Replies to This Discussion

Permalink Reply by Zoe on February 6, 2010 at 5:45pm

Interesting topic, and a bit advanced for me!! I'm a vegetarian and one of my favorite lunches involves nut butter (almond, hazelnut, cashew, etc). I eat it on crackers or even (I know juvenile) with bananas. I have been just bolusing for the carb (crackers or banana) and I am fine at 2 hours, but then by the time for dinner I am high and need to add correction. I thought this was from the fat in the nut butter delaying the absorption. Is it a combination of pure protein and fat? Most of your solutions are for pumps and I'm on MDI. Tuatara, can you gtell me more about how you do the dual bolus with injections? When do you inject?

• ▶ Reply

Permalink Reply by Gerri on February 6, 2010 at 8:51pm

Zoe,

Tuatara has a pump.

It's probably from the fat since fat slows digestion more than protein. The protein in nut butters isn't difficult to digest because it's already pulverized & also isn't a large amount of protein.

If you're typically going high between meals, it could also be that your basal insulin dose isn't right.

The way to handle this without a pump is to take a second injection to head off the high from fats/protein. Naturally, this takes a lot of testing eating the same food to learn when the spike occurs. If dinner & lunch are 4 hours apart, then test a 2 hours & again at 3 hours.

• ▶ Reply

Permalink Reply by Tuatara on February 6, 2010 at 11:07pm

Nope - tuatara (me) uses injections.

I was wondering if anyone else has tried more than one injection to deal with high protein meals.
What I've tried is one shot 15 mins before to catch the carbs and another small one after (say) an hour to manage the protein which is slowly converted to glucose over several hours. It was an experiment I tried a couple of times and seemed to have good results. More testing needed. YMMV.

It seems that dual wave boluses (to simulate first phase/second phase pancreatic response) provide the best post-prandial numbers (see here for example).

Cheers.
Paul

• ▶ Reply

Permalink Reply by Zoe on February 7, 2010 at 7:17am

Thanks, Gerri and Paul. No, I don't typically go high between meals. I think I mentioned on here that I did some adjusting of my basal and I think I finally got it right! Usually the only time that happens is with the nut butter lunch. I was about to give up on that food but will try your recommendations. I eat 5 hours apart and am always fine at 2 hours, so it's somewhere in the middle that the spike occurs. I'm willing to do some fiddling for nut butter. (Though I worry about gaining weight and it's not the most weight friendly food..lol).

• ▶ Reply

Permalink Reply by Tom S on February 6, 2010 at 6:35pm

I do not bolus for protein per my CDE, Endo, and Dietitian - except if the protein is breaded or in some kind of sauce - any sauce. Just have to guess what is in the sauce or breading - this is where testing helps to determine how that menu item reacts in your body.

• ▶ Reply

• ‹ Previous
• 1
• 2
• Next ›
• Page