Sugar Alcohols and High Blood Sugar

Hi all,
This isn't an Omnipod discussion so much as it is a general diabetes question. Twice now my daughter has taken Pure Protein bars to school for her afternoon snack at 2:15 and both times when we have checked her BG for dinner at 6 pm, her BG is SKY HIGH, as in > 350!! (and her BG was in the upper 100s at snack time)

These bars have 16 grams of carbs, of which 2 are sugar and 6 are SA, namely maltitol. She was bolused for a total of 13 carbs, subtracting half the SA as we were taught. I cannot believe that a protein bar would affect her BG so drastically! Then when she is bolused, her BG plummets. I bolused her for 50 carbs at dinner and when I checked her at bedtime at 8:30, her BG was 73 with 2.75 IOB!!

Has anyone had a similar experience with sugar alcohols? Would any of the other ingredients be a culprit as well? These bars also have glycerin, which I now understand is also a sweetener. Bottom line is, these bars are Pure Trash, I will not allow my daughter to eat any more of them, and I'm taking them back to Costco for my money back!

I have had similar problems with Atkins bars and candies. They are supposed to have only 2 or 3 "net carbs" due to their use of sugar alcohols and other ingredients.... however they also skyrocket my blood sugar.

I've found that other bars like Nature Valley protein bars behave more reasonably. The chocolate-peanut protein bar lists 14 carbs. When I bolus for that, it seems to work out.

Since on Dexcom I've been able to experiment a bit with sugar alcohols and proteins.
1. I have to bolus for protein, I put in the pump 10 grams of carbs for 30 grams of protein. This seems to work well.
2. I just don't do sugar alcohols at all, as the effects on the blood sugar levels are too disappointing to justify use of this fake staff :-) Typically bs goes up just same as with regular carbs, just the peak is a bit delayed.

Sorry man, no brake here.

One more, nuts - I used to think nuts are carb free so great snack to have.Wrong... The protein and fat from nuts will spike bs but 4-6 hours later. This is why I had highs 300+ after eating pistachios or peanuts after 8 pm. Now I have nuts no later than 6 pm, so I can bolus for the spike.

Using Dexcom is eye oppener

Thanks for the quick replies. We have also had the NV protein bars - with 5 g fiber, they are net 9 carbs and don't spike my daughter the way these others have (not to mention they taste better). I also realized that maltitol is in the Breyer's NSA ice cream we eat, but the ice cream doesn't spike her like that.

I'm typically not big on SA either, and we don't make a practice of seeking out sugar-free stuff except for a few items we eat occasionally, like ice cream and low sugar Smucker's jelly.

Biedronk, good point about protein. I've read that it can indeed have a slight effect on BG, like if you eat a meal or snack that is primarily protein, but I've never known how much to account for in a bolus. And the nuts - never thought about them causing a spike. We love the flavored almonds and offer them to the kids as a healthy snack, but I've never taken note what it does to BG. My daughter usually wears a Dexcom but she's been having a bad skin reaction to the sensor lately (you might have seen my recent discussion there).

Geez, we're almost 3 years into this dx and there's still so much to learn! It blows my mind. The AP and encapsulation can't happen fast enough!!

I found going for T1 support group very informative. People share their experience and this gives you some ideas to try.

interesting conversation, Jacob rarely eats anything sugar free so cant really contribute to that end, but social stressor or excitement at school can't be ruled out, even at 16 Jacob will have some strange high numbers ( over 400) pop up at school and we can't come up with any other reason but stress or a hormone surge, sometimes things he really isn't aware of. But of course the bars were probably a contributor. best of luck, amy

I agree. I'm very involved in our local JDRF chapter and attend mom-to-mom dinners and other events, and we have recently started an active FB page.

I know, adrenaline can really do a number on Liz's BG. Then I freak out and bolus for it, only for her to go crashing down after she's removed from whatever situation is triggering the adrenaline rush. It's almost like a "false" high and a total judgment call on how (or if) you should bolus for it.

Sugar Alcohols are interesting compounds. They vary DEEPLY in the way they interact with the body, and how it affects hormone actions (i.e. insulin) A Google search will bring up a lot of horror stories, but take them all lightly as many of them are far from useful info. However, do not take sugar alcohols lightly in a diet. Depending on what your daughter ate for lunch, her exercise levels, and many other factors they might have a whole range of other affects on BG. As a Diabetic, I try to stay away from them. Normal folks can process them just fine, as they have the hormone production abilities to handle the extremes in both directions. Diabetics don't.

I don't use a CGM but my experiences match yours. I have to take a great deal of care over the delay in delivery that results from proteins and fat, with the proteins requiring an addition to the bolus and both causing a delay.

IRC Bernstein has 6g protein = 1g carbohydrate, but a simple bolus of that would cause the OP's reported result, a low BG an hour or so later. Consequently I play with delayed boluses and use corrections to fine tune 2-4 hours after eating.

I gave up on sugar alcohols too, many years ago now. Even at that younger age they threw my guts into chaos and this is not a good thing to happen when you are young, active, and far from a toilet.

John Bowler