I have been eating primal for about 2 weeks and have been having high blood sugars even though I'm eating less than 40g carbs on average every day. I'm talking like between 200 and 300 most of the day. Sometimes I can get down to 140, but that doesn't last long. I have heard of protein being converted to glucose in the body over the course of a few hours, could this be what's happening? How do I cover this with insulin on MDI?

So far I totally love this way of eating and I really want it to work. I love not being hungry!

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I don't use insulin but perhaps I can help you start to find a solution. You are correct, about 58% of protein is available for conversion to glucose as is about 10% of fat. However they peak several hours after a meal.

You might want to check out the TAG Group here on TuD. TAG stands for Total Available Glucose and is a set of techniques for insulin users to account for the conversion of protein and fat to glucose.

Another group to check out is the Dr. Bernstein group again here on TuD. There are several insulin users in this group who have found that daily carbs in the range you are talking about helps them keep their sugar in better control.

Consider joining these groups and posting your questions there. There are many knowledgeable people there who would love to help you. A drastic change in your diet requires an adjustment in your insulin regime but it is very doable.
knittykat,

I have been diabetic for 32 years now. I run www.dsolve.com which is dedicated to treating diabetes using primal / low carb diets. You absolutely have to cover protein (and to a small degree fat if you are looking for perfect control) with insulin if you are type 1. Dr. Richard Berrnstein does a very nice job of explaining this as does the book Total Available Glucose. The two take different approaches but arrive at the same place. Basically a rough conversion factor is 100% of carbs, 58% of proteins (just the protein, not gristle or fat), and 10% of fats convert to glucose. As you reference the protein and fat metabolize much slower. If you are on multiple daily injections (which I was up until a year ago) then I would use novolog (or any fast acting) for the carbs and I would take a second bolus of regular (at the time of eating, not 30 minutes before) to cover the protein. If you are using a pump then you can use the dual-wave feature (for example, I will take about 5 units of novolog in the morning with my bacon and eggs taking 2.5 immediately and 2.5 spread over the next two hours. Most people use a 1.15 to 1.25 per hour for the protein / fat coverage. One more thing--you can find a lot more on this at a group here called Taggers United or Dr. Bernstein-- both are groups that discusses this approach in more detail. Net/net you absolutely need to cover protein if you are type 1.

Hope this helps.

p.s. do you knit -- i learned in college much to my friends dismay--something about the motion and math made it meditative ;)
Thanks for all the advice! I will check out those groups.

I do knit! It's my way of sitting around doing nothing without doing nothing :)
You know what, I've been resistant to the idea of a pump, but after reading what you wrote here, a pump is starting to look pretty good! (Coincidentally, I'm going to a presentation on pumps at my CDE's office on Thursday. Now I'm a bit more excited about going to that than I was. Thanks!)
Ahhh, day one of addressing the protein and it's working already! Thank you both for your advice!!
Phishery I see that you mention above that you used to be on multiple injections daily. Can I ask what your regimen is now? I am on DR. Bernstein for 2 months now and am having success. I take Humalog for before meals and sometimes even after and NPH in the Morning and split doses at night time. Heck, if my BG is high I have even tried NPH several times in a day. I guess I am feeling stuck. I don't really know how much of any insulin to take anymore. If you or anyone else has some helpful advice I will take it. I feel like I take insulin all day long and every 3 hours at night time. Should I take Humalog for Bolus and buy a vial of R for more bolus after eating and then NPH in the morning and continue splitting doses at night? My fasting BG has been anywhere from 119-232.
Are you 40 grams of carbs coming from non-starchy veggies? If you're eating fruit or high-starch veggies (sweet potatoes, carrots, etc.), those will cause spikes.

Have you done a consistent study? I recommend to eat the same meals at the same time of day for two weeks. Chart your blood sugars and meals and injections on a chart. Look for patterns. Have your doctor help you adjust accordingly. This is how I solved the mystery of my own type 1 diabetes and now my numbers are always low (73-85 pre-meal).
Hi Knittykat...I also have high blood sugars while eating Primal/Paleo. I'm seeing a new endocrinologist who stopped my insulin...it wasn't working for some reason. He is trying me out on Byetta and Metformin...so we will see how that works. I need to walk or exercise after every meal...and this helps. I also take some supplements from Whole Foods to help my blood sugars. I am very weary of going back to insulin because I swell up, am always sleepy, and feel the need to eat all the time. The Primal/Paleo WOE :) makes me have more energy and keeps my weight in check. I also don't bloat. I hope that the Byetta works for me. Good luck KnittyKat!

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