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Insulin for Low Carb High Protein (Bernstein Protocol)

Discussion in 'Insulin' started by Mbaker, Mar 30, 2020.

  1. Mbaker

    Mbaker Type 2 (in remission!) · Well-Known Member

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    With the disclaimers that no one (especially Type 1's) should just try this without proper guidance and understanding of carb counting, can someone explain how to count insulin requirements when a high protein low carb diet is undertaken. Preferably the method Type 1 Grit members use would be ideal. If you are able to either provide a formula or real food example that would be great. Thanks in advance.

    AGAIN IF YOU READ RESPONSES, DO NOT JUST JUMP INTO THIS PROTOCOL.
     
  2. Muneeb

    Muneeb Type 1 · Well-Known Member

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    I believe Dr Bernstein uses 0.75 units per gram of protein. But he also uses long lasting insulin's instead of what we generally use (fast acting).
     
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  3. Mbaker

    Mbaker Type 2 (in remission!) · Well-Known Member

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    Thanks for this information, appreciated.
     
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  4. Diakat

    Diakat Type 1 · Moderator
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    Some T1s use half the carb units for protein as high protein can spike us.
     
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  5. ickihun

    ickihun Type 2 · Master

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    And me. I spike on nuts, too many or too much plain meat. Too much is the key for me. My body tells me what is too much. Of which I'm thankful.
    That spoke lasts longer if the protein is mixed with fat. However if just enough fatty protein before bed prevents me having a morning liver dump. A great start to my day of keeping bgs down. No matter what i eat. In fact on 2 occasions now I've had slight RH after carb. Which I monitor heavily so manage well. I was warned after a Roux-en-y op it's possible. I'm still losing slowly now though. Still no change on trapped nerves though. Need less levothyroxine with LESS opiates. I'm still learning but protein is my meal's backbone not veg or carbs.
     
  6. ickihun

    ickihun Type 2 · Master

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    I can eat 50g of mixed nuts but it seems if more then I really should novarapid 5units. However I'm still IR. Still losing weight but now coming off stomach area. 15½st of still good muscle density but stomach fat. Once no fat internally less IR and protein eating can be reassessed.
    If I eat too much carb I still need 5 novarapid units but a bounce effect which isn't present from too much protein.
     
  7. hyponilla

    hyponilla Type 1 · Well-Known Member

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    Hi, I started following the Bernstein diet shortly after I was diagnosed and it's been a year now. My approach is slightly looser as I eat up to 50g of carbs a day and some of the foods that are on the no-no list. You learn the rules then bend them. For insulin, I take ActRapid (short-acting or regular) and NovoRapid (fast-acting). Because I don't like to waste insulin and I have NovoRapid for corrections, I use it to dose for the carbs as well. Either would work here, providing you pre-bolus. I dose with regular at 50% for the protein at 1u:15g. For anyone reading this please note that these are my ratios and yours are likely to be different. With insulin it's better to take too little than too much, so be very careful and get medical advice before adjusting your insulin doses.

    I have three meals a day with 0g-20g-20g carbs per meal. For breakfast, I have two eggs and 40g of cheese and take 4u of regular insulin. Most of this is to offset feet on the floor when getting out of bed. At any other time of the day, I'd take half of the insulin for this meal. Unless I wake up low, I never have carbs in the morning. For lunch and dinner most days, I have 200-300g of vegetables and 150-200g of meat.

    A typical lunch would be chicken or pork and a salad with avocado and olive oil for extra fat. I pre-bolus for 20g of carbs with 2.5u 15-30 minutes before eating. I dose for the protein when I finish eating and if it's less than 40g I take it in one shot. If the cut of meat is very fatty like pork belly I wait longer after eating before taking insulin, up to an hour and a half.

    For dinner, I often have stir-fry, stew or curry. I just skip the typical side dishes and have some extra vegetables. I often have 50g of protein with dinner, and take a split bolus dosing twice for the protein giving the second dose more than an hour after eating. In the beginning, when I took it all in one shot I would have a lot of hypos. I'm also really careful with taking insulin for protein if I'm having alcohol with a meal.

    While this sounds a bit tedious it's become second nature and it's just something I do. Because I'm drip-feeding the insulin in small doses I don't have too many hypos and my last HbA1c's are in the low and mid 30's. It's an excellent way to control blood glucose but I get that this way of eating is not for everyone. My boyfriend went ketogenic for a few weeks and he was super depressed by the end of it. I thought he was going to top himself when he had to eat curry without naan or rice. It's possible to get decent diabetic control without going ultra low carb and the most important thing is to find a diet that's sustainable for you.
     
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  8. Mbaker

    Mbaker Type 2 (in remission!) · Well-Known Member

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    Thank you for the detail, very comprehensive. I also take protocols and tune to my tastes. I eat butternut squash and very occasionally small amounts of parsnip, as this means dinner times are the same for the entire family and I like them. My HbA1c has stayed flat and my glucose monitor says i'm alright.
     
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  9. Mbaker

    Mbaker Type 2 (in remission!) · Well-Known Member

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    Thanks, I have seen that some count fat as if it were 10 grams of carbs. It seems that individuality matters.
     
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  10. LooperCat

    LooperCat Type 1 · Expert

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    I dose for lean protein at half the dose for the same g of carbs.
     
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  11. oldgreymare

    oldgreymare Type 1 · Well-Known Member

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    As I'm trying to be stricter low carb, I am now also estimating bolus insulin for protein at 50% my typical carb ratios. Still struggling to accommodate in addition influence of fat (butter, cheese, nuts, etc) on both amount and timing of insulin dosing.
     
  12. Alexandra100

    Alexandra100 Prefer not to say · Well-Known Member

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    I advise going straight to the horse's mouth by either buying his book "Diabetes Solution"
    or watching some videos from his Diabetes University: youtube richard bernstein insulin
    The book is not cheap, but it's a massive hardback "bible". The videos are of course free.
     
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