Trying to figure out how to MDI for zero carb diet

I am eating two meals a day, almost exclusively meat, eggs, cheese, and come in under six grams of cho per day. But I’m having a hard time bolusing for the protein/fat, as I obviously need something longer lasting. Has anyone else eaten this way and figured it out? I’m wondering about NPH but I haven’t used it myself for about 16 or 17 years, I think. And I would have happily told you that I would never use it again. lol Right now I’m not having any lows at all, which is pretty important to me (knock on wood!), and I fear that NPH is just a recipe for lows. I think maybe I’d rather do a second injection of humalog at 2 1/2 hours post-prandial or so.

The other thing to consider is that I plan on going back on a pump before too long, but could be a year. I’ve got a two year old who’s still nursing and sleeping with me and he’s awfully mischievous and naughty (in the sweetest way, of course) and I just don’t feel like I can juggle him and a pump at the same time. But I am willing to bet we could totally handle it by the time he’s three.

I think you should take a look at the TAG group here. It is great! They have methods to bolus for protein/fat. I too am still figuring it out as I am on a mostly protein based diet. I do take NPH don’t love it but it’s all I’ve got for long lasting. I am still trying to figure out the correct amount. Humalog a couple units an hour to two hours after eating works ok for me. Sometimes I need more some times less. Depends on the amount of protein I eat.

Good luck!

Hi rubidoux,

I haven’t used injections in about 7 years, so I am not the best resource. However, if I were to try TAG w/ MDI, I would talk to my doctor about possibly using Regular insulin, since its onset and duration would more closely mimic the digestion of proteins and fats in my body. I think the max duration is 6 - 8 hours, so it would be better than NPH.

Just a thought.

I guess regular does make more sense. Humalog came out just a few months after I was dx’d and I got it right away and never looked back. It would really feel odd to do NPH or Regular. God, I hated them! But I will try it if I can’t make humalog work.

Today I did an injection when I ate and another about two hours later and it seemed to work out okay. I’m not spot on with my quantities, but fairly close. No sugars above 168 today! That feels like real progress.

Have you done any basal testing? IMHO that’s teh first thing all insulin users need to do. You have to at least know where your basal gaps are.

Can you get Regular Insulin? I haven’t used that stuff in a long time. I find Novolog(Novorapid) works well for me.

Pick some standard meals and titrate an insulin dose for them by testing every hour or use a CGMS. Keep those same meals every day and vary your doses. Then take what you learned and try them on new meals. I use different I:C ratios for different parts of the day.

Something I do is bolus for quantity. If I eat a large salad, I’ll add an extra unit or two just for the “Chinese Restaurant Syndrome.” It’s a trial and error thing.