Suggestions with Handling OMAD

About two years ago I switched to a 16:8 intermittent fast, with my goal to be have more of my day not going up or down because of carbs and insulin. I had a great experience, and over time condensed to an 18:6, then 20:4, and finally a 23:1 OMAD diet the past month. It’s been awesome, and I’ve been able to get my average down below 120. My only issue is with my larger than normal meals happening late in the day because of my job, I’ve been getting some middle of the night highs. I know why, with the abundance of protein and fat delaying the spike, but I just haven’t gotten a bead on exactly how much to give up front vs over time on the extended bolus (omnipod).

If anyone has any tips from an OMAD point of view, or just anyone who has a lot of success bolusing for high protein and fat meals, let me know!

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I’m on the keto diet for better overall health. I’m not exactly keto yet but I’m eating very low carbs. Since I’m eating 90% far and protein I definitely had to start looking at protein and take insulin. I take an immediate bolus for net carbs and convert 30% of protein to carbs and give myself an extended bolus over 2 hours. So far it seems to be working for me but the jury is still out. I’m just starting to like almond milk and monk fruit so as I say I’m getting started and I like it. My big question was can type one diabetics be on a keto diet?

I did keto for a few months with great success in blood glucose control. My issue was it evident early that I couldn’t sustain that diet. I have much more willpower with fasting, especially when I know when i can it, there are (almost) no restrictions.

I did find it challenging to bolus for protein and fat on that too, but my basal rates were higher than needed (didn’t realize it) so that helped keep it down. I was running around a 1.0 unit per hour rate. Once I started going omad, i realized that my afternoon rate is actually 0.6 units per hour and my early to mid morning (which is my peak) is 0.9 units per hour.

Here are tips from another diabetes forum, although doesn’t appear to be very popular.

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I do TMAD. Two meals a day but closeish together.
I eat meal 1, at 11 am and meal 2, at 5 pm.

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Before I started to use DIY Loop, I was eating low-carb meals (< 30 grams/day) twice per day. I took two boluses for each meal. The first one was calculated using the carb content of the meal in the usual manner: carbs/insulin-to-carb ratio and given at least 15 minutes before eating.

I also took a separate dose to cover fat and protein. I counted up 50% of the protein grams and added it to 10% of the fat grams and thought of that total as carbohydrate equivalents.

Once I knew the carb-equivalents for the protein and fat, I decided by the insulin-to-carb ratio and found the total insulin needed for protein and fat. I delivered that bolus in an extended fashion so that I never exceeded 1.2 insulin units/hour. I delivered the protein/fat extended bolus right after the immediate carb bolus.

For example, if my meal was comprised of 10 grams of carbs, 60 grams of protein and 60 grams of fat, using an insulin to carb ratio (I:C) of 1:10, here’s how I figured my dosing. Immediate carb dose: 10 carbs/10 (I:C) = 1 unit of insulin.

For the extended bolus to cover protein and fat, here’s the arithmetic I used. Protein 60 grams x 50% = 30 carb equivalent grams. Fat grams 60 x 10% = 6 carb equivalent grams. Total carb equivalents grams = 30 + 6 = 36.

Divide 36 carb equivalents by 10 (I:C) = 3.6 units. Since I want to limit my extended bolus to a maximum of 1.2 units/hour, I will deliver these 3.6 units at 1.2 units/hour for 3 hours. Typical extended boluses ranged from 2-6 hour duration.

I found this system to be dependably repeatable and enjoyed excellent glucose control, especially 3-6 hours after the meal.

Is there any way that you might be able to switch your one meal to earlier in the day? Eating close to bed-time (< 3 hours from last bite to head hitting the pillow) increases the risk of poor post-meal control and it sabotages your ability to sleep well.

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Thank you for the very well described reply!

Unfortunately as far as meal timings, i coach football so during the season unfortunaly 7:30-8pm are the earliest I get home to eat. The other 8 months out of the year I will eat a 5pm meal with the family, and that definitely is easier.

Crazy part is, even with my sleeping highs sometimes exceeding 200, I still have averaged 120. Once i dial in these big meals I should be getting down closer to 100. Excited about that.

“You will have great sugars but what good is that if u have heart attack”
Told to me by an endo. Tread carefully. Have ur blood cholesterol checked more often

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No doubt! That is the thing I didn’t like about Keto, just didn’t feel right when i neglected some entire food groups.

Does OMAD hurt cholesterol and others if the meal is balanced, just bigger and one time a day?

As with any eating plan, do what makes your body and your mind feel best. For some, intermittent fasting works great. For some, it leaves them feeling lethargic for part of the day. For others, it leads to disordered eating and can even trigger an eating disorder. Listen to your body; it is very wise.