As a low to moderate carb eater, I haven't found the need to bolus for protein except for one meal. I sometimes eat an omelet for breakfast which I originally counted as 4 carbs for the vegies and found I kept being high. So I upped it to 6 carbs and it works out fine.It doesn't seem that many of us who aren't Bernstein level low carbers have to bolus for protein. I also think that when people develop their I:C ratios based on pp results, it can automatically take that into account unless their diet changes dramatically. Personally, I don't have any desire to count/measure anything else!
But then, That picture definitely doesn't represent my diet!
I toss in like 5-10 extra G of carbs worth of protein most of the time. I hardly have any meals or snacks where there isn't some protein floating around. I'm not as adept at "knowing" protein serving sizes but just kind of "boost" the insulin to cover it a bit.
I dunno if it makes a difference or not but it seems to have helped get rid of some post-meal highs and sort of get me from 5.3-5.8 to 5.1-5.2 for the last year or so. I agree there's not much evidence that that makes a huge difference but I prefer spiking to 120 after meals to spiking to 140 or 160 or whatever?
I move back and forth from low carb (breakfast/ lunch) to high carb (evenings in the rumpus room...) pretty much every day so I'm not sure I'd agree that moving around is a problem. I think that it may be hard to have your rates and ratios calculated if you move around a lot but I'm very conservative during the day during the week and it seems to give me a good, basic confidence that my ratios are set close so, if I eat 75G for dinner occasionally, I can be confident that the post dinner number will be pretty decent.
i think you're a vegetarian, zoe..yes? thus, i'm talking like a plate of a large piece of protein 4 - 5 ounces and veggies, as indicated in pic above, you'd probably find, if no other carbs, you'd have to bolus for it,it's gonna turn to glucose and sometimes it does hit later. If one is still honeymooning, he/she may still be able to cover it w/out insulin, that's what I ate entirely while i was still honeymooning..but it doesn't work anymore. If I eat a meal with more carbs vs. protein, i'll do what AR does, add maybe 5 - 10 grams for protein, depending on BG's at meal, etc...so many things to factor in. I think people on pumps usually will use the other features; dual, extended, square wave, etc..bolus to help with proteins and fats when higher in the meal and if they're truly low carbing. If I eat a meal like the pic, i will actually weigh the protein and do the 50% split for protein, which sometimes doesn't work but better then no insulin and will sometimes have to take a small hit/dose later...that's my experience anyway. :)
Thanks to all that have replied. Its all very interesting. I do like to eat carbs, but sometimes they make me feel terrible. We are working on getting my insulin to carb ratio and basal right, so when that happens hopefully things will fall into place.
I really believe in the low-carb diets that are focused on eating good fats like the New Adkins. However, I am very active and my body could never make the transition over to these diets after 2 years. I always felt very lethargic. I need grains for some reason and shoot for about 35 carbs a meal and 3 meals a day. It works for me and I have an A1c of 5.7. I have taken bits and pieces from each one of the books and through experimentation I have created a plan that works for me. So my main advice would be to remember that everyone one is different. What works for one person may not work for you - so keep reading, keep asking questions, keep exercising, keep experimenting, keep experimenting and keep experimenting. I am still tweeking my program after 20 years.
I usually eat 2 meals per day and 1 snack, sometimes just the two meals. I wait 20 minutes before eating. I eat low carb, about 50-70g per day. No grains, no potato or starchy veggies. Most of my meals are made from scratch by me, those out are at good quality restaurants only. I'm on levimir,novolog, and symlin. I did the smaller meals at first which helped but I felt I was starving all the time and have gone back to one largish breakfast/brunch about 9g and one larger evening meal about 25g and one snack about 10g. I also take novolog at various times when I spike due to various things like basal running out. This is what works best for me so far, but everyone is different and what matters is what works best for you.
I eat and manage my diabetes very similarly to you. I was wondering about the Symlin. How do you find it is working for you, when do you take it etc.? are you t1?
Yes, I'm type 1 I was diagnosed last May. I find Symlin does help my cravings however it does also cause nausea for me even at the lowest dose. And when I have to do a correction with novolog to lower bg I just get hungry again. But it does help. I have to be more careful about hypos during the meal since I wait 20 minutes to eat, but I do get the hypos anyway.. and then I spike later.. that also happens with or without Symlin.. I do still have fluctuations and I guess there is no way for me to flatline. Maybe that is just me, I'm not sure. When you take Symlin you reduce your insulin, I found I didn't need to reduce it as much as they said to though, Each person is different. I take my bolus, wait 20 minutes, usually cooking my meal and then take symlin directly before eating. I haven't taken it for the past few meals though because my insulin needs seem to be decreasing and I'm having a lot of hypos.
Thanks for your reply. I was having similar issues with hypos after eating. Now I split my bolus. I take two thirds at mealtime and the rest after I finish. It seems to be helping. I was going low at three hours. As my endo puts it..."it's a poor man's pump." You may try something like that... it could help. It's an extended bolus in essence so your not loaded upfront with too much. You have to experiment with the amounts per your own needs.
