and do fine.

If you eat a large amount of food

#3

Complicating it even more, protein only converts to glucose when there are limited other carbs available–a steak with potatoes won’t, a steak with a salad will. Where the tipping points are, or what the spectrum looks like, I’m not certain.

#4

I'm not sure about the details of how it works. I've never looked into it to try to understand it. But, yes, it happens.

If anything, eating "mass quantities" of protein could possibly be more distressing (for you) since your BG is likely to go up and tend to stay up for a long(er) period of time. It takes a longer, more gradual time for the protein to be digested.

This is why if you want to take a "bedtime" snack to compensate for your basal insulin (the Lantus), usually you'll pick something with more protein than carbs. Or at least slow(er) digesting complex carbohydrates.

You seem somewhat upset at the moment so I think we should put off "the talk" about pizza for later. :O ;)

-iJohn

#5

Madison, protein and fat both can raise blood sugar. And do so much more gradually and over several hours, in contrast to carbs.

Don't be worried about the 200... That's okay for now, in the early stages of learning. As I mentioned in your other discussion, you're young, healthy, and moderately high BG won't hurt you significantly or permanently for a long time. At this point in your D journey, focus more on learning how to control your BG in the 100-150 range so that hypos are not as much of a risk, and therefore not something to constantly fear.

Dealing efficiently with protein and fat with injections is difficult. When you eat a high protein meal, set an alarm on your smartphone to remind you to check your BG at 4 hours after eating, and then use a Humalog correction bolus if needed.

#6

I'm really glad you posted this thread. It has answered a big question for me. I like to go to a deli that makes a killer roast beef sandwich with over half a pound of beef. When I eat one of these belly busters, I inject novolog for the carbs and test 140 or below at 2 hours. But at my next meal or 5-6 hours later I am high. Now I know why.

1 Like
#7

I wouldn't personally blame the protein. First of all 60 grams for a meal is a lot. If I go anywhere near 50 my results are unpredictable. There is something Bernstein calls "the law of small numbers" where big intakes can lead to big mistakes, small intakes smaller (or no) mistakes. Also, you don't know what was in that sauce - it could have had sugar adding to the carbs.

But my educated guess? The rice. Rice is one of those foods that is often "more than the sum of its parts" - that is dosing under your usual I:C ratio can be inadequate. For many of us rice is just not workable and we stay away from it. I know I do (and, as a vegetarian, rice used to be a staple in my diet!)

#8

I just had a talk with the doctor on the phone. I told him what some of you said about me taking too much insulin and I asked him about taking lantus twice a day instead of once a day.

He said he was keeping my insulin high to keep the load off my pancreas. This would prolong my honeymoon period. As long as I was having a stable honeymoon period this would be best for me.

As for the twice a day lantus, he feels that with once a day if taken at bedtime would be have a high effect in the morning and would be wearing thin by evening. Taking it twice a day gives an almost level effect throughout the day.

Since we have not found a local facility to manage my care he is contacting a doctor in a nearby military outpatient clinic to take care of me until I can find a local source. This would give me access to diabetic supplies at outpatient pharmacies.

He said I should be knowledgeable enough to be trusted to vary my mealtime insulin according to the meal. He wishes I could get a half unit insulin pen but there are non in the system. I was on a 12:1 ratio now, so if I ate 48 carbs it would be 4 unites, 60 carbs 5 units and 72 carbs 6 units. He didn't want me to eat more than 60g carbs per meal except on a special occasion. It was ok for me to vary my humalog but keep the lantus the same unless told otherwise by a doctor.

I asked him about my high BUN test (21 where 7-20 is normal), he said it was possible I had eaten a high protein meal or was a little dehydrated. They would retest everything in a month.

#9

Taking *too much* insulin to take a load off your pancreas makes no sense. You'll just go low a few hours after a meal, and then in correcting that low, you're likely to go too high, so your average sugars are likely to suffer, too. The doctor is right that it's helpful to aggressively keep your sugars in check, but that means taking the right amount of insulin, not excess insulin.

Your I:C ratio may actually be 1:12, but I'd be surprised, my guess is you're actually closer to 1:20. You'll be able to test this down the road, by testing how much X grams of carb raises your BGs and how much X units of insulin lowers your BGs, both tests performed while BGs are stable and not impacted by other factors.

#10

do you have workbooks like this one?
http://www.bd.com/us/diabetes/download/insulin_adjustment_workbook_complete.pdf

#11

Looks interesting, I'll check it out tomorrow.

#12
Since we have not found a local facility to manage my care he is contacting a doctor in a nearby military outpatient clinic to take care of me until I can find a local source.

Just out of curiosity, whose military is the outpatient clinic part of? JASDF? US? Some other? If the US, which branch?

I spent some time with military doctors for my diabetes before they eventually decided it would be best to make me someone else's problem. Of course, this was back in 1979 so not really relevant any longer.

I don't know what current (US) policy is about insulin dependent diabetics being on active duty. So keep in mind that if you are talking to a military doctor, T1D could be more theory than experience for them.

-iJohn

#13

US military, all branches have dependent outpatient clinics. We go to Yokota AF because it's closer.

#14

School has mid winter break Thursday and Friday so no school. I have an appointment to see a new doctor on Thursday. He won't be an endocrinologist but will have my records from the hospital.

#15

The doctor said it would be ok for me to change my humalog if I was going to eat less or more food. I have never done that yet. My dose is 5 units for 60g carbs. With only 5 units, I could change it to 4 units for 48g carbs or 6 units for 72g carbs. I only wish I could inject in half units but I can't get a pen that does half units. My mom is trying to get one from her friends in the US but I will need to find a source for the humalog cartridges. I would ask Teruo where he gets his but we are not speaking, he said some things that made me mad at him. I liked him but not that way and he went too far.

No school today we are going to my appointment with a new doctor, he will take charge of my treatment. He has my records and the old doctor told him about my case.

#16
I only wish I could inject in half units but I can't get a pen that does half units. My mom is trying to get one from her friends in the US but I will need to find a source for the humalog cartridges. I would ask Teruo where he gets his but we are not speaking, he said some things that made me mad at him.

Have you tried reaching out via the contact information on their websites to the companies which offer the pens? They may be willing to just send you a 1/2 unit pen for free in hopes of encouraging you to use their insulin. Or they may be able to provide you with contact info for a source of the cartridges in your area.

I am confused. Can't one buy everything online & get it delivered in a few days in Japan?

I never used insulin pens. Frankly, by the time they became common I was either happy enough using a syringe or already using a pump, so I know next to nothing about them. But companies were always willing to send me free glucose meter to get me to use their strips. I would be surprised if it did not also work that way with the insulin pens.

As for Teruo, honesty is best even though the short term consequences may be unpleasant. (Young) men are just too ready to delude themselves that their aspirations have some basis in fact. Unlike diabetes, everyone runs into that problem in one way or another while growing up.

-iJohn

#17

Nobody sells the HumaPen LUXURA HD pens online except from Canada. I think they are prescription only in the US. That is the one Teruo uses. I'm sure I could get one from a Japanese doctor but I haven't went there yet. Anyway, I wouldn't be able to use it unless we found a source for the humalog cartridges.

I doubt Teruo wants to be my friend unless I go along with his stupid fantasies. I have no interest in "making out" with him or any other boy.

#18

P.M. Me. I can get you one of these pens.



What you really need for tight BG control is a pump, however. Just my opinion. After my then-11-year-old daughter was diagnosed with Type 1, I went ballistic in order to get her on a pump. 4 months later, she was using a pump and a Dexcom CGM. MUCH tighter control, along with freedom to eat what she wanted when she wanted was the result.

#19

As I said, I have never used pens and so I knew nothing about them. However, I have now read the Wikipedia article on them and I am, thus, an "expert". ;-) More seriously, I found the following remark in that article interesting.

Insulin pens are used by 95% of insulin-treated patients in Europe, Asia, Australia and Scandinavia with excellent results. They are currently underutilized but growing in use in the United States.

It's just a guess but it seems to me that if pens have that much market presence, then there should be more options open to you than one model of pen.

Also, FWIW, if you're curious about where/how Teruo gets his pens, have some other person (your mother maybe?) ask either him or his parents about this. You don't have to be the one to talk to him to find this out. Improvise. Adapt. Overcome.

The other point about Teuro which I think I was staggering in the general direction of may have been this. I'm sure there have been times recently when all you have wanted is to just be "normal" again. To not have to deal with all this. For it to just go away. To not have diabetes.

Well, whatever happened with Teuro, it sounds to me as though it is as normal as it gets. The only thing about it which seems to pertain to diabetes is possibly a (small) part of the context. Other than that it was perhaps an almost quintessentially normal part of growing up.

This may just be me, but I think somewhere the universe is smirking at you and saying, "You're welcome." Life can be a ■■■■■, but that's also normal, isn't it?

Improvise. Adapt. Overcome. (Maybe?)

-iJohn

#20

"unless I go along with his stupid fantasies." Maybe you are angry, but this made me smile. The teenage life really isn't all that easy.