How best to manage the protein spike...

[Kateyo]

Hi, I'm just looking for other people's experience of this. I have given (very) low carb another go. I'm on fiasp via pump. I've seen the benefit of low carb in that things tend to flatline more however the protein spikes are a nightmare to manage and I've found my SD has increased because of it. The spikes are quite difficult to get back down (a lot is my own fault as I spot the rise and correct but not in time and with cgm lagging behind it can be too late). I just wonder is it better to be lower carb but still have carbs in diet and ensuring that Bs remain under 7.8 at the one hour mark or on v. low carb but battle with protein. I'm not sure that it's doing me any good at the minute with SD on the up

 

[Kristin251]

I’m on MDI, not a pump and am ultra low carb. To preface this I also have nasty digestion so this works for me as well

I eat 5 small meals a day. Never more than 3 oz protein at one time or I’d need to split boluses.
I only take 2 units lantus and get DP so mornings are of course worse. I prebolus 20 min and eat bf. ( a thin slice of turkey with avocado smashed in it then wrapped in lettuce) An hour or hour and a half later i take a small bolus to stop the morning rise. Then I make my lunch with 2 oz protein and half an avocado ( I split lunch into two meals) 3 hours apart. Then I have a happy hour cheese or egg snack with my wind down cocktail. Then dinner 3.5 hours after my ,ast lunch. Usually 1.5 oz protein and more avo. I take 1/2 unit with all meals. I add a few vlc veggies to each meal.

Here’s the kicker. If I eat just protein and veg and no avocado I spoke faster and higher. If I eat just veggies forget it. Even just eating alone I’ll go a bit higher. So for me, the fat, fiber and carbs in the avo slow the protein and keeps me low. And the protein slows the carbs in the veggies and avo. I refer to it as bridging the gap between insulin and food to marry them. I also prebolus 20 min ahead at each meal and I stay rock steady.

Avocado is as important as insulin to me. I love them so it all works out. Hope you love them too!

I can’t advice on a pump but perhaps keeping doses lower and more often? Not sure if that works in pump land but the way I eat is my version of a pump. Low doses, more often.

 

[Kateyo]

I’m on MDI, not a pump and am ultra low carb. To preface this I also have nasty digestion so this works for me as well

I eat 5 small meals a day. Never more than 3 oz protein at one time or I’d need to split boluses.
I only take 2 units lantus and get DP so mornings are of course worse. I prebolus 20 min and eat bf. ( a thin slice of turkey with avocado smashed in it then wrapped in lettuce) An hour or hour and a half later i take a small bolus to stop the morning rise. Then I make my lunch with 2 oz protein and half an avocado ( I split lunch into two meals) 3 hours apart. Then I have a happy hour cheese or egg snack with my wind down cocktail. Then dinner 3.5 hours after my ,ast lunch. Usually 1.5 oz protein and more avo. I take 1/2 unit with all meals. I add a few vlc veggies to each meal.

Here’s the kicker. If I eat just protein and veg and no avocado I spoke faster and higher. If I eat just veggies forget it. Even just eating alone I’ll go a bit higher. So for me, the fat, fiber and carbs in the avo slow the protein and keeps me low. And the protein slows the carbs in the veggies and avo. I refer to it as bridging the gap between insulin and food to marry them. I also prebolus 20 min ahead at each meal and I stay rock steady.

Avocado is as important as insulin to me. I love them so it all works out. Hope you love them too!

I can’t advice on a pump but perhaps keeping doses lower and more often? Not sure if that works in pump land but the way I eat is my version of a pump. Low doses, more often.

Thanks for taking the time to reply! I’ve definitely found avocado to help as protein spikes me as soon as I start eating, not entirely sure why! I’m definitely seeing the benefits as rather than spiking up into 7s then back down to 4s and having to snack to keep myself from dropping low (while on a lower carb diet) I’m sitting steady then spiking into 6s about 2 hours after eating but I find that I’m having to inject quite a bit to get this back down while the protein/fat digests (1-2 units). It’s frustrating me as I know a lot of people on low carb can stay between 4-5 after eating. I don’t mind a small spike into 5s or even as much as 6 but I’d like to mimic the body whereby the spike drops back to normal relatively quickly. It’s early days for me I suppose and trial and error needed. Luckily I do love avocado though which helps!

 

[Kristin251]

Thanks for taking the time to reply! I’ve definitely found avocado to help as protein spikes me as soon as I start eating, not entirely sure why! I’m definitely seeing the benefits as rather than spiking up into 7s then back down to 4s and having to snack to keep myself from dropping low (while on a lower carb diet) I’m sitting steady then spiking into 6s about 2 hours after eating but I find that I’m having to inject quite a bit to get this back down while the protein/fat digests (1-2 units). It’s frustrating me as I know a lot of people on low carb can stay between 4-5 after eating. I don’t mind a small spike into 5s or even as much as 6 but I’d like to mimic the body whereby the spike drops back to normal relatively quickly. It’s early days for me I suppose and trial and error needed. Luckily I do love avocado though which helps!

Me too. Protein is an immediate spike without my beloved avocado. I also can only eat small amounts of protein at a time. The avocado is the only food I found that prevents the spikes and drops, other fats don’t act the same. True, more injections but I stay steady most often between 80& 90 with little movement.
I think of it like this. With low carb we need low insulin doses. So they don’t last 4-5 hours. Mine lasts 2-2.5 in the morning and around 3 in the afternoon. So I simply run it and need to inject and I can’t inject without eating or I’ll drop. So I eat a small snack with protein and avocado. I found quantities of each to make a difference as well. Approx 1 oz of protein to 1 oz avo seems to be my magic portions. Not enough avo and protein spikes. Too much avo and I spike. Here in the US we don’t deduct carbs. So in the UK 5 Oz avo is three carbs, here it’s 12.5. Fiber of 9.5 BUT, my body acts like it’s 12.5. I have to bolus for it and I can use a spoonful to stop a drop. The little bit of veggies I eat are very inconsequential and my bg acts the same whether I eat them or not so it’s all about the protein and avo. So the protein and fat, fiber and carbs marry the timing of insulin and food.
I also prebolus 20 min as that’s when my insulin starts working. If I’m low I eat a few minutes sooner.
Yes, I’m OCD aa I hate those fluctuations!
Hope this helps.

 

[ringi]

Maybe more good fats and less protein would help.

 

[ickihun]

I find the carb/protein balance interfers with the delay of a spike or not but on low carb I find protein is converted to glucose in carb absence. One or the other gets converted but most likely due to presence of basal insulin?

If excessive maybe do a test to make sure basal is not too much?

The body will always want glucose, from somewhere when insulin is ample.

 

[Kristin251]

I’m sorry you’re going through this but super nice to know I’m not alone. And I have figured out how much of everything to eat to stay steady. I rarely move more than 10 (US) points either way.
For me the avo with every meal and prebolusing was my key.
I also follow the recommendations of .8g per kg lean body mass for my protein and I divide it throughout the day.

I feel there are carbs in the meal then gluconeogenisis doesn’t happen so fast but without carbs we will tyrn protein into bs so I bolus for half. So 2 oz of protein will act like roughly 7 carbs.

And as I said above, I think with the smaller doses it just runs out sooner.
First thing in the morning, when were most resistant, mine only lasts a little over an hour before I start to rise. Then I get the morning rise so take 1/2 unit. My noon lunch it lasts about 2 hours before I start to rise but at 3:00it lasts about 3.5 hours. As you can see, loads and loads of testing but now on autopilot

 

[Kateyo]

I’m sorry you’re going through this but super nice to know I’m not alone. And I have figured out how much of everything to eat to stay steady. I rarely move more than 10 (US) points either way.
For me the avo with every meal and prebolusing was my key.
I also follow the recommendations of .8g per kg lean body mass for my protein and I divide it throughout the day.

I feel there are carbs in the meal then gluconeogenisis doesn’t happen so fast but without carbs we will tyrn protein into bs so I bolus for half. So 2 oz of protein will act like roughly 7 carbs.

And as I said above, I think with the smaller doses it just runs out sooner.
First thing in the morning, when were most resistant, mine only lasts a little over an hour before I start to rise. Then I get the morning rise so take 1/2 unit. My noon lunch it lasts about 2 hours before I start to rise but at 3:00it lasts about 3.5 hours. As you can see, loads and loads of testing but now on autopilot

Haha I feel better knowing I’m not the only one these things happen to as well! I hadn’t thought about the low doses before and the fact they probably don’t last the full 3-4 hours, that’s a good point! I had a great start to day, stayed nice and steady overnight and through breakfast but then waited too long to bolus for lunch (a salad) as I was sitting a little low beforehand so crept up to 6 and stayed there longer than I’d like but pre bolusing definitely worked for breakfast so part of this is needing to be patient while I work out how low carb works compared to lower carb which would have seen me having 30g carbs each meal. It definitely changes how you need to think and react. If I can just work it all out...I’m very impatient! Thanks for all your help!

 

[Kateyo]

I find the carb/protein balance interfers with the delay of a spike or not but on low carb I find protein is converted to glucose in carb absence. One or the other gets converted but most likely due to presence of basal insulin?

If excessive maybe do a test to make sure basal is not too much?

The body will always want glucose, from somewhere when insulin is ample.

I’ve been testing basal lately and for the most part it’s holding me steady but definitely still need to check a couple of time periods during day to make sure they’re ok and I bet once I do that it will all change again and basal testing will start again thanks for the advice

 

[Kateyo]

Maybe more good fats and less protein would help.

True, I could try that and see what happens, thanks

 

[ringi]

@Keteyo If you don't have a CGM, this may be a good time to use some of your savings to buy yourself 1 month's worth of sensors. Also for some reasons most people who get on well with Type1 and low carb seem to have read Dr. Bernstein's Diabetes Solution

(I think there is an "insulin" that has a higher half-life that some people use for protein, using a different pen for protein than carbs. but your pump settings should let you spread out a dose of very short half-life insulin to get the same response curve.)

 

[Kristin251]

Haha I feel better knowing I’m not the only one these things happen to as well! I hadn’t thought about the low doses before and the fact they probably don’t last the full 3-4 hours, that’s a good point! I had a great start to day, stayed nice and steady overnight and through breakfast but then waited too long to bolus for lunch (a salad) as I was sitting a little low beforehand so crept up to 6 and stayed there longer than I’d like but pre bolusing definitely worked for breakfast so part of this is needing to be patient while I work out how low carb works compared to lower carb which would have seen me having 30g carbs each meal. It definitely changes how you need to think and react. If I can just work it all out...I’m very impatient! Thanks for all your help!

Here again, just a salad with no avocado I would spike no matter when I bolus. I’ve tried protein and veggies with some other fats , no avocado and I go higher than if I did eat some avo. There’s something magical that happens when I eat it with other foods. But it still acts like a carb if I don’t have protein in the meal, I’ll rise higher than with protein.
Fatty animal fat makes me rise higher but later. If I have a burger I have to split my bolus. Mediterranean fats do t do that at all. And other than avocado they don’t slower or lower my rise. Or keep me steady. It’s kind of ridiculous I have to eat avo with every meal but it an enormously healthy fat and I love it and since I eat small meals it’s no biggy. I just plop a wedge on my plate.
I’m glad prebolusing is helping. It does take some time to figure it out and also figure out Approx when you’re running out of insulin. I peak in about an hour. Wherever I am then I’m not going to go any lower. Then as the day goes on it lasts slightly longer but not as long in the morning.
How low carb are you aiming for?
And NOBODY ever called me patient. Lol