I have to bolus for no carb meals especially eggs. Indeed I have to bolus as much for a trad English breakfast as for my normal porridge and berries. That's no different now though to when I was on MDI.
This has got some scientific basis. It isn't just carbs that cause insulin to be released in people without diabetes and if a non diabetic produces it , then surely we need it too.
Jenny Brand Miller before she got involved with the glycemic index was involved with a small study in which they tested portions of different foods containing the same amounts of calories to find the insulin response, obviously in non diabetics.
Some of the protein foods elicited surprisingly high amounts of insulin, cheese for example caused a similar amount of insulin to be released as porridge, beef more than pasta. They created a simple insulin index.
More recently , again in another very small study, they did some studies on mixed meals using these foods. They used their index to predict the insulin response to the meals. It was moderately successful.
They found that a meal of beef steak and potatoes ( ≈40 g carbohydrate ) produced twice the insulin response of meal of grain bread, peanut butter, and milk despite a similar amount of carbohydrate (≈37 g )
One meal pasta and lentils 63g carb produced the same amount of insulin as the grain bread, peanut butter, and milk meal with 37g of carb .
Like their first study it was very small so underpowered and nothing anyone could work with but does demonstrate that the amount of insulin released in non Ds (and I assume T2s) isn't totally determined by the amount of carbohydrate.
insulin index:
http://www.ajcn.org/content/66/5/1264.full.pdf+html
mixed meal experiment
http://www.ajcn.org/content/90/4/986.long
I don't know where that leaves us as it suggests that dosing according to carb content alone isn't necessarily very accurate and it's not just the effect of adding the protein either as different protein foods produced different responses.
Practically, I know that with meals I eat regularly I tend to use the number of carbs and think about the GI when first eating someting or at a restaurand. Then in future I adjust the dose according to previous experience rather than completely accept what might pump tells me.
More of an art than a science!
