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Type1: Protein - effect on blood sugars query

N

Norfnife

Member
Messages
9
Type of diabetes
Type 1
Hi,

I am a new member to this forum, but have been a Type 1 diabetic for almost 40 years. Recently, I decided to try to eat a low carb diet as my blood sugars have been erratic and I am now suffering the side effects of too many highs and lows, despite following all the dosage and dietry advice given by my doctors.

I eat no more than two slices of toast for breakfast each day (usually no more than 30 CHO) then I try to wait until dinner time before I have a low carb dinner, typically no more than 50 CHO. As a result, I am ALWAYS hungry, so to fill me up and not affect my blood sugars, I started eating roasted chicken as a snack. However, I have now found out that as little as 100g of pure protein can cause a delayed effect on blood sugars (3-5 hrs afterwards) the same as drinking 20 CHO of glucose!

Does anyone have any knowledge of how I can factor in this delayed reaction to the protein without having to do even more blood tests each day? Also, how many carbs are there in roast chicken anyway? Every website I have checked has said nil carbs, nil sugars, so I am now stuck - and very hungry!

Any help or advice is much appreciated - I do manual blood tests approx. 15 times per day and just use the prefilled pens for my insulin (Lantus Solostar and Humalog).

Thank you in advance!
 
Hi @Norfnife

Yes, protein can have an effect on your blood sugars, especially so, I find, I eat it without carbs.

Have you considered spreading your carbs over the day in 3 meals? So maybe have some of your dinner carbs for lunch? Perhaps it's that gap in the middle of the day that's contributing to your hunger?

how high does your BS go those hoyrs after you've eaten the chicken?
 
Thanks, @azure , for the reply. I used to eat three times a day but found that either my sugars were too high or I was having to take far too much Bolus to counteract the rise so I was going hypo too often. It is for this reason alone that I decided to cut right back on carb-laden meals, my reasoning being less carbs means less insulin so less hypos plus the added benefit of fewer highs too! Also, the problem with eating a lunch and then less carbs at dinner is that I will still be hungry as every thing on the planet contains carbs, so this would just mean a much smaller dinner snd I don't eat much as it is anyway.

I am not convinced that my insulins are the correct ones for me and am currently 'in discussion' with my doctor in the hope I can try others which may work better for me, but in the meantime, I feel as though I am starving to death! It won't be the diabetes which kills me, it will be starvation or malnutrition at this rate! I am actually beginning to think that even my cutlery may contain carbs which is why my sugars are still so erratic... I actually haven't noticed my sugars going particulary high after eating some chicken, but this may just be because I tend to eat some mid-afternoon so the next blood test I do is before dinner and this changes on a daily basis with no rhyme or reason.

I am really tearing my hair out trying to find a diet which works for me, but every thing I try just seems to fail, so any help is much appreciated! I really cannot cope with yet more complications with my health....
 
@Norfnife I found when I went lchf I had to test more. It's the only way to get a handle on the changes and stay safe. When I ate something new, I'd test every hour until the spike stopped. Then next time you know to reduce your bolus, take earlier or delay.

Unfortunately until you get to know the affects you do have to test. I find fatty meats can be upto 4 hours later and go on for a number of hours. Chicken is pretty quick for me. As the saying goes YMMV.
 
I sympathise @Norfnife Diabetes is hard work even when things are going well, so it's tens times as hard when things aren't working.

Have you tried a basal test to make sure your basal/background insulin is correct? Getting that right provides a firm foundation to build on.

I understand why you're looking to reduce carbs, but you shouldn't go hungry : ( I eat moderate carbs and I bulk up my meals with plenty of veg as well as protein and fat. If you have time to post a thread with a day's meals, insulin and BS results that might be helpful. There are some great folk on here who can offer advice.

One thought I have is timing of your bolus. I find bolusing in advance helps me stop the spike after meals. Eg for breakfast, if I time my bolus right I'm looking at a 6 two hours after rather than an 11.

Certainly, investigating a change of insulin might be sensible too.
 
Your starvation is most likely from fluctuating bs. Highs and lows both. Many of us find we can control our bs better on a low carb diet and use mostly above ground veggies for those. Some of us also eat moderate amounts for protein and not excess or that can also turn to bs. We also eat higher fat, enough to satisfy. The fat will help slow the spikes and keep them a tad lower. Many of us do t eat any grains, breads, cereals etc or starchy veggies.
You can eat eggs in any form for breakfast. I eat guacamole with celery for BF and I can take very small amounts of insulin. Avocado is a great food for steadying bs. Lunch and dinner can be some protein on a salad or lettuce wrap with some additional fat such as mayo or more avocado. Dinner same and / or some additional veggies.
If you decide to give up more carbs be careful with insulin as you will most likely need lots less. Error on the side of caution

In my personal experience I could never keep bs steady eating carbs. I would have lots of highs and lows and as I cut back on carbs I was much steadier and used much less insulin. I think it's much easier for people on pumps as they can spread their insulin out slowly. The tricky part is getting your insulin there at the same time as your food. Each macronutrient digests at different times hence the lows and highs.
 
Ok, firstly, I have NEVER heard of a Basal test! What is it and what would it show? The only Basal 'testing' I have ever done was when I first started on Solostar amd went as carb free for a week as I could until I found what I thought was the correct dose for me. This has since been adjusted down slightly by the hospital but I am keen to try Tresiba as I have heard great things about this insulin, but I have yet to convince my doctor! I actually take my Basal in the morning as I found this suited my lifestyle better and as it is supposed to last 24 hours, could not see what difference it would make (I only take this once a day).

I am also finding that whatever carbs I eat in the morning, I need to triple my morning Humalog (insulin sensivity gone mad?) as 2.5 times leaves me with high sugars most of the day. As a result, I also want to try Apidra, but I realise that changing just one insulin at a time is better so I know which is working. Any suggestions which one I should change first - Basal or Bolus?

I am also finding that even when my sugars are say 12 before bed, some nights they will plummet and I will go hypo in the early hours and other nights, I will wake up in the morning still high (I was 12.7 before bed last night, 16.2 this morning so took my usual triple amount of Humalog after eating 27 CHOs for breakfast and then went hypo at lunchtime and had to eat almost 40 carbs before my sugars stopped dropping).

I am also currently using a CGM, albeit borrowed and I only have it for a couple of weeks, but I am still none the wiser despite checking both the CGM plus doing additional blood tests to check its accuracy throughout the day.

I also do not live in an area where things like fresh avocados are available year round and although I don't mind eggs, the thought of eating them every day makes me feel quite sick!

Can I take it that the carbs in chicken is one of the unknowns and that I should just start snacking on my fingernails, maybe....??!!

Thank you for your help and suggestions with this - I really do appreciate it and I really don't want to sound as though I am unwilling to try your ideas, it is just that I already know that some will not work for me, whether because of produce availability, my taste buds or my very limited finances!
 
Information on basal testing - http://www.salforddiabetescare.co.uk/index2.php?nav_id=1007

It is basically carb free time to check you basal is keeping you level - except instead of just carb free, you do it fasting, because, as you have found out, sometimes carb free meals can push you up. Doing a bit of basal testing while you have the CGM ought to be really helpful.

What would be your typical days menu?
 
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There aren't any carbs in chicken, but the protein in it can increase your BS, as you've found out.

@catapillar has helpfully put a basal test link there for you. It's not fun to do, but can provide really useful info.

It's not uncommon to need more insulin to carbs in the morning - I do too I tend to,eat the same breakfast most days as I know what insulin dose works and how far in advance to have it. For lunches I choose from a selection that I know work, and that way I don't have to think too much as I'm pretty busy. My evening meal varies more but I'm quite sensitive to insulin then so don't have many problems.
 
A typical day's food for me is two slices of toast and butter (very occasionally Marmite and/or peanut butter too!) for breakfast, a small amount of roast chicken or a single celery stick with salad cream mid-afternoon as I am feeling completely starving by this point, and then a salad with either a small bread roll or crackers in the evening. The salad is dressing-free, but at the moment my favourite is to eat iceberg lettuce, watermelon, tomatoes and feta cheese with a sprinkling of crispy onions. Yum!

In the winter months, the evening meal is more likely to be a home-cooked curry or a stew with a few potatoes or a couple of dumplings, but I was a trained chef so know all about nutrition and low/high GI. As a result, I eat full grain, high fibre where possible and I eat vegetarian a lot too - except for the chicken which came as a shock when I heard about the effect it can have on blood sugars!

The end result is that I spend 99% of my day fasting, do a lot of blood tests even with a CGM attached and my sugars are still all over the place. I definitely get the dawn phenomenon and this then seems to set the tone for the day, in as much as my sugars go up to unacceptable levels even if I have not eaten anything and I then spend the rest of the day chasing my tail trying to get them to where they should be whilst eating as little as possible to survive!

I have never been a fan of 'fat' so my diet is probably best described as LCLF, although I do understand about healthy fats. I just don't want to eat them all the time! I was always led to believe that the Basal Bolus regime allowed you to eat a 'normal' diet but this appears to be far from the truth, for me on my current insulins anyway!
 
Many here have a piece of ham or some type of protein and a piece of cheese for BF. I occasionally have a piece of deli turkey on a large piece of lettuce with mayo and mustard. The fat ( mayo) is very important to me or my protein will spike me faster and higher. Most of us a are most insulin resistant in the morning and become more sensative as the day goes on. Many on this forum just have coffee with heavy cream because anything else spikes them. I need a very small, almost no carb no protein BF and is why I eat avocado. I need just fat in the morning. Lots of us eat a very small BF as well. NOT many eat carbs for BF for the same reasons you're seeing, spike. It's hard to reel the spike back in and get control the rest of the day.
The type of fat and protein make a difference in my spikes. I will spike fast and high on dairy/ cheese so I don't eat it. I will spike much further out with saturated fat and sooner with lean protein. I need to add fat to lean protein to slow it. All forms of grains breads etc send I'm sky high.

I never did a basal test but I take my basal at night. I found I couldn't take it during the day as it works on food even though not intended to and I kept having hypos so I take it right before bed and what I go to bed at I wake up really close. I have had to adjust it but have been set for a long time now

I eat less than 20 carbs a DAY all in vegetables and about 4 -5oz protein a day. This has allowed me to severly reduce my insulin but more importantly it stopped the hypos and spikes in its track and everything stays low and steady. I also eat the same meals at the same times of day. I rotate foods but keep the macros at each meal the same. I take the same amount of insulin at all 3 meals but my lunch is bigger than BF and dinner bigger than lunch as I become more sensitive as the day goes on. It took a lot of testing to find meals and quantities that work but I could run on autopilot now and not test but I still ALWAYS do.
 
Ok - thanks for writing out your diet Can I ask about your weight - you don't have to say what it is, but are you trying to lose any, gain any or stay steady?

And can you give an idea of your blood sugar resukts during the day?

People here eat varying amounts of carbs - anything from less than 30g a day to more than 200g. You need to,find what suits you.
 
This is a great idea which I am more than willing to try, but I do not use a pump so how on earth could I even begin to adjust my Basal insulin if I inject this just once a day?
 
personally I would try to find a different BF. That toast would make me ravenous in the morning and it would last all day.
Have you tried taking your basal at night or splitting it ? I have never done that so maybe azure could advise you. That might help the DP as well as hypos during the day.

You don't have to gob the but it will slow the carb and insulin spike. Do you like nuts? I see you like peanut butter. Maybe PB on celery would be a suitable breakfast. Some protein fat carbs and fiber. Bingo. Most likely will stop the hunger too

As azure asked, what are your numbers, we don't judge by the way, and what about weight?
 
I tend to eat near normally. Low carb diet often means an increase in animal fats. This is not good either. I have had laser surgery and they told me not to eat any red meats and only occasionally white meat. Eggs are quite a good replacement fortunately we have a few chickens. But I do eat meat sometimes. I think using the basal and bolus regime it should be possible to set a near correct basal dose. Then try to sort out the bolus for whatever is eaten. None of it is easy and lately I am having troubles also, think we all do at some time. Its a balanceing act.
type 1 for 50yrs done DAFNE
 
Norfnife said:
This is a great idea which I am more than willing to try, but I do not use a pump so how on earth could I even begin to adjust my Basal insulin if I inject this just once a day?
Click to expand...

Essentially, if your basal test shows you staying flat (within 2mmol/l) your basal is right. If it shows you rising, this suggests you need more basal. If you are dropping, it suggests you need less.

Is solostar lantus? Lantus isn't very responsive to changes, so if you make a change, give it a few days to settle in before repeating a basal test to see if it's working (OK, basal testing is awful, but if you are already fasting 99% of the day hopefully it will be a walk in the park for you). What's your current basal dose? If you end up changing it as a result of the basal test, don't change more than 10% at a time.

In terms of being able to manage carbs, have you looked into the timing of your bolus - again, it would be good to look at this while you have the CGM. We all get told inject with your meal, but if you do that, you might have digested the carbs before the insulin starts working & then it is much harder for the insulin to work in high blood sugar environment. With the CGM, you can inject, wait until you can see the insulin working and then eat - obviously you have to be ready to eat pretty sharpish, so you could just experiment with moving your bolus back 5, 10, 15 minutes until you hit a time that works for you. My pre bolus is different at different times of day and for different meals.
 
Norfnife said:
This is a great idea which I am more than willing to try, but I do not use a pump so how on earth could I even begin to adjust my Basal insulin if I inject this just once a day?
Click to expand...

You don't have to use a pump to basal test The idea is your basal should keep your BS steady all day and night. Obviously, eating and bolusing insulin will affect your BS, so a basal test (not eating for various segments of the day) will let you see if/when your BS goes high or low. You can then think about adjusting the amoutn of basal you take, or even the timing of split the dose (for some insulins).
 
The thought of eating the same thing day in, day out would make me want to give up now, so that really is not an option for me. As a former chef, I enjoy a very varied diet and am not scared to adapt almost any recipe to make it more diabetic friendly, so for me, variety definitely is the spice of life! Perhaps this is part of the reason my bs fluctuates so much, but to limit what I can eat would make my life not worth living....... As I said, I was told by the doctors that the Basal Bolus regime allows diabetics to eat whatever they want, i.e. a 'normal' diet, so I really don't get why we are then almost forced to eat such a restrictive menu.

I am now fatter than I was, but skinnier than a while ago. I was painfully thin for most of my life (became diabetic at age eight and stayed skinny until my mid-thirties). My main problem with losing weight is that I am now almost completely blind (yep, thanks diabetes!) so I find it very hard to exercise as I cannot even walk without needing someone with me (confidence issues too). I have lost almost a stone (14lb) at my last weight check probably due to the starvation diet I am currently following, but I would definitely like to lose more to get closer to where I used to be. The diabetes is also affecting my thyroid though so although I have not yet been prescribed any medication, I feel that this is holding my weight steady rather than letting me lose.

My blood sugars through the day differ greatly from day to day, regardless of whether I eat the same and do the same or not. Some days I need to eat nothing and my sugars still go high, other days I can eat nothing but chocolate and my sugars stay low... I have noticed that hot weather seems to make me more insulin sensitive - most but not all of the time - and I weigh my food and use the 100/500 rule religiously to calculate my starting dose of insulin each morning. I even started compiling a log of all my insulin doses, meals and carbs, highs/lows and and extra info which may have affected my control for my diabetic doctor, but it is barely glanced at - and I have been doing this for almost eighteen months now!

I have to give the CGM back next Friday so I am hoping that it will enable those in the know to actually do something for me as I feel as though I am fighting a losing battle at the mo.....
 
Ok, guess what I will be doing tomorrow! Unfortunately, I only have the CGM for a few more days so my fingers will suffer, but I am willing to try anything! Thank you!
 
Thanks, @catapillar . Yes, Solostar is Lantus so I will not rush things. I currently take 20 units at 10am each day, so calculating a 10% adjustment will be easy - to start at least!

I do know that the Humalog is not working quickly enough for me as it seems to kick in approx 1.5hrs after I have eaten, which means my sugars are already way too high. It is for this reason that I want to try Apidra (I also had a very delayed reaction with Novorapid). Short of injecting today for a meal I intend to eat tomorrow, I am struggling to find a Bolus which works quickly enough for me but which won't then keep working for too long so I end up hypo.

Hopefully, if I can get the Basal test sorted, the rest will work itself out but I do not have a lot of support from my doctor here and although he is willing to let me try things if I nag enough, he does not seem willing to be proactive unless I ask.
 
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