not taking insulin with a no carb meal?

RuthW

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Unfortunately that doesn't hold true for many of us. Sadly it's the usual what's good for the goose isn't necessarily good for the gander...
So, the advice not "completely wrong", then, Tim. It is probably wrong for a lot of people, depending on what the rest of their diet and activity is like, as well as how much residual insulin production they have, how much of a "muscle bank", etc, etc. The point is that there are many, many factors for each of us.

In clinical work medical personnel know to pace the information they give. They are not expecting that the patient will have a single consultation for the rest of their life, so they give out info piece by piece, most likely info first. That way people get the bare bones right, then according to each patient's needs their regimen can be tweaked.

Your advice on protein and bolusing IS useful, but if I did that I'd be hypo every day, so your advice is not "completely wrong" but neither is the advice the OP was given initially. Noblehead is right: "Try it and see!"

I think black and white stances often involve unjustifiable criticism of medical personnel
 

tim2000s

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So, the advice not "completely wrong", then, Tim. It is probably wrong for a lot of people, depending on what the rest of their diet and activity is like, as well as how much residual insulin production they have, how much of a "muscle bank", etc, etc. The point is that there are many, many factors for each of us.

In clinical work medical personnel know to pace the information they give. They are not expecting that the patient will have a single consultation for the rest of their life, so they give out info piece by piece, most likely info first. That way people get the bare bones right, then according to each patient's needs their regimen can be tweaked.

Your advice on protein and bolusing IS useful, but if I did that I'd be hypo every day, so your advice is not "completely wrong" but neither is the advice the OP was given initially. Noblehead is right: "Try it and see!"

I think black and white stances often involve unjustifiable criticism of medical personnel
That's a fair point, however, I firmly believe that not indicating to people that actually, there is a factor linked to protein and it can cause your blood glucose levels to rise, even early on in life as a T1, causes insulin levels to be set incorrectly. From that point on it will always be a struggle to manage the condition well.
 

RuthW

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That's a fair point, however, I firmly believe that not indicating to people that actually, there is a factor linked to protein and it can cause your blood glucose levels to rise, even early on in life as a T1, causes insulin levels to be set incorrectly. From that point on it will always be a struggle to manage the condition well.
The more info the better ultimately, but I don't think its true that people start in one way and then can never change. That's a behaviorist view of human nature. People need info, motivation, skills, hope, and probably many other intangible properties to change. But they do change. Newly diagnosed people are often overwhelmed. Old-timers can be depressed. For those people "all-out" doesn't work. Step by step achievable targets seems the longer route but actually gets you there quicker. Tortoise and hare, and all that! :)
Anyway, let's not go off and derail.....
 

TorqPenderloin

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That's completely wrong advice unfortunately. Typically, you need about 50% of the insulin you would for the equivalent weight in carbs. Protein does cause your body to release glucagon which generates an associated BG rise.
Tim, I normally agree with you, but the research I've read suggests a bit different.

One particular study (Protein Controversies in Diabetes) tested glucose levels in subjects who consumed protein only, glucose only, and then a mixture of both.

My interpretation of their findings was that glucose consumption only had expected results (raised blood sugar). Protein only consumption had almost no effect on blood sugar levels. However, a combination of protein and glucose had increased effects beyond a glucose only meal.

Long story short- my understanding is that there is a big difference between eating a protein-only meal and eating a protein/carb meal when discussing blood sugar levels.

Disclaimer- that was my basic interpretation of their findings. You may interpret it differently. The study was done in 2000 and there may be more recent studies done that had different findings.
 

alaska

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In Poland, the effect of fat and protein on blood sugar is better understood than in the UK.

They have a system used by people on insulin pumps which accounts for both the protein and fat in meals. It's called WBT (Wymienniki białkowo-tłuszczowe).

WBT is used in addition to WW (ie carb counting). WBT involves calculating the number of calories in protein and fat and applying a formula to turn that into an insulin dose for the combined protein and fat.

It's generally only recommended for use with insulin pumps as you can use the extended boluses on pumps. On injections it would require an additional injection around 2-3 hours or so after the meal to cope with the slow peak at the 3-6 hour mark that results from the protein and fat.

If interested visit:
http://cukrzycapolska.pl/dieta-cukrzycowa/wymienniki-bialkowo-tluszczowe/ -and use Google translate or, if in Chrome, right click and select translate to English
 
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ewelina

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I believe that when you bolus for carbs only, small fraction of your ratio covers protein/fat. Try to do simple experiment and eat carb only meal and you will see you need a bit less insulin. I did it for plain rice and was a bit shocked that I needed 0.8 unit for 10g (instead of my standard 1u). Nobody really eats carb only meals thats why the ratios for mixed meals are a bit different. Dafne promotes carbs only counting but their advice is for 'normal eating'. if you follow NHS healthy eating plate I suppose you don't need to count protein or fat
 
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noblehead

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I only bolus for protein-only meals if they are huge. So, almost never. I can eat a few ounces of cheese between meals with no impact on my blood sugar. Same goes for avocados and some nuts (but some nuts seem to be quite carby according to my meter).


Your very fortunate Ruth, I find if I eat cold meats or cheeses between meals then it impacts on my bg levels, particularly so if I were to eat some late evening before bed.
 

RuthW

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I think ewelina nails it pretty well. If you tend to eat a consistent combination of foods and take a consistent bolus, you probably account for all the 'extras'. And I tend not to snack between meals so probably, if I checked, is find I'm only snacking when my bs is dropping because of some other factor. If you run an incredibly tight ship and calculate every factor, maybe you need the protein/fat thing. For me the thing that messes with all calculations is little bursts of activity, rather than protein. I'll consider it when they start working it into pump algorithms. (You might be talking me into it, here, guys.)
 

johnny37

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I never dose for salad. My Collins Little Gem gives leaf salad as 2.9% carb. The labelling on my packet of Waitrose mixed leaf gives 1.2%. Green peppers are similar , though red and yellow are a bit higher. The average salad would therefore contain less than about 1% carb. Together with fish cheese egg or chicken would be as good as nil carbs. Not worth stressing about. Perhaps the effects described above are caused by other things than food affecting your blood glucose.