I've been experimenting with a low carb diet and am noticing that I need to take insulin for fat and protein in my foods. I can't figure out the optimal ratio though. I have looked online with no success and thought I would ask on here... before I have to ask my roommate if I can borrow her biochem book to figure it out. haha.
Dr. Bernstein recommends that you count half the protein as carbs, so I would count 30g of protein as though it were 15g of carbs and bolus accordingly. I don't count fat.
Another view is a more modern version of the exchange system called Total Available Glucose (TAG), where you count carbs as 100%, protein as 58% and fat as 15%. This system is taught at certain places as a way to count carbs. Joslin also has a blog on TAG, but they count carb/protein/fat as 100/50/10.
When having a meal that is dominated by protein and fat, your insulin timing and profile is also of concern. Protein can take 3-5 hours to digest, by the time it hits your bloodstream, your insulin may be gone. You can deal with this by delaying your bolus, using R or if you have a pump using an extended or dual wave bolus.
Thanks! I've read Dr. Bernsteins book and have been doing the half protein as carbs thing but it just doesn't seem to be enough. I'll look into the TAG system. I think incorporating insulin for fat will make a difference. Thanks so much! I'm on MDI's but I've noticed that waiting to bolus for high fat and protein meals helps.
Thanks again, Hannah
What do you mean it is not enough. Are you high at 2hrs or do go high 3-5 hours after? I think a delayed bolus may really help for those high protein/fat meals.
My highs have been 3-5 hours after meals. I may try delaying my bolus further. Thanks.
There's a Group here on TUdiabetes called Taggers United, you might want to look there & ask questions.
There's an MDI technique that I learned from KellyWPA and others called tiering. You take a portion of your insulin before the meal and then take a second shot an hour or two later with the rest of your calculated amount. The first shot will take care of your carbs and the second will handle the protein and fat.
Of course getting the amount of insulin, correct split and correct timing are all things to be worked out but that's even true if you use a dual wave bolus on a pump.
That is a good suggestion. Another option would be to use Regular (R).
I do low carb & count 50% of protein grams. I take a small bolus to cover the carbs & a second injection several hours later. I don't bolus for fat. But, if it's a fat heavy meal, I delay the second bolus since fat slows down digestion.
That is what I have been doing for some time. Didn't realize someone else had figured it out too. I developed the method some time back as experience showed it was the only way to get a flat response. For me, anyway.
As Annabella suggested, there is a group for taggers. Here's a link TAGgers UNITED
Hi fellow Houstonian! We just tried a low carb diet with my son and had the same problem. I never figured out how to dose for the fat and protein seperately, but rather we did 12 meals that we repeated and I figured out how much insulin was needed for each meal individually (i.e, oh, he shot up to 170, therefore needed 1u extra). It worked, but he used almost as much insulin for a 10 carb meal as he did a 30 carb meal, so we switched back to 30 carb meals.
Maurie, I've heard of a split shot before but haven't tried it. It may be a good time to try it out. Thank you for you input!
David, That's awesome that you were able to figure it out on your own. Glad it works for you!
Thanks! I'll check it out.
I have been trying to use 50% for protein but now with another shot a few hours later. I'll give it a go. Thanks for your insight.
You sound like such a dedicated parent! I am finding that my low carb meals are requiring almost as much insulin but with less of an immediate spike right after meals. I have a continuous glucose monitor and it helps me see the difference. It does seem a lot easier to eat higher carb meals though, low carb meals can be a lot of work. haha. Best of luck to you and your son! Thanks for sharing your experience.