Last night, I had a slightly carb-y meal but then was worried that I dosed too high. Anyways, 1 hour after eating my bg read 105. So, fine!
I just bought Stur, which is stevia sweetened as is meant to be added to water (anything in my quest to drink more water!). I drank a glass of water with a small squeeze of stir, and then after half an hour, I tested again because I was about to go to bed. It read 155!
Is it possible that stevia, which is 0 calorie and 0 carb (and 0 everything else for that matter) caused this spike in just 30 minutes? I was completely shocked! Anybody else have this reaction?
I have never spiked from 0-carb Stevia. I wonder what else was in that “slightly carb-y meal?” Perhaps something was just slow to hit, or fat or protein slowed digestion of the carbs. A 1-hour test is good, but not always, in my limited experience, the peak.
I usually test after 2 hours, but I was actually worried that I over-dosed from my meal so I tested sooner. It was my husband’s birthday, so we went to a vegetarian restaurant we like. We shared seitan buffalo wings (basically it’s seitan with buffalo sauce) which I have had many times before, even when I wasn’t using insulin. I also ordered a savory waffle. Calorie King told me that a belgian waffle has 47 carbs, so I dosed for all of that, but I only ended up eating less than 1/4 of it. The seitan is most definitely fried, so it’s possible that fat/protein impacted things. I dosed with 6 units because I had estimated a carb heavy meal of 60 carbs. And there’ no way that I actually ate 60 carbs.
I’ve never had this experience before, so I just assumed it was the stevia.
I use about 6-9 packs of stevia every day and have not found that it’s a major contributor to my BG inconstancy’s…my BG goes up or down with every finger stick, with every meal, and even when I skip meals…I like Stevia
So - most of the time I eat LCHF, this meal was certainly a treat! Apparently I don’t understand the relation of carb + fat. I understand that it slows the digestion of the carbs, but thus far I’ve actually found this to be helpful in managing my meals. Even when I am not eating low carb, I have tried to add in some fat. I guess this was just my first encounter with that kind of spike…
Also, how does one calculate then, if it’s not just a ratio of carbs : insulin? According to my calculation, I took too much insulin based on the number of carbs that I ate. Wouldn’t that cause me to go too low, or counteract a spike, by inadvertently over-dosing?
My guess (and it’s only that), is whatever carbs you ate were a combination of low glycemic index and high fat/protein (plus a bunch of other variables). 105 @ one hour after eating seems low to me, although I don’t know where you started from, but in my world that would be a clue that the insulin action is outrunning the digestion a bit. The 155 (was that @ 1.5 hours after eating?) would confirm it.
Other variables would be what was your activity level that day; were you trending up/down/flat before eating; any stress, etc?
Also, I find certain flour preparations, most notably sourdough, really has a huge impact on my BG. I routinely double my bolus for the carbs associated with sourdough bread and then add an extended bolus about an hour after eating and that is still rarely the right amount to cover the rise in BG.
Interesting about the different flours - I had not thought about that! Until recently, I was grain-free - so it’s possible that I just haven’t noticed figured out what grains/flours impact me in different ways.
I am a pretty new insulin user, and so far, I haven’t had this kind of reaction! I have calculated my insulin needs solely on a carb ratio, which is why this was very surprising to me.
LOL. Sorry about that. “Your Diabetes May Vary”. Just a shorthand phrase for the fact that each case is separate and individual and no two people respond the same way to a given food, medication, or other factor.
ah! Good to know. It sounds like I messed up with my carb counting and not considering fat/protein… so maybe not so much YDMV with the stevia. I think the only way to know is to try the stevia again and see if there’s a similar reaction.
In an online course on diabetes I took a couple of years ago the instructor said that people eating low-carb may want to consider adding protein to their calculations for insulin. She suggested not counting the first 5 grams of protein, but counting 50% of those over 5 grams as carbs. I’ve never tried it, as I eat moderate carb and normally have enough carb in each meal that I really don’t need to include protein in my calculations. I know of other low-carbers who just count 50% of protein as carb in their calculations without discounting the first 5 grams. Fat just slows digestion/absorption up and doesn’t need to be in the calculation for insulin.
Again, the above is just a starting point. Another YDMV situation.
Without debating specific numbers, Bernstein (and others) say the same thing—in a meal dominated by carbs, the effect of protein on BG is negligible; but in a low-carb meal, some part of the protein should be factored in.
I’ve written about this here before but apparently you are not familiar with dosing insulin for fat and protein. I eat a low carb high fat diet. For every meal I take an immediate dose of insulin based on the usual insulin to carb ratio. In addition I deliver an extended bolus via my pump. This extended bolus counts 50% of the protein carbs plus 10% of the carb grams as “equivalent carb grams.” I then divide that total by my insulin to carb ratio and deliver that total bolus over time, usually 2-4 hours, at a maximum rate of 1.2 units per hour.
I been using this system since 2012 and it’s been consistent and highly effective for me. I got this idea from an inactive sub-group here at TuD called “TAGgers United.” TAG is an acronym for “total available glucose.” This concept was written about in a book by a dietitian decades ago. The idea is that in a carb limited diet, especially, a certain portion of protein will be converted to glucose in the liver by a process know as gluconeogenesis. I’m uncertain about the metabolic process for fat but my experience counting 10% of the fat grams as equivalent carb grams has worked well for me.
Extended boluses are a gentle insulin dosing tactic that give you the flexibility to terminate them early if needed.