[rak1978]

Honestly, I'm not sure if protein alone raises my blood sugar.
The only meal that I occasionally go without any carbs at all would be breakfast and then I have the dawn phenomenon going on, so my blood sugar keeps rising on it's own, even without carbs.
I think you're right, Subby, that the best way to test would be to avoid any snacking at all. I just had the couple of bites of eggs so that I could take the met.
I do have a head cold right now as well, so this may be all for not, but we shall see.
So far, other than the immediate 30 pt rise upon waking, I've been dead even. My major morning problems usually start coming on about now, so we'll see.

Thanks for all the help. I am quickly finding out how little I know. It's not surprising that I have been in a loosing battle. Education is a good thing. And you can't get this kind of education from the endo. I haven't been around for a few weeks and it's nice to be back.

[Subby]

Hey that's great to have a flat BG period at the start of your testing, inspires confidence and you have somewhere to come from if things start drifting. Have fun!

[JJM335]

Rachel:

A couple more points to add what others have posted.

If the problem is spikes at 2 h after eating and lows after 4, you need to try to get the insulin working as quickly as possible. You might do better with Apidra than with Humalog. Based on the figures put out by the manufacturers, Novolog and Humalog have a duration of action of 5 - 6 hours, whereas Apidra is less than 4 hours. Although Apidra won't start working much more quickly than Humalog, at 2 hours after taking your bolus, about 65% of the Apidra will have been active, compared to around 50% for Humalog.

More insulin active earlier means less of a spike. If you can combine than with a pre-bolus, that will also give you a bit of a push. A second plus point is that with Apidra you will have used up all your bolus after 4 h, whereas with Humalog, there will still be a fair amount of active insulin left to give you a late hypo.

A lot of people love Apidra, others don't find it helpful, but it might be worth talking to your endo about giving it a try.

Joel

[rak1978]

Originally Posted by JJM335

Rachel:

A couple more points to add what others have posted.

If the problem is spikes at 2 h after eating and lows after 4, you need to try to get the insulin working as quickly as possible. You might do better with Apidra than with Humalog. Based on the figures put out by the manufacturers, Novolog and Humalog have a duration of action of 5 - 6 hours, whereas Apidra is less than 4 hours. Although Apidra won't start working much more quickly than Humalog, at 2 hours after taking your bolus, about 65% of the Apidra will have been active, compared to around 50% for Humalog.

More insulin active earlier means less of a spike. If you can combine than with a pre-bolus, that will also give you a bit of a push. A second plus point is that with Apidra you will have used up all your bolus after 4 h, whereas with Humalog, there will still be a fair amount of active insulin left to give you a late hypo.

A lot of people love Apidra, others don't find it helpful, but it might be worth talking to your endo about giving it a try.

Joel

Thanks, Joel! I hadn't considered this. I will talk with my dr about it. Also, I just checked my pump and I had 4 hours plugged in as the active insulin time. I just changed it to 6. That may help in regards to stacking and corrections.

[CarrieJett]

This thread has taken a new turn, but after reading the carbs debate, I have started really paying attention to my protein, especially for dinner. I was curious about Sarahspins experience with protein, and I actually am starting to think I have a similar constitution!
While eating a lot more high-protein, low carb, I used to wake up a few times with my BG at 200+, no explanation. Very frustrating. My endo couldn't figure it out, especially because I am very athletic andburn food like crazy.
I have tried over the last week or so to eat less protien at dinner. I used to eat like chicken and greens, now I have been eating veggies, rice, and beans.
What do you know, every morning I have been waking up with a lovely 90 on my meter, and no lows in the night! I used to be pretty convinced about lo carb, but I can't debate my numbers!
I've also been taking the pre-bolusing advice, and no more sleepy post-meals. Wow! Thanks everyone, I can't wait to see my labs in a few months...

[genie86333]

Originally Posted by CarrieJett

I have tried over the last week or so to eat less protien at dinner. I used to eat like chicken and greens, now I have been eating veggies, rice, and beans.
What do you know, every morning I have been waking up with a lovely 90 on my meter, and no lows in the night! I used to be pretty convinced about lo carb, but I can't debate my numbers!

Hi, CarrieJett.

Have you tried testing (both ways) during the night? It's possible that with the chicken & greens you were going too low at night & rebounding up to the higher level. Maybe a snack before bed would help. What are your post-dinner readings with the veggies, rice & beans? If they're ok, then no reason to change it if you like that diet, but if they're high, you might want to see what the chicken/greens dinner plus a bedtime snack do

[rak1978]

CarrieJett, that's really interesting. It is apparent that we are all extremely different, and there isn't one diet that works for all. I find that when I eat extremely low carb I am steady, but high all day. It seems that I would have to increase my basals substantially without bolusing for meals...either that or figure out how to bolus for proteins/fats.

Subby, Protein DOES raise my blood sugar. I did basal testing two days in a row for the early morning until mid-afternoon.
The first day I had small portions of protein/fat and they definitely raised my blood sugar both times (by about 40-50 mm/dl). This was for a couple of bites of eggs and a slice of cheese. I wasn't sure that this was due to the snack until today, I thought it was possible that it was due to my basal being decreased at those times. So, today I did a second basal test to confirm without the bites. No spikes. It was dead even all morning.

Thanks to everyone for all of your suggestions. They were super helpful. I have been pre-bolusing and the numbers have been improved significantly. No major spikes, no major hypos. It's amazing to me that my dr never has suggested this to me (or the basal testing, for that matter!). He is very attentive and likes to be involved, but I'm surprised that he didn't think of these things.

Thanks again to everyone for your help!

[CarrieJett]

Originally Posted by genie86333

Hi, CarrieJett.

Have you tried testing (both ways) during the night? It's possible that with the chicken & greens you were going too low at night & rebounding up to the higher level. Maybe a snack before bed would help. What are your post-dinner readings with the veggies, rice & beans? If they're ok, then no reason to change it if you like that diet, but if they're high, you might want to see what the chicken/greens dinner plus a bedtime snack do

I may have to do some more testing to be sure, but I am basing a lot of it on a week of CGM that I did recently. I assumed that I would be going low during the night, and that's what my endo thought but in fact I wasn't. I was steady all night rigt around 100, then at 6am I would climb up to 200 in a half hour. Dawn phenom, yes. If I up my lantus it's too much and I get a lot of lows.

I wonder if the protein gives my liver a big boost for my DP? This is a new experiment, so I will keep track of my dinners and maybe torture myself with nighttime readings and post my findings. Wish I had that sensor all the time! It bring out the geek in me.

In experimental mode, I also did some pre-bolus testing, nd found that it takes an entire half hour for my humaog to kick in in the morning!

[It Ain't Over]

With the low carb diet I think it is important to find what the rate of the rise in Bg's with the various foods, and the rate a bolus lowers your bg.
If those two were to match up perfectly your bg's would remain the same after a meal.
The hard part is to sort them all out and at the same time find a bolus that is correct for that meal.
With the low carb diet this does become apparent but it requires a lot of work to find the patterns.
After 9 months on the diet I am beginning to understand some, but not all of this. I have found that everything put into my mouth will raise blood sugar eventually.
I try to eat the same basic food every meal. Easier to work out the details. It is not absolutely necesary to do it this way. We all know that.
Have found green vegtables raise bg the least. Cheeses raise it for the longest time, and meats raise bg's the most and fastest. Any food requires a bolus. But if I eat a breakfast of sausage and a 2 oz serving of cheese, which I do most days, I can bolus 1.6 and the bg's will remain flat until lunch. With lunch I eat about the same and add in some green vegatables. Bolus goes to 1.9. Dinner is about same as lunch, but I am a little more insulin sensitive at that time, so bolus is 1.6.
Doesn't seem like that much difference, but it makes for a steady bg with me. The point is to take the time to find out. Eliminate as many variables as possible and test-test- test until you know. Then you can add in the variables and make the adjustments.

[Lilly164]

This is a very interesting thread. Rak1978, your BG numbers look just like mine!
Delaying eating breakfast for 30 minutes or more has really helped morning numbers. That said, I want to qualify by adding, NOT, for a morning low, An AM reading of 140, take insulin, wait 30-60 minutes to eat.
I always eat carbs with breakfast. Oatmeal and milk, usually. Another change that seems to have helped is reducing the oatmeal to 32 grams, (it was 1/2 cup) add 1 cup milk and 1/4 cup cottage cheese for some more protein.

Delaying food in the morning to allow time for insulin to reach the cells and reducing the carbs a bit seem to have helped, not solved the DP.
The suggestion to allow more time between insulin and food all day looks good. I plan to give it a try.

Thanks all.
Lilly