Bolusing for fat, protein AND carbs in a meal

yingtong

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Hi RugthW,I was13 when diagnosed,but my parents kept all the paperwork they were given.I am experimenting with protein and fats after discussion with my dietician,once I have finished I will show my results on the forum,my initial results show that that fats and proteins effect blood sugars,some more than others.
 
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iHs

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Although I always counted my carb intake in 10g exchanges (1966 for me), I never counted the protein and fat and was told that I didn't need to in the presence of carb and that worked ok for me until I decided to have a go at eating low carb food for a lot of my meals.
 
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yingtong

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I was changed from counting calories to 10 g food exchanges in1964 and I still use some of the10g exchanges today as it works for me.
 

azure

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I like to learn about this stuff and followed the TAG total available glucose, where it is bolus for about 100% carbs, 50% protein and 10% fat.
the polish is very different, If you are doing 100g of protein =1 measure and 100g of fat =1 measure, or did I misunderstand and I have the wrong end of the stick?

I think I just got it, you add the protein and fats together, and 100g of both together = 1 measure ...right?

Are you using a different system @freddy2 ? I briefly mentioned bolusing for protein to my pump nurse, but she didn't volunteer much about it. Have you been given actual help from your pump team about calculating boluses for fat and protein?
 

freddy2

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Are you using a different system @freddy2 ? I briefly mentioned bolusing for protein to my pump nurse, but she didn't volunteer much about it. Have you been given actual help from your pump team about calculating boluses for fat and protein?
I'm T2 and as said, like learning about this stuff. I don't want to be in a position where I'm cluless, for when it is my turn to get insulin. I hadn't heard about the Polish before. TAG has been talked about here, there are a few that use its principles, Robert would be a good one to ask. and the group flatliners on TuDiabetes too.It's over my head, but they talk about squarewave bolusing.

This gives an outline about TAG ‘total available glucose’
https://healthonline.washington.edu/document/health_online/pdf/CarbCountingClassALL3_05.pdf
 
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RuthW

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Reporting back.

Wow! Just wow! Big kisses and superstar status for Ewelina for introducing this topic to the forum.

I reported one "experimental day" that was successful, now two more.

I had been planning to keep practicing with my usual medium carb, low fat diet but with increased protein. Instead, I had one of those weekends that was potentially difficult for diabetics. Big family do on Saturday and day in the park then eating out on Sunday.

On Saturday my sister cooked for the whole family: salmon with breadcrumb coating and sour cream sauce, asparagus (with butter), potatoes dauphinoise (high fat), followed by a chocolate cake with strawberries (with a bit of sugar) and whipped cream.

This is cooked by my sister who has not ONE but TWO sisters with Type 1 diabetes.

My other sister with T1 has been struggling a bit lately and started low carbing. She got fish, asparagus, strawberries and cream. I ate everything except the chocolate cake, with second helpings of potatoes. I bolused a dual wave: 4 units for carbs, then 2.2 units over three hours. We got no real advance warning, so I had to bolus at the table, which was not good. Nevertheless, my blood sugar 2 hours after the meal had only risen by 1.3mmol. Three hours later it was actually 0.5 mmol below the pre-prandial reading, and throughout the evening, it remained in the 6s. I woke with a FBG of 5.3 at 8.30 am.
 
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RuthW

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Day 2, Sunday (today). The usual porridge for brekkie, then "lunch" was a couple of slices of toast with peanut butter, a slice of Turkey ham and a few green beans from the fridge (I know, I know, awful, but I just shoveled it down while the offspring was getting dressed to go the park in what little was left of daylight).

Walked around Hyde Park. Shared a piece of carrot cake with ( separate) cappuccinos. Walked a bit more. Went into Pizza Express on the way home ( this is from She who upthread expressed willingness to give up pizza forever because it is "too difficult to bolus for). Ate three quarters of a large pizza (Romana). Followed by dessert - three salted caramel profiteroles with cream. Bolused 3.8 for carbs and 1.5 over three hours for pizza. One hour later, when I gave into dessert, bolused another 1.5 (wild guess bolusing.)

Now, let me see if I can post yesterday's blood sugars. Whoops no, I can't post a picture of my phone showing them with times and carbs etc, but here they are in time order starting at 8.30 am and ending at 23.30:

8.30 am 5.3;
9.03 (before breakfast): 5.3;
10.30: 6.7;
Before lunch (13.16): 7.8;
After lunch (15.06): 5.4;
After mid-walk carrot cake : 5.7;
Before dinner (18.17): 5.8;
After dinner (20.29): 4.8;
Mid-evening (21.09: 5.7;
Night (23.30) 5.9.

Not a spike to be seen, and I was really searching for them. Please note, that's all finger pricks. I don't have CGM.

It also seems that it is protein that I need to bolus for, and fat doesn't seem to make a difference. However, I may decide to get really all over it and start searching for spikes in the depths of the night.

But wow! It works. A ton of thanks to Ewelina for telling us about what I shall henceforth call " the Polish method", and to Tim for his many postings about bolusing for protein.
 

ewelina

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Reporting back.

Wow! Just wow! Big kisses and superstar status for Ewelina for introducing this topic to the forum.

I reported one "experimental day" that was successful, now two more.

I had been planning to keep practicing with my usual medium carb, low fat diet but with increased protein. Instead, I had one of those weekends that was potentially difficult for diabetics. Big family do and Saturday and day in the park then eating out on Sunday.

On Saturday my sister cooked for the whole family: salmon with breadcrumb coating and sour cream sauce, asparagus (with butter), potatoes dauphinoise (high fat), followed by a chocolate cake with strawberries (with a bit of sugar) and whipped cream.

This is cooked by my sister who has not ONE but TWO sisters with Type 1 diabetes.

My other sister with T1 has been struggling a bit lately and started low carbing. She got fish, asparagus, strawberries and cream. I ate everything except the chocolate cake, with second helpings of potatoes. I bolused a dual wave: 4 units for carbs, then 2.2 units over three hours. We got no real advance warning, so I had to bolus at the table, which was not good. Nevertheless, my blood sugar 2 hours after the meal had only risen by 1.3mmol. Three hours later it was actually 0.5 mmol below the pre-prandial reading, and throughout the evening, it remained in the 6s. I woke with a FBG of 5.3 at 8.30 am.
Thank you Ruth :) I'm really glad it works out for you. It gives so much more freedom to eat whatever we want (almost whatever :))
In the last year they started introducing new improved model in Poland. They calculate calories from fat and protein separately. When I find out how it works (not much information online) I will post it here
 
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RuthW

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Yes, next year I'm gonna do a wild guess bolus for the chocolate cake too ;)

And I had SUCH an enjoyable time sitting in the corner with my T1 sis comparing and locating pump features and swapping tips on management! You know how teenagers look at their phones together. We were like that with our pumps!
 
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azure

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I'm T2 and as said, like learning about this stuff. I don't want to be in a position where I'm cluless, for when it is my turn to get insulin. I hadn't heard about the Polish before. TAG has been talked about here, there are a few that use its principles, Robert would be a good one to ask. and the group flatliners on TuDiabetes too.It's over my head, but they talk about squarewave bolusing.

This gives an outline about TAG ‘total available glucose’
https://healthonline.washington.edu/document/health_online/pdf/CarbCountingClassALL3_05.pdf

Thank you. Hopefully, it'll be a good while before you need insulin :)
 
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RuthW

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I'm T2 and as said, like learning about this stuff. I don't want to be in a position where I'm cluless, for when it is my turn to get insulin. I hadn't heard about the Polish before. TAG has been talked about here, there are a few that use its principles, Robert would be a good one to ask. and the group flatliners on TuDiabetes too.It's over my head, but they talk about squarewave bolusing.

This gives an outline about TAG ‘total available glucose’
https://healthonline.washington.edu/document/health_online/pdf/CarbCountingClassALL3_05.pdf
As a Type 1, this stuff about fructose is irrelevant and dangerously misleading. For anyone on insulin, fructose has the same effect as any other sugar, and requires insulin when eaten or drunk. That article is very badly written. It refers to diabetes as if all diabetes is Type 2.
I think you are taking this thread off topic.

Ok, the link has changed. Thank you.
 
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freddy2

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As a Type 1, this stuff about fructose is irrelevant and dangerously misleading. For anyone on insulin, fructose has the same effect as any other sugar, and requires insulin when eaten or drunk. That article is very badly written. It refers to diabetes as if all diabetes is Type 2.
I think you are taking this thread off topic.

Ok, the link has changed. Thank you.
no, it's the same link I originally posted. my opinion of frustose you may have read on another topic. perhaps if you search my posts, you may find the post you mean and and comment there.

I recall posting 1 video on fructose and the Polyol pathway and another on insulin / leptin resistance and it's relevance, which had fructose as its main sublect.

But you are right in that for a lot of T1, fructose is just another sugar and doesn't have issues.
 
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RuthW

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Yes, sorry, the app seems to have been updated and the new version had me flipping about between threads today when I was trying to page up and down inside them. I may very well have read another posting of yours on the same topic in a different thread! (I'm not the only one having this problem today)
 
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RuthW

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Yes, Freddy, I really got confused yesterday on the forum. When I was trying to navigate on my iPad I kept getting flipped from thread to thread, when I was trying to page through just this thread. I really don't know what happened and I was hopelessly confused. But obviously I read both your postings and thought they were both in this thread.

I actually posted a complaint later about how the app was misbehaving and transferred to my phone.

You and I agree that what Type 1s are trying to bolus for is Total Available Glucose. Your posting and link IS useful, and not derailing.

(Mea culpa on the accusation of derailing. I can delete it but then no one will know what we're talking about.)
 
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ann34+

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That's interesting @yingtong, do you recall how the fat/protein to insulin ratio worked?

I was only ever told to count carbs in Carbohydrate Exchanges, one exchange equalled 10g of carbs.

Although the diet i was given was based on CHO exchanges, i was also told in some detail what protein and fat amounts to eat for my veggie meals - with examples - eg. one egg, one oz of cheese, 2oz peanuts, 2 tbls baked beans, and a given daily allowance of butter and milk, etc, and told to keep to about that. older books at that time still showed the black and red line diets. It was not suggested that i alter the actual daily amount of insulin very much , other than corrections, I still find it is best to keep to this
 
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