Injecting for protein and fats?

Jaspreetds said:

Hi

I am on a low carb diet but am finding I still have to inject for proteins and fats. If I don't my sugar can rocket up to 14/15. Is this normal or is my body weird? If I increase my basal rate will this mean I will not have to inject?

Click to expand...

Maybe your body is very efficient at turning proteins and fats into glucose. I'll tag @tim2000s as I believe he can give you a better answer than I can.

This is perfectly normal. Fat has a tiny effect on blood sugars, and you probably won't need to inject insulin to cover it. Protein is a different story, especially in the absence of carbohydrate. The body can convert protein into glucose through a process called gluconeogenesis. It does this much more slowly than with carbohydrate, which is really good news for diabetics. Injected insulin cannot keep up with carbohydrate. You will almost always see a spike in blood sugars to begin with. However, injected insulin is much more suited to matching the absorption rate of protein.
Now the million pound question: how much to inject? Unfortunately it varies from person to person. As a guide, I inject 1 unit of fast acting insulin for every 20 grams of protein I eat.
In regards to your long acting insulin, you should not alter that to match your food intake. The idea of basal insulin is to keep your blood sugars stable throughout the day. If your basal dose is correct, if you were to go a day without eating or exercising, your blood sugars should not go into hypo or high levels.

Jaspreetds said:

Just really confused, thought my sugars were supposed to be much more controlled with this low carb diet? Just had a home made tuna salad and injected 2 units but sugars gone up to 12.7 ( they were 7.5 before eating)

Click to expand...

What was in your tuna salad? Amount of protein and carbs in veg need to be accounted for when low carbing. How much tuna did you use?

To give you an example for me today, I ate a lunch with next to no carbs and 50g of protein, 35g fat. I injected 3.5u before eating, got a slight rise, then needed 2u each hour after the meal for two hours to keep stable, then 1u three hours after it to bring my bg back down.

It's not straight forward and most people start at an insulin protein ratio that is half what they use for carbs, then still have to inject later to counter the longer term rise that occurs.

I'm currently reading a book called "Your Diabetes Science Experiment" by "Ginger Vieira". She's a T1 bodybuilder who has to gain/lose weight quickly for competitions and obviously reduce fat and gain muscle. She documents her T1 reaction to different foods/conditions as "experiments" and has come up with formulas for lots of areas like protein. It's not LC specific but has lots of helpful info on areas other than carbs. ie protein, fat, exercise & stress.
She treats protein as 50% carbs except the 1st 20g. ie 90g of protein = 35g carb (90-20)/2. No mention of split/multi bolus (might come later in the book).
Well worth a read.

tim2000s said:

What was in your tuna salad? Amount of protein and carbs in veg need to be accounted for when low carbing. How much tuna did you use?

To give you an example for me today, I ate a lunch with next to no carbs and 50g of protein, 35g fat. I injected 3.5u before eating, got a slight rise, then needed 2u each hour after the meal for two hours to keep stable, then 1u three hours after it to bring my bg back down.

It's not straight forward and most people start at an insulin protein ratio that is half what they use for carbs, then still have to inject later to counter the longer term rise that occurs.

Click to expand...

That's interesting; I would quote my insulin to carb ratio as 1:1 (i.e. I unit of bolus for 1 gram of carb - not CP). For what you've eaten there I would probably have the same; about 3-4 units of bolus but would not ordinarily add further corrections.

Every single consultant I have ever discussed this with just doesn't believe the ratio. What I'm probably doing is automatically calculating the protein response there I suppose.

Anyway glad to see that I'm not some freak and others have the same type of bolus response!

Best

Dillinger

Dillinger said:

That's interesting; I would quote my insulin to carb ratio as 1:1 (i.e. I unit of bolus for 1 gram of carb - not CP). For what you've eaten there I would probably have the same; about 3-4 units of bolus but would not ordinarily add further corrections.

Every single consultant I have ever discussed this with just doesn't believe the ratio. What I'm probably doing is automatically calculating the protein response there I suppose.

Anyway glad to see that I'm not some freak and others have the same type of bolus response!

Best

Dillinger

Click to expand...

Interestingly enough, when I was at the hospital in January, I met with the dietician who raised the topic of bolusing for Protein and gluconeogenesis. That was a first!

Everyone's protein ratio is different.

I would advise starting at one third of your carb ratio and working up from there as needed.