Bolusing for protein

[lisa821]

Cyborg, your post caught my eye. I'm trying to eat more of a balance between carbs and proteins. I've been vegetarian for the past 5 years or so and I don't think I've been eating the correct amount of protein for me. For the last couple of days since I upped the protein, I've noticed my blood sugars being very stable, but elevated--for example, they've been in the 150-range before meals and two hours after, even though I did a correction bolus and a carb bolus. Normally I'm in the 105-range before a meal and around 120 two hours later. I'm not eating a huge amount of protein--roughly 14 grams protein per 30 grams of carbs. I didn't think the protein would affect me unless I ate a lot more of it.

So if I did a combo bolus where I cover the carbs up front, how do I figure the bolus for the protein? Or maybe I could do something like 50:50 over two hours?

~Lisa

[Cyborg]

The way I bolus for protein is as a completely separate bolus from the carb bolus. I calculate the "equivalent carbs" of the protein I consume as a percentage of the grams of protein. When I first started doing this, I had to eat meals that consisted of protein alone so there was no outside influence on my bg from carbs. For me, I knew protein affected me as I had eaten Atkins diet type of meals before and seen the effects on my bg.

I started using a value of 50 percent to calculate the equivalent carbs. I'd eat something like a steak for dinner and nothing else, or some eggs for breakfast and nothing else. Based on some advice someone else had given, I used a 30/70 combo bolus over 3 hours. It has always seemed to work very well and that part I never needed to adjust. I did play with the percentage used to calculate the equivalent carbs going all the way up to 75% and then settling back down at approximately 66%. Each gram of protein affects my bg about 2/3 as much as a gram of carbs, but over a longer duration. This is surely an individual thing that you will need to carefully determine yourself. Just keep your meter and glucose handy.

For example, if I were to eat a 10 oz. steak. 10 oz. of steak has approximately 81 grams of protein. I would calculate the equivalent carbs as 81 * 2/3 = 54 grams of equivalent carbs. My I:C ratio is 1:5, so I'd take a bolus of about 11 units. I would do a 30/70 combo bolus over 3 hours, so that would equate to approximately 3.3 units immediately (the 30 part) and 7.7 units over the next 3 hours (the 70 part). Obviously this is something that can only be done with a pump. The immediate part of the combo bolus could be done while on MDI by those that are affected by protein consumption and are using a fast acting insulin for meal boluses.

Here is some additional information (http://www.insulin-pumpers.org/howto/pfandbs.html) on how fat and protein affect bg. If you decide to try it, start with a low percentage and gradually determine what works best for you. It definitely has helped keep my bg down and help me to achieve a good a1c. Hopefully this will help and good luck.

[lisa821]

Thanks, Cyborg! That info is extremely helpful to me. :)

I will experiment with this over the next few days and see what happens. I never thought a moderate amount of protein would affect my blood sugars at all, but it looks like it might be somewhat. Veeeerrrry innnterrrrestink....

~Lisa

[Dewey]

I put your posts in a new thread, because others may miss the question and not be able to respond otherwise. Hope this helps. :)