Going hypo after eating omelettes: how do I bolus for it?

[Lanny]

If you’ve been reading my posts on the “Group 7 Day Waking Average” thread you’ll know I spent yesterday fighting hypos & it’s the same again just now. Both times have been after eating omelettes!

I’ve only recently re introduced them back into my diet after having cut them out due to liver & digestive problems. I tend to eat them 3 times a week & my digestive system can handle that, so far. They’re mostly protein though with virtually no carbs as I cook mushrooms, cheese & dried mixed herbs 3 egg omelettes! They really fill up & I either have it for breakfast or lunch. I had the usual dose of Novorapid yesterday before the omelette of 44 units & went hypo just 49 minutes after eating. Today I reduced the dose by more than half at 20 units & went hypo again at 90 minutes.

I’m wondering how others would bolus for something that’s virtually all protein & no carbs? Would you bolus for it at all?

2 days in a row of hypos after eating omelettes is not a coincidence I think & would like to get the bolus right as I’d like to continue having them; digestive system permitting!

Any ideas? Maybe delaying bolusing as proteins are digested at a slower rate than carbs? What would you do?

 

[porll69]

49 years type 1 and have never injected for protein. I know we are all different and some people do need to bolus for protein. 44 units of insulin for me would mean 440g of carbs

 

[grovesy]

49 years type 1 and have never injected for protein. I know we are all different and some people do need to bolus for protein. 44 units of insulin for me would mean 440g of carbs

@Lanny is a Type 2.

 

[porll69]

@Lanny is a Type 2.

I did see that. Still 40 units for a 3 egg omelette seems a lot?

 

[eggyg]

I personally wouldn’t bolus anything for that omelette but of course we’re all different. Do you bolus the same for every meal regardless of what you have? I know type 2s usually require more insulin but I would have thought the general ratio rules would still apply. No carbs equals no insulin, X amount of carbs required a ratio of X:X or do you not carb count? Just curious to how you work out your doses.

 

[helli]

One of the reasons why I have not adopted a low carb diet as someone with Type 1 is that I find protein incredibly difficult to bolus for.
For me (and I emphasise that we are all different), I only need to bolus for the protein if I have less than 10g carbs in a meal. When I have 10g carbs or more, I bolus for the carbs only.
If I have less than 10g carbs in a meal, I need to bolus for the carbs AND protein. A rule of thumb seems to be that protein needs about half as much insulin per gram as carbs do. So, if someone was to take 1 unit of insulin for 10g carbs, on a very low carb meal, they would need 1 unit of insulin for 20g protein.
However, I find that not all protein is equal - for me, fish requires less insulin than egg.

In addition, I find the impact of the protein on my BG is later than when I eat carbs. So I take insulin for protein after I eat rather than before.

But, this is for me ... and we are all different.

 

[Ljc]

I find I do not need to bolus for protein.
I suggest you reduce your bolus for the same omelette again or go commando and try it without any bolus but keep a close eye in your BGs

This diabetes lark sure is fun

 

[Lanny]

No I don’t carb count & have more or less fixed doses! They go down throughout the day as I’m most resistant when I get up & less resistant as the day goes on. I just add corrections for anything naughty like a glass of coke, some chocolate after a meal etc. It used to be +2 for each naughty item but, my insulin doses have just been increased for Winter & I find because of the extra insulin my corrections have gone up to +4.

I used to eat omelettes before in the past but, with other things like toast, sausages, baked beans etc. for breakfast p. It’s only now, this is the 2nd week, that I find the 3 egg omelette with loads of mushrooms & cheese is filling enough on its own. Also, I can’t eat fried breakfasts anymore, due to liver & digestive problems, & can’t remember when I last had sausages. I sometimes eat benecol light on toast & seeded bread really helps me keep my digestive system working.

I think I’ll try no bolus at all next time & work my way up from there?

 

[Lanny]

Oops! A case of you posting while I was typing @Ljc

 

[Ditto]

That is scary coz it's only eggs! I hope you can sort it out.

 

[Inka]

No I don’t carb count & have more or less fixed doses!

I’m Type 1 but could you look at adjusting your doses depending on the meal you’re about to eat? If you kept a record, you could maybe see what dose works for each meal and the best time to inject.

Like @helli I only have to bolus for protein if I eat a meal with no or minimal carbs. I don’t often do this because I find control harder and often get a rise a few hours after eating.

My suggestions would be to cut down your insulin further, inject later - ie after the meal or 30 mins after finishing eating or whatever. You could also possibly take zero units for the omelette and then only take correction doses if you’re high at 90-120 mins. As with so much in diabetes, I think it’s a matter of experimentation.

 

[grovesy]

No I don’t carb count & have more or less fixed doses! They go down throughout the day as I’m most resistant when I get up & less resistant as the day goes on. I just add corrections for anything naughty like a glass of coke, some chocolate after a meal etc. It used to be +2 for each naughty item but, my insulin doses have just been increased for Winter & I find because of the extra insulin my corrections have gone up to +4.

I used to eat omelettes before in the past but, with other things like toast, sausages, baked beans etc. for breakfast p. It’s only now, this is the 2nd week, that I find the 3 egg omelette with loads of mushrooms & cheese is filling enough on its own. Also, I can’t eat fried breakfasts anymore, due to liver & digestive problems, & can’t remember when I last had sausages. I sometimes eat benecol light on toast & seeded bread really helps me keep my digestive system working.

I think I’ll try no bolus at all next time & work my way up from there?

I am not an Insulin user, but I have found over the years what I could tolerate has changed many times, so had to adjust. Maybe you just need to review, and adjust your approach.

 

[Sally71]

We wouldn’t bolus for a meal like that either, then if there was any rise from the protein it would probably only be small, but if not we would just do a correction dose later.

@Lanny that sounds like a good plan to try no bolus at all and work from there. If you're taking fixed doses of insulin for meals then it means you need to be eating fixed amounts of carbs, which many people would find very boring! I hope you can find what works for you!

 

[nonethewiser]

As always nowt straightforward with diabetes.

Lanny, no carb meals like omelette can be difficult to get right, back when on injections could bolus 3x, small amount before 2 hours after then 3-4 hours after depending on bg.

Find just eating slice of toast with meal changes things, something for pre bolus to work on then bit more later on for slow digestion of protein, this works for me anyway, dont give up on meal it just needs some tweaks mate.

 

[Lanny]

Uhmm! Interesting! I tried the omelette again for an early lunch earlier, 3rd time this week already & no more eggs this week, without any bolus at all & my BS has fallen steadily for just over 4 hours now: as if I hadn’t eaten anything at all; but, I got a filling & satisfying meal!😱🙄😛 Before lunch 09:39 BS 8.5, after lunch 12:04 BS 6.5 & 13:43 BS 5.8!😱

This is the first meal I’ve come across where I don’t need to bolus for at all! It’s such a pity that I can’t risk eating too many eggs as my liver & digestive problems can’t handle it! I was risking it by having omelettes 3 days in a row, I’ll find out later how my digestive system handles it, but, I wanted to test out my hypothesis?🙄

 

[grovesy]

Hope you don't have any detrimental effects.

 

[rebrascora]

Great result Lanny.
There are other very low carb meals you can try without needing a bolus injection ... doesn't have to be eggs/omelette. This is how many of us low carb eaters manage our diabetes and the less insulin you inject, the less chance there is of getting it wrong.... and weight loss can be an added bonus of eating low carb.

 

[everydayupsanddowns]

Great that you have had such success with the no-bolus omelette @Lanny

I was only thinking about eggs myself recently... We stopped regularly having them in when my youngest turned vegan, but I am really fancying them again, and am considering ditching some (or most!) of the carbs from my lunches so that I have less circulating iob for my afternoon dog walks.

All connected to how my new pump can adjust things slightly.

We have had forum members in the past for whom eggs in particular seemed to need a bolus in a way that other protein sources didnt... so I guess once again it’s a matter of “Your Diabetes May Vary” 🙂

 

[Ljc]

@Lanny . No bolus needed , that’s great.

I am currently experimenting with fruit. After a couple of successful tries , I’ve added Nectarines to my list of ,an Apple, a pear, a peach or berries that if I am in range I don’t need to bolus

 

[rebrascora]

@Ljc Talking of fruit, I am enjoying stewed plums from the garden with my low carb granola, seeds and yoghurt breakfast at the moment and not having any problem with them spiking me. They are even stewed with a tiny bit of Demerara sugar and a few sweeteners as they are cooking plums. I also found stewed rhubarb and stewed apricots with sweetener worked well with breakfast. Nice to be able to use the garden produce when it is in season. Anyway, just some other suggestions of fruit to try. 2 heaped dessert spoons of the stewed fruit seems to be about the right portion size to get away with for me.