Question about meat, please.

[Johny]

Hi all, lately i have tested my sugar levels 2 hours after only consuming meat and they have been high, i can't work this out because i was under the impression that meat had zero carbs.
I didn't realize that meat would rise my sugar levels so high.
thanks for any advise.

[KarenBC]

If I have a meat with a high fat content my levels tend to be high.

[Johny]

Thanks Karen, i didn't know that the fat content would rise the sugar levels up, i guess i have got a lot to learn yet.
Johny :)

[someone]

First of all, meat is loaded with fat and protein which can prolong the time it takes for other carbs to be absorbed. Many see this when eating pizza.. the cheese makes the bread absorb much slower.

I believe gluconeogenesis can also play a role here. Have a look at Gluconeogenesis - Wikipedia, the free encyclopedia (http://en.wikipedia.org/wiki/Gluconeogenesis) and Gluconeogenesis - Glucose Metabolism from Fats, Proteins (http://www.carbs-information.com/gluconeogenesis.htm). This is more likely to occur on a low carb or carb free diet. Essentially, pyruvic acid is made as your body metabolizes protein (or carbs) which can then be converted to glucose via gluconeogenesis.

[davef]

The other thing to watch is things like breaded chicken.If you have chicken in bread crumbs you have to take into account that while the chicken itself will probably be fine the bread crumbs (or batter) could hit your BG.

One other thing to watch is sauces, so chicken wings with a hot sauce could also hit your BG, the true could the the same if you have a sauce with your pork, beef or lamb.

Your approach of eating and then testing is spot-on and then best way of learning what foods suit you best.

[BrianSCohen]

Johny,

This is an interesting topic. Actually this kinda blows the whole obsession withe the whole carb thing. I've been following strict low carb diets for some time now and have found that I will routinely convert protein to blood sugar. I believe Dr. Bernstein recommends that those following his diet plan should bolus (insulin) based on about a conversion of 3g of protein into the equivalent of 1g carb (about a third of protein gets converted to blood sugar). Perhaps there are others more familiar with his specific recommendations. I've also heard that in a pinch, fat can even be converted to blood sugar, although in general gluconeogenesis only converts fat to ketone bodies.

Protein and fat also delay or blunt the blood sugar response, so any blood sugar response you have will be stretched over a longer time. I find that if I eat a zero carb meal with significant protein (30-50g), I may still have a 30-50 mg/dl rise and a 20 mg/dl rise at two hours. It is for this reason that Dr. Bernstein recommends strict control of protein portions, as his carb guidelines are low enough that overeating protein will disrupt blood sugar control and even lead to weight gain.

[Johny]

Thanks everyone for sharing your knowledge & reffered url's, it is very much appreciated
many thanks,
Johny :)

[BlueSky]

.... Dr. Bernstein recommends that those following his diet plan should bolus (insulin) based on about a conversion of 3g of protein into the equivalent of 1g carb (about a third of protein gets converted to blood sugar). ...
I am not so sure about this. If your body needs amino acids to do repairs and maintenance, it won't turn them into glucose. Only the excess protein, above the physiological requirement, will be available for being turned into glucose. I don't eat more protein than my body needs to look after itself - about 60 grams a day.

I can't see that protein would be a significant source of glucose, not for me anyway. But I have also noticed that a meal consisting of eggs, cheese and mushrooms increases blood glucose substantially. Fat is also used in gluconeogenesis, but you wouldn't see much of that after a high fat/protein meal. It would be more spread out over.

I suspect that the increase in BG after a high protein/fat, zero carb meal has nothing to do with glucose made from it. Perhaps it is what Bernstein calls the Chinese Restaurant effect - glucose released by the liver as food enters the stomach.

[Johny]

Thanks Blue Sky, our systems are a complicated mechanism, you guys are so knowledgeable. i have a lot of learning to do.
Johny :)

[Brian.M3606]

Wow, amazing what knowledge is available here. A lot of things make more sense now. I had been replacing my love for carbs with meat, eggs and cheese. BGs were all over the place, frustration set in and I went back to eating carbs.

Now I know why things are leveling out that I am on a more balanced diet: little bit of lean protein, tons of green vegatables.

Thank you,

Brian

[xMenace]

I'm always in favor of validating my assumptions as much as I can.

There is a phenomenon where if you are fasting for some time and you consume any food, your BGs will rise. I always experience this at lunch when I sleep in and skip breakfast. I've tested by eating just a plain lettuce/rabbit food salad with zero carbs and fats. My BGs went from 5's to low teens in half an hour. I now double+ my normal dose for these lunches.

I'm not saying this is what you experience, but as a control, do what you did with the protein but this time have a plain salad with no dressing. If you get a rise, something else is going on. Perhaps your basals are off.

[BlueSky]

There is a big discrepancy between the carbs foods contain and the effect they have on blood glucose. There is also a big discrepancy between the glycemic index of food (the effect it has on blood glucose) and the amount of insulin they soak up. Food like meat and fish aren't listed in the GI tables because they contain no carb. But they have a major effect on blood glucose, and they use a lot of insulin. Below is a bar chart showing different foods and their insulin index.

The insulin index is pertinent for us diabetics as it is an indication of how much insulin we need to inject (or has to be produced by the beta cells of a T2). As you can see, meat and fish have lower insulin requirements than carby foods, but it is still substantial.

According to the chart, Jelly Beans should be the most effective food for treating a hypo. :o

[Emm]

That's an interesting graph bluesky - where's it from? Is there more info on other foods too?

Of course, as good as the graph is, we also have to consider that each and every one of us is different. All the little bits & pieces need to be considered too - like how much exercise you get, and how much carb you eat daily (if you don't eat much carb you'll convert more fat & protein into glucose).

I do inject to cover meat, at a lower rate than carbs. A decent chunk of steak is worth a fairly full dose to me, but a couple of thinner slices of roast meat isn't even worth considering. So yes, meat can sometimes give quite a decent boost to my blood sugars.

It helps to write down what you eat & what your BGs are - maybe not every meal of every day, but any time you can do it. It's very very handy to look back on, and you'll notice trends that you completely missed without the visible reminder.

Johny, are you taking any meds at all? How long does it take for your blood sugar to get back into range?

[jacobsam622]

Thanks Blue Sky, our systems are a complicated mechanism, you guys are so knowledgeable. i have a lot of learning to do.
Johny :)
When you eat carbs your liver tucks some away for future use because even while sleeping the brain needs glucose this process is called gluconeogenesis. In a normal person ie without diabetes insulin controls the amount of sugar produced by the liver in Type II diabetes, however, insulin is unable to inhibit sugar production in the liver, lack of communication between insulin and the liver causes the amount of glucose to rise. So in short if you dont eat some carbs your body will do it for you. Aint diabetes fun.:eek:

[BlueSky]

That's an interesting graph bluesky - where's it from? ...
It us from An Insulin Index of Foods: The Insulin Demand Generated by 1000-kJ Portions of Common Foods in the American Journal of Clinical Nutrition 1997, Vol. 66: pages 1264-1276 by Susanne HA Holt, Janette C. Brand Miller, and Peter Petocz. That is the same Jennie Brand Miller of the Glycemic Index fame, from the University Of Sydney. You can download the study from here An insulin index of foods: the insulin demand generated by 1000-kJ portions of common foods -- Holt et al. 66 (5): 1264 -- American Journal of Clinical Nutrition (http://www.ajcn.org/cgi/reprint/66/5/1264).

No, they didn't do any other foods. This approach, which I believe is far more pertinent, was abandoned in favour of the Glycemic Index. The insulin index shows that the carb content of food is not the key driver of insulin demand.

I felt tremendous relief when I saw this, because I have never been able to get carb counting and application of a carb ratio to work for me. I can now see that it is not all my fault ... ;)

[Johny]

My head is still spinning with the amount of combined knowledge here, unbelievable :) thanks so much.

Emm - i take 2 x 500 mg Metformin tabs per day and usually my levels first thing in the morning are between 4.4 - 4.9 , 2 hours after meals are normally always below 8.0 which my doc recommended.

I have not tested again after the 2 hour period as yet.
When i had the meat only [corned beef and roast chicken, no skin ] but they flew up to the 12.0 mark 2 hours after consuming them, which prompted my post.

Previously, for a main meal i have had mainly just boiled cape cod fish, no veg's with it and measured my levels 2 hours after and they have been under the 8.0 score, no problems.

[Emm]

Aha! Corned Beef is full of additives etc - in my experience it's one of the worst meats and it shoots me up miles high if I don't 'overdose' on the insulin.

I really don't know what it is about the corned beef (surely it's mostly beef, then salt... what else could be so bad?) but it's a troublesome meal for me.

[davef]

My head is still spinning with the amount of combined knowledge here, unbelievable :) thanks so much.

Emm - i take 2 x 500 mg Metformin tabs per day and usually my levels first thing in the morning are between 4.4 - 4.9 , 2 hours after meals are normally always below 8.0 which my doc recommended.

I have not tested again after the 2 hour period as yet.
When i had the meat only [corned beef and roast chicken, no skin ] but they flew up to the 12.0 mark 2 hours after consuming them, which prompted my post.

Previously, for a main meal i have had mainly just boiled cape cod fish, no veg's with it and measured my levels 2 hours after and they have been under the 8.0 score, no problems.

Sounds like you are doing well with your numbers, those morning ones are excellent! Many of us aim for slightly lower numbers for 2 hours after meals, around 7.7 (140) and you could achieve this with a little tweaking of what you eat. Did you eat veg with the corned beef and chicken? a meat only meal may sounding tempting and like a good idea, but as with most things with this disease, balance is important. It would be better to include veg in your meals, especially veg with plenty of fibre will help counter the carb you eat so that you get a slower and more even release of the sugar from the carbs and so don't spike.

In relation to the corned beef, are you talking about the canned variety or the "fresh" version. I'm not a fan of either version (and I'm a meat lover and Irish!) but I believe that both versions would be high in salt, the canned version probably has other ingredients which may account for the spike.

Keep up the good work!

[volleyball]

Johnny, you have shown that eating a pure meat such as fish was no problem, when you had processed meat, it went up. There tends to be carbs associated with the processing of meat. This plus the glycemic load can drive you up. Any carbs in a large volume of meats will tend to make people rise. Carrots, peas and corn in a crustless shepards pie will probably be fine at a slice or 2. But eat half of it and the loading may come into effect.
It is a lot to "digest". It is complicated, but so is our bodies. Very complicated machines and while many alike, there are so many different models.
Even 2 people considered the same, would have different reactions due to the day activities, and what they had at previous meal

[BrianSCohen]

Understanding the way that our bodies respond to different foods is just very complex. I eat a high protein diet, often over 200g/day. I have to believe given the low amount of carbs that I eat that much of my blood sugar level comes from gluconeogenesis from the protein. As Bluesky pointed out, I probably only need 50-75g/day to sustain normal bodily operations, excess becomes available for gluconeogenesis. However, I may very well eat a chicken breast for lunch, which according to fitday has 60 g of protein.

The paper that Bluesky cited is very interesting. It confirms many of the things that we have heard in the past. In particular, it states that insulin response is not always proportional to blood glucose, and that several factors are known to affect insulin response, including f"ructose, certain amino acids and fatty acids, and gastrointestinal hormones such as gastric inhibitory peptide, glucagon, and cholecystokin." The further supports the idea that protein itself may invoke an insulin response beyond just gluconeogenesis. It also explains why fructose is not such a good thing for diabetics, as it invokes and insulin response disproprotionate with the effect on glucose. I mostly avoid fruit and have tried to eliminate HFCS from my diet. The final thing of interest is that the "chinese restaurant effect" is perhaps the gastrointestinal hormones (and cholecystokin which helps digest protein and fat), and that eating a big meal, even one with no carbs and no protein could invoke an insulin response is interesting.

The most important take away for a diabetic is that even if we monitor blood sugar exactly and figure out how the foods we eat affect the blood sugar we are still not done. None of the tools we have for self management tell us about insulin response and thus we just have to deal with some uncertainty.

[mcgriff]

Great info in this post. I will start to tinker with my bolus dosages and see what happens. So far, carb counting seems to be keeping me in the 130s 2 hours after I eat. But, I do notice that after a dinner high in meats my levels tend to rise to the 180s 2 hours after. I've been thinking it was my carb counting mistakes. Nice to know that the proteins may be the gremlins in my after dinner highs.

[Johny]

It sure is excellent information everyone is providing.
Emm - i would not have ever thought of the chemicals used in the pickling process of the topside beef, i will be very careful with it in the future.

davef - no veg's with either meat meal just the meat itself, it was the fresh corn beef, the one you cook at home.... my first Ac test was 6.0, doc said it was good, normally breakfast and lunch readings are always well under 7.0, the main meal is bigger & of course, i get the highest reading then but i am learning to tweak it around with lower GI vegetables & portion control.

volleyball - It sure is a lot to digest & our bodies are very complicated, but you guys have helped me a lot in trying to understand it, much, much more than a diabetic instructor i had initially when first diagnosed, who only liked the sound of her own fast talking voice and didn't like to answer any questions, so that didn't last long, i have been trying to learn myself.

BrianS - i am starting to get more of an idea of the whole picture to some extent, it is very complex to say the least.
I guess the best thing to do is test, test, test with all foods but also take in account the variable amount of exercise in comparison to what ever food we have, but i do understand
the uncertainly we still face with insulin.

Thanks very much everyone, you all have been very helpful.

Johny :)

[Evermont]

... and that eating a big meal, even one with no carbs and no protein could invoke an insulin response is interesting...

This must be a hypothetical meal but...

I'm having trouble even imagining a 'big meal' that has no carbs and no protein. I'm stumped. What are we talkin' about here, just fat and micronutrients? Maybe some insoluble fiber (carbs that don't count)? EVOO with a crushed up vitamin pill? Help me understand!

I mean, even if your meal was just a huge bowl of avocado (nutrition info (http://en.wikipedia.org/wiki/Avocado#Uses)) it's still 8.5% carbs, 2% protein, 15% fat and 73% water. Avocado is the closest thing I can think of that is actually food and mostly fat. Even then for every 8 parts fat you're getting 4 parts carbs and 1 part protein.

I guess the practical implication here is that no matter what you eat (assuming it's actually food) you should expect blood glucose to rise. All foods are something like 99% water+carbs+protein+fats, the rest is micronutrients. We all know too well that certain specific kinds of carbs will have the greatest effect. The new info is that proteins and fats will also have some effect. Add to this the fact that stress, infections, medications and various normal internal workings of the body itself will raise blood glucose.

The net seems to be that our ability to effect blood glucose is, in practical terms, limited to a mere fraction of the variables at work. There is no ideal food. Variety which is itself vital, necessarily brings with it things that are guaranteed to raise blood glucose even if you cut way back on carbs. It is up to us to manage it all as well as we can.

Good luck y'all!

[BlueSky]

... We all know too well that certain specific kinds of carbs will have the greatest effect. The new info is that proteins and fats will also have some effect. ...
Keith,

That proteins and fat require substantial amounts of insulin has more significant implications for people who inject insulin. It makes a nonsense of the popular practice of basing bolus dosing on the number of grams of carbohydrate that will be consumed. Insulin:carbohydrate ratios are applied to the amount of carbs in the meal, giving the amount of insulin to be injected/infused. Fat and protein are normally ignored. Pumps are even designed like this. You enter the carb count and it tells you how many units you need, based on the carb ratio. When I was trialling a pump, I had to over ride all the dosing suggestions and insulin-on-board corrections.

DEs have always insisted that, if the carb:insulin ratio isn't delivering in-target blood glucose, I must be doing it wrong. Either I have got the Insulin:carb ratio wrong, or I haven't counted the carbs correctly. I know from many years of trial and error that this is not so. From the graph we can see that fish uses as much insulin as grain bread. And ignoring protien/fat foods in insulin dosing decisions is a bad idea :mad: .

We should be basing our bolus insulin doses on an insulin index, not the carb count. Mixing foods creates complications, of course. And the different rates at which insulin is used by different foods also needs to be taken into account. But as long as the insistence that bolus doses should be based on carb counts, a lot of T1 diabetics will continue to feel like failures. :mad:

[Evermont]

...has more significant implications for people who inject insulin...

Oh yeah, I keep forgetting that my insulin is running on auto-pilot but many aren't. So I understand that these things are factors for dialing in your dosages. You express yourself with impressive ease and effectiveness Bluesky.

[jacobsam622]

Here is a link that will provide more answers to your question its called how things work.

Howstuffworks "Fat Cells: Lots More Information" (http://health.howstuffworks.com/fat-cell4.htm)

[BrianSCohen]

This must be a hypothetical meal but...

I'm having trouble even imagining a 'big meal' that has no carbs and no protein. I'm stumped. What are we talkin' about here, just fat and micronutrients? Maybe some insoluble fiber (carbs that don't count)? EVOO with a crushed up vitamin pill? Help me understand!


Evermont,

Here is a meal to try. Get a bag of Shiritaki noodles, as much as you want. Here is a 1 lb bag (Konjac Glucomannan Wet Noodles (Shirataki) (http://www.konjacfoods.com/product/noodles.htm). Use more if you are really hungry. Each 1 lb bag contains 0 grams fat, 0 grams protein, and 9 grams of carb, however all 9 grams are soluble fiber. Cook the Shiritaki and then serve it with olive oil. Of course olive oil has no protein or carbs either. If one bag of this is not enough several of them would surely be enough to give you "chinese restaurant" effect.