Protein powder conundrum

[O_DP_T1]

Hi all,

I wonder if someone could help out here, this is a bit long so please bear with me.

On days that I train in the morning I seem to get a huge spike later in the day after a protein shake let me explain below:

7:30 - Take morning insulin (reduced dose due to training)
8am - Breakfast (porridge with natural peanut butter and 1 scoop protein powder 60gC 29gF 43gP)
10:00 - Training
12:00 - Post training lunch (80gC 20gF 50gP) for this I take a slightly reduced bolus rate otherwise I am hypoing all afternoon. The above keeps me in the 4.0-5.5 range.
4:00 - Snack time - level is usually around 3.8-4.5 here so I take a protein shake (15gC 7gF 48gP) and this ends up giving me a HUGE spike after a 2-3 hours anywhere up to 12-17.

I am using the USB Pure Protein GF-1 powder by the way.
https://uk.usn-sport.com/en/pure-protein-gf1

Does anyone know why this is happening?

I can understand that by 4pm the lunch time bolus has run out surely the basal can deal with the 15g of carbs.

I’ve been a diabetic fort about 40 years plus and using this powder for quite a few years whilst on the twice a day human M3 insulin and NEVER had any issues with it; the highest it would spike me might be to a 7 or an 8. I’ve switched over the MDI (NovoRapid and Levimier) a few months back and protein shakes are causing havoc.

Any advice would be great.

 

[catapillar]

One serving of protein shake has 15g of carbs and 48g of protein. If at 4pm all you ate having is a protein shake this is 4 hours from your last decent serving of carbs. In the absence of carbs your body wants to get glucose from somewhere. It still has to replace all the glycogen in your muscles you burned through in your training. If you aren't eating carbs it will do this through gluconogenesis - it will turn protein eaten into glucose. This is a taxing prices for the body, so it doesn't bother doing Gluconogenisis when you are eating a decent amount of carbs, and it takes time which is why you're seeing highs 3hrs later.

Basal isn't designed to deal with 15g of carbs. Basal should keep you flat-ish when not eating or bolusing. If your basal could deal with 15g of carbs, on the days when you didn't eat it you'd be hypoing like nobody's business.

What's your I:C ratio?

 

[O_DP_T1]

Thanks caterpillar in that case should I

A) Make that shake 40g carbs with the 48g protein in which case, would I need to take a an additional shot?
B) Have a snack of 20g carbs around 2-3pm so there is some additional carbs in the system to replace glycogen, just take a unit or 2 extra at lunch for that snack
C) Crank up the post training carbs to like 80-100g to replace glycogen

I:C ratio post training is 1u insulin to 10g carbs for lunch time, on non training days it's more like 1u of insulin to .8g carbs.

 

[O_DP_T1]

OK just tried this again this time the macros are (30gC 7gF 48gP) have taken 3 units of NR with the shake, will take another additional 2 for the protein in 2.5hrs at which point it'll be dinner time so I may just add the 2 units to that meal dose.

 

[catapillar]

OK just tried this again this time the macros are (30gC 7gF 48gP) have taken 3 units of NR with the shake, will take another additional 2 for the protein in 2.5hrs at which point it'll be dinner time so I may just add the 2 units to that meal dose.

But you've had 30g carbs. If you've got 30g of carbs, your body isnt going to bother going to all the trouble of gluconogenesis so there should be no need to bolus for protein.

 

[urbanracer]

Sorry for butting in but your GF-1 is Protein Isolate, not Protein Concentrate. It is only 4.7g of carbs per serving.

Don't know if this changes your calculations, - long time since I've been to a gym!

 

[O_DP_T1]

So this is what happened yesterday post protein powder consumption.

5pm BGL 7.1 take shake and 3u NovoRapid
6pm BGL 9.9 and rising slowly
7pm BGL 12.4 and sky rocketing
7:30pm Bolus for dinner + 2u for protein shake + correction units
9pm BGL 6.1 Normal service has resumed again

Looks like the 3u was not enough to cover the shake.

@catapillar @urbanracer exactly my original thoughts why would I need to bolus for the protein because of the carbs in the shake.

To be honest guys this NEVER happened on the pre-mixed twice aday insulins, on some days If I was busy and didn't have time to eat I'd had 2 of these shakes aday to reach my macro needs with NO BG rise.

This is REALLY getting me down and annoying me, any pointers would be greatly appreciated.

 

[becca59]

Interesting that you take protein shakes. I’ve had this discussion with my son. They have done tests somewhere which show drinking a glass of milk after workouts has exactly the same effect on muscle recovery.
I also read somewhere recently about concerns with young men taking protein shakes and a negative impact on fertility. (Important issue for my son)

From a diabetes angle it may be easier to bolus for a glass of milk. Just a thought!

 

[urbanracer]

To be honest guys this NEVER happened on the pre-mixed twice aday insulins, on some days If I was busy and didn't have time to eat I'd had 2 of these shakes aday to reach my macro needs with NO BG rise.

Not sure how much help I can be as I am not exercising the way you are or using protein drinks. I have recently changed from mixed insulin to MDI though.

So how long ago did you change over from twice a day and what insulin/ how much were you using then and what are you using now?

 

[catapillar]

To be honest guys this NEVER happened on the pre-mixed twice aday insulins, on some days If I was busy and didn't have time to eat I'd had 2 of these shakes aday to reach my macro needs with NO BG rise.

Have you basal tested to see if you're on the right basal dose? If you're not, that could be playing a part in the rise. Here's a good guid on how to basal test - https://mysugr.com/basal-rate-testing/

 

[O_DP_T1]

Thanks guys

@urbanracer I was on Humlim M3 30/70 twice aday for almost 30 years plus before I switched to MDI I was on 56u in the morning and 16u at night. Currently I am on NovoRapid and Levimier I take 17u of Levimer once a day in the evening at the same time. I started on MDI just before Christmas, and tbh I've not really settled on it yet.

@catapillar I think I might need to basel test and see.

Funny thing is if eat similar macros in 'actual food' and only bolus for the carbs part then there is NO real spike just normal 8ish and back in range post 2hrs.

 

[catapillar]

Thanks guys

@urbanracer I was on Humlim M3 30/70 twice aday for almost 30 years plus before I switched to MDI I was on 56u in the morning and 16u at night. Currently I am on NovoRapid and Levimier I take 17u of Levimer once a day in the evening at the same time. I started on MDI just before Christmas, and tbh I've not really settled on it yet.

Levemir lasts about 12 hours. A 17unit dose might las a bit longer. But if you're taking it in the evening basal testing might show its run out by early afternoon, when you're having your protein shake. I was advised to take one shot of levemir am and one pm to cover the whole day, but it's worth basal testing to find out how it works for you.

 

[kev-w]

It's 20 years since I used whey protein supplements for training but remember there being 2 basic types, one had carbs added and one never, the one without was drinkable, but that was probably on humilin s, if you bought one at the gym it came with a raw egg in it which I don't think is particularly digestible.

 

[O_DP_T1]

Levemir lasts about 12 hours. A 17unit dose might las a bit longer. But if you're taking it in the evening basal testing might show its run out by early afternoon, when you're having your protein shake. I was advised to take one shot of levemir am and one pm to cover the whole day, but it's worth basal testing to find out how it works for you.

This is an intrsting theory as it has passed my mind before. Having said that on a 'normal-ish' at about 4pm onwards there is very sometimes a rise like may be from 6 to 8.5 just before dinner, and others there is none.

 

[O_DP_T1]

So here's an interesting one.

Yesterday no day time training, at 5:30pm check BGL it's 5.5 and slowly dropping so pop 2 dextrose tabs as I'm about to make my journey home from work, check BGL again after 1hr once at home and 3.8!!!!

Now if that was a gym day levels would have been MUCH higher at that time of day!!!

 

[urbanracer]

So here's an interesting one.

Yesterday no day time training, at 5:30pm check BGL it's 5.5 and slowly dropping so pop 2 dextrose tabs as I'm about to make my journey home from work, check BGL again after 1hr once at home and 3.8!!!!

Now if that was a gym day levels would have been MUCH higher at that time of day!!!

After the gym??

Your liver may dump a load of glucose in to your system in response to strenuous exercise.

 

[O_DP_T1]

After the gym??

Yes seems on days where I train in the mornings I see raises after 4pm even without eating. On non training days this doesn't happen.

 

[Deleted Account]

Yes seems on days where I train in the mornings I see raises after 4pm even without eating. On non training days this doesn't happen.

Are your "non training days" the day after your training days?
The reason I ask is because your training may reduce your glucose supplies (as @urbanracer mentions you may have a liver dump after exercise). Hence you have less to "drip" into your blood stream for the next 24 to 48 hours. If you maintain the same basal dose, this may result in a hypo.
I always reduce my basal by about 20% for 24 hours after exercise. This includes both cardio (running) and resistance (climbing) exercises.

 

[O_DP_T1]

Yes generally I train every other day.

So on the days that I train in the morning there there is a liver dump around 4pm onwards which is usually about 4-5 hours after training has finished and I've had lunch with bolus etc etc.

On the days that I DO NOT train all is generally good even after 4pm.

Will reducing the basal not make the liver dump spike higher as there's less background insulin around, sorry to ask these questions but this nonsense has only started since I've been on MDI and it's a real hassle. Never happened on the twice a day pre-mixed regime.

As always all advice is greatly appreciated.

 

[Deleted Account]

I can only describe what did when I was on MDI and exercising regularly.

I usually exercised in the evening before tea and gave myself my basal dose after tea .. so my basal dose was soon after exercise and I was able to clearly associate it with the "day after exercise".
The days when I did no exercise, I gave myself my "normal dose" of basal.
The days when I exercised, I reduced by basal for the next 24 hours by about 20%.
(If I exercised on two consecutive days, I would reduce my basal further on the second day. For example, when I went on a 14 day trek through the Himalayas, about half way through, I had more than halved my basal.)

My understanding is that this closely resembled the behaviour of a healthy pancreas - the liver drips glucose 24 hours a day and the pancreas responds by releasing insulin 24 hours a day. When a non-diabetic pancreas detects a rise in BG such as responding to food, the pancreas releases more insulin.
With basal bolus, the basal replicated the insulin release due to the liver glucose drip and the bolus replicates the insulin release for food.

When we exercise, we use some of the reserves of glucose in our liver (this is likely to be your liver dump at 4pm on your exercise days) so there is less glucose to drop as it is filled back up again over the next 24 to 48 hours. A healthy pancreas would release less insulin and we need to inject less basal insulin.

Given the times of your exercise and basal, the relationship between the two is not as obvious.
I *think* you need less than normal basal after your 4pm liver dump. This may mean you need to increase your basal on your exercise days as it seems to be working fine on your recovery days (day after exercise).