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Calculating insulin for fats and protein.

Discussion in 'Type 1 Diabetes' started by Randaaa, Apr 27, 2016.

  1. Randaaa

    Randaaa Type 1 · Newbie

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    do you know website to learn how to calculate insulin dosage in the meals that contains only protein and fats ??
     
  2. mojo_101

    mojo_101 Type 1 · Well-Known Member

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    You may find some information and a spreadsheet if you search for TAG as this relates to calculation including total available glucose - including from protein and fats. I will see what I can find when I get a moment.
    Good luck.
     
  3. Kristin251

    Kristin251 LADA · Expert

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    Personally I bolus for 1/2 proteins. It is said roughly 58% protein turns to bs and roughly 10% fat. Timing on injecting insulin will matter too as protein is slow and fat slows it more. I find I have to inject either right before or during the meal or infill go low 1st before my food gets there. I try to eat just a few veg to fill in the gap.
     
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  4. rachel162

    rachel162 Type 1 · Well-Known Member

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    A very approximate starting point seems to be to bolus 50% of your carb ratio for protein, and 10% for fat (i.e. if you'd normally bolus 1 unit for 10g carbs, then you'd bolus 0.5 units per 10g protein and 0.1 units per 10g fat). However, this will vary from person to person and depending how carb heavy your diet is. If you eat a fairly high carb diet you may not have to worry too much about fats and proteins, but as I for example eat fairly low carb, I am more sensitive to protein. However, I don't personally have to worry about fats, they barely affect my sugars at all.

    Also I'd be careful with the timing of doses. If I'm only eating protein and fat, I'll work out the dose, and either bolus just after the meal or use an extended bolus on my pump to prevent a low and later high, as protein takes longer than the insulin to affect my levels.

    Don't know if this was much help or not, but good luck!
     
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  5. TorqPenderloin

    TorqPenderloin Type 1 · Well-Known Member

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    Here's a link that discusses the 50-60% protein conversion theory: http://journal.diabetes.org/diabetesspectrum/00v13n3/pg132.htm

    In short, that's based on a 100 year old study that has largely been debunked. It's widely agreed that a good bit of excess protein does convert into glucose. However, "Glucose" doesn't necessarily equate to "blood sugar."

    Disclaimer: I'm not saying I think you're wrong, but it's a topic that's widely disputed.
     
  6. noblehead

    noblehead Type 1 · Guru
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    Going to tag @ewelina into the thread as she has some useful advice and a link to a website that discuses bolusing based on the calorie content of the meal.
     
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  7. Kristin251

    Kristin251 LADA · Expert

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    For me protein has a profound effect. I did not read the link but I would also imagine what is in the rest of the meal make a big difference. I am extremely low carb so I believe I gluconeogenisis quite rapidly. Now if there were carbs in the meal I'm not sure how that would work.
    The OP was asking about a mainly protein and fat meal with the absence of carbs. Not sure if previous carb meals and full glycogen stores would matter either. I eat a keto genie diet so not lots of stored glycogen. I assume everything matters and makes a difference just as everyone's miles vary.
     
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  8. ewelina

    ewelina Type 1 · Well-Known Member

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  9. Blackers183

    Blackers183 Type 1 · Well-Known Member

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    Latest paper I can find on the matter published September last year is "Optimized Mealtime Dosing for Fat and Protein in Type 1 Diabetes. Application of a Model Based Approach to Derive Doses for Open-Loop Diabetes Management".

    http://care.diabetesjournals.org/content/diacare/39/9/1631.full.pdf

    It seems a few people who post here adopt a very similar dosing strategy.

    Cheers
    David
     
  10. tim2000s

    tim2000s Type 1 · Expert
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    If I was to be cynical, I'd suggest that that paper simply affirms that the best way to treat HCHF or HCHP meals is using the combo bolus and determining the best split requires trial and error, as many well managed Pumpers have already found out!
     
  11. Blackers183

    Blackers183 Type 1 · Well-Known Member

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    Yep, that's the way it seems. If I am to read papers correctly there is just too much individual variation on how we process foods and insulin to come up with a standard that applies to all, just look at how different our ratios can be. This appears to have been in part the problem with the Warsaw method. All very frustrating for diabetics!

    However from my perspective the recommendation in the paper combined with your and others feedback (strategies used) are a really good base to work from.
     
  12. tim2000s

    tim2000s Type 1 · Expert
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    It's interesting actually. This is a key issue with the two major open source "Artificial Pancreas" projects. One uses specified carb absorption times while the other works it out as it goes based on carb amount entered. I find the second one is far easier to use and more effective for me.
     
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