Protein and blood sugars

Hi @emmay

Yes, protein can affect your blood sugar, particularly in the absence of carbs.

Most people find it's best to basal test without eating anything and do it in segments over a few days

Here's a useful link:

https://mysugr.com/basal-rate-testing/

Yep! That would be Gluconeogenesis. Have a look at the below short clip.

emmay said:

hi, my nurse has been asking me to do some carb free meals to check my background insulin. I believe however that when I have protein as part of that meal it affects my blood sugars. This obviously goes against the diabetes principles and my nurse is a bit sceptical.
I have read a few articles and books which include this topic and they note the same affect, so I presume it's not just me that is affected?
At the moment I am making a complete guess of how much insulin to take but have been using the ratio of 1 unit of insulin to 10g of protein.
I would be interested to hear if others have had the same issue.

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emmay said:

Thanks I will check the link out.

Would also be interested what insulin amount to take for eating just protein as is a good way of reducing my carb intake

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Protein causes a delayed rise. If you have a look at the Type 1 section, you'll see people commenting about bolusing for protein.

Personally, I find it easier to eat carbs with protein (even a small amount) as it means it's not necessary to bolus for the protein So even with a low number of carbs, you should be able to disregard the protein unless you're eating a large amount of it. Counting the carbs only is usually ok in that situation.

Good luck with the basal testing. Allow yourself a few days. It's a pain, but can give useful info

I bolus for half my protein. So if I'm eating 21g (3 oz) I bolus as if it were 10 carbs. Then, for me , if I eat more than three oz at a time I have to split my bolus and take a little more in an hour or so to cover the delayed rise. I am very low carb and I do gluconeogenisis fast but the rise is slower and longer hence the split bolus.

emmay said:

hi, my nurse has been asking me to do some carb free meals to check my background insulin. I believe however that when I have protein as part of that meal it affects my blood sugars. This obviously goes against the diabetes principles and my nurse is a bit sceptical.

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I don't know why the nurse is sceptical as the modern opinion is a basal test is a fasting one where no food is consumed.

Gary Scheiner (author of the book Think Like a Pancreas) wrote the following article which is worth a read, you will see that he says no food should be consumed during the test and the previous meal has to be low in fat so it doesn't effect the results:

http://integrateddiabetes.com/basal-testing/

To put things into perspective, for a protein based meal I need as much insulin as I do for a meal that contains 40g of carbs.

emmay said:

I will have to pick her up on that as she clearly said it just had to be carb free not nothing to eat at all. Thanks for article was interesting

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The DSN is not that ... engaged with the reality of living with type 1. Yes, the main thing that impacts blood sugar is carbs. But that is massively over simplistic. Carbs certainly aren't the only thing. If you aren't eating carbs but eat protein your body will strive to turn the protein into glucose, because the body realises when you aren't eating carbs it has got to get its energy from an alternative source. This is gluconogenesis. It's a process which takes a while but will mean that no carb meals will still impact on your blood sugar. So advice to eat no carbs but still eat to do a basal test doesn't really result in a a terribly reliable result from the basal test. It's better to basal test fasting.

Basically the old advice for basal testing was to not eat carbs but just eat some eggs. It turns out eggs are this pure source of protein that the body can do gluconogenesis on and lots of type 1s need to bolus for eggs. Basal testing with carb free meals is old fashioned. Essentially because real life experience shows it doesn't really work that well.

emmay said:

I viewed this video, was very interesting although I don't count my protein when I'm eating carbs, only when I eat them on their own. something to consider tho when having a large portion of protein with carbs. Thanks

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And certainly if you decide to reduce the carbs in future, worth keeping in mind the impact of protein. Just to mention that Dr. B recommends a R insulin (diluted insulin) which is less potent and apparently is great for matching the BS rise from protein. I haven't used it yet myself, so can't comment. I use Apidra. Just worth keeping in mind, the timing of the effect of fast acting insulin vs. effect of BS rise from protein. With Apidra with my meals (which are generally HP & LC), I find my BS will drop and then increase slowly over the next 3-4 hours. Because I am taking very small amounts of insulin, the initial drop is not into dangerous Hypo territory.

emmay said:

Hi @CHIET1
I haven't heard of Apidra insulin is it new had a quick look on internet and says it is mostly used for type 2's?? Like the fact that it starts working so fast I currently use humalog and I have to take 30mins before I eat which is a serious pain and means there is no room for having any extra carbs (not a bad thing for my waist line)

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Its a rapid acting insulin like Humalog. I live in Switzerland, perhaps it is not used as much in the UK, I am not sure. It normally kicks in within 15 minutes.