Do you "count" protein?

[gavin86]

Just wondering. Since anywhere up to 40% of protein can be converted to glucose, do you count it and use it at all for calculations?

It would make things difficult, with its digestion/conversion taking longer than many bolus insulin last, especially if you're eating fat/protein combo...

This info I took from general reading about protein metabolism, and one seemingly well-considered study I could find on the subject (will try to find a link when I get home)

 

[azure]

@gavin86 No, I don't count protein. Like many Type 1s, I find it's only protein in the absence of carbs that needs to be counted.

As you say, it's harder to bolus correctly for a meal containing protein and no/minimal carbs. I generally avoid such meals.

If you look at the Type 1 section, you'll see a few threads asking a similar question. As the majority of Type 1s here eat moderate carbs it's not an issue unless the amount of protein is large.

Would you like me to move your thread to Type 1?

 

[tim2000s]

There have been a lot of discussions about this in the past. There is a Polish group that has built an algorithm for calculating how to best bolus, taking into account carbs, protein and fats (fats delaying absorption can change what you need to bolus) and as greater understanding of macro effects on glucose absorption have been learned, there have been more studies.

You might find both of these two documents interesting:

http://www.ucdenver.edu/academics/colleges/medicalschool/centers/BarbaraDavis/Documents/ATDC 2014 Slides/2.1 Wolpert Fat-protein.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3609492/

Most of us have learned that we need to develop strategies to handle protein and fatty foods, and that different macro mixes end up in different absorption profiles.

For a standard amount of carbs, higher fat and protein causes longer absorption than lower fat and protein, which obviously presents some issues. Pizza is a classic example of this.

 

[azure]

Ah, the pizza effect! : D Yes, fat is another thing to consider if meals are higher fat. I use an extended bolus for those, but on MDI I used to split my bolus if necessary.

Here's an article about the effect fat can have:

http://www.joslin.org/news/dietary-fat-can-affect-insulin-requirements-in-type-1-diabetes.html

.

 

[gavin86]

Thanks guys, I'll have a read and look around here.
Feel free to move it @azure

 

[azure]

Thanks guys, I'll have a read and look around here.
Feel free to move it @azure

Done

My advice is to start simple. You'll gradually get a feel for how different meals affect you. I rarely count protein (apart from in the circumstances above) but I do take into account higher fat meals as detailed in the JDRF link in my post above.

 

[noblehead]

Depends on the source of protein, beans & pulses, nuts and yogurt I include the carb value in the meal-time calculation, if it's say chicken, turkey or fish (moderate portions of) eaten with carbs then I don't bother as it seems to have no impact on bg levels.

Protein eaten in the absence of carbs, like an omelette/scrambled eggs I have to bolus for, in fact I need as much insulin for a low-carb meal like eggs than I do for my average meals that always contains carbs, but I've seen some type 1's say that they can eat protein and not have to bolus so it just goes to prove how different we all are, the best bet is to test your postprandial bg levels and work it out from there.

 

[col101]

I find of I've eaten carbs either with high protein or within a few hours them I don't need to bolus. If I'm going very low carb eh basal testing then protein does raise BG. Seems very individual to me so go with whatever works for you.

 

[Kristin251]

I need to bolus for half my protein. So if I'm having 3 oz (20g) then I bolus as 10 carbs BUT I eat vlc higher fat. If I eat more than 3 oz at one time I need to split my bolus. I only eat about 5 oz animal/ fish protein per day so 2 at lunch and 3 dinner so I don't split unless we go out and I eat more. I have avocado and a handful of low carb veggies with every meal.