It's about time...

[Amity Island]

Why is it no matter where you go, which doctor you see, which nurse you see, their response is always one of doubt, disbelief and dismissiveness?

Isn't it about time people working in the medical profession actually started listening to what patients are telling them rather than giving their standard first response of are you sure? it's unlikely! that's not right, have you got proof? where is your evidence?

How can you grow as a person or as a doctor if all you do is base your response/advice on what you have done before (dogma) rather than trying to listen and perhaps learn something new? Surely learning relies on listening and trying new things, not ignoring or doubting everything people tell you. Know it alls usually know very little because they stopped listening and learning.

I've got an upcoming appointment with the specialist Dr and I have had big problems with blood sugar levels several hours after eating a meal which contains protein such as a chicken breast or piece of meat. I bolus for the carbs in the meal which works very well, but once the insulin/carbs have run its course after say 5 hrs, my blood sugar will then keep rising for several more hours. I asked the diabetes nurse, who had no idea about protein conversion and glucose, her answer was, there is only for example 5g carbs in 100g of peanuts, "so it can't be the nuts causing the 6 unit rise in blood sugar".

I know already (dogma) what the Dr will say, it cant be the protein, it must be your basal (which it most definitely isn't). I get same rise if I have a carb free, protein rich cooked breakfast.

If doctors don't know about simple things like this then what hope is there for blood glucose management for diabetics?

Attitudes to learning and living really need to change.

If anyone on the forum can give me a starting point for adding in extra insulin after the bolus for the meal has ran out please could you share? e.g if on a 1:1, for say 100g of protein, what amount should I work with as being converted into glucose? half at 50g = to an extra 5units 5 hours after meal.

Thanks very much.

 

[HOBIE]

Good luck !

 

[grovesy]

I have read many times were people have said that protein alone they have to bolus for.

 

[Robin]

A quick search on this site for 'Bolus for protein' turned up several pages, it might be worth having a browse through. Unfortunately, because people differ so much, it may be a question of trial and error for you. I know that if I have scrambled egg on its own for breakfast at 8am, I need a unit of insulin around 11am, but that's me, it may not be the same for you.
Somewhere on here, someone posted a chart of how much protein and fat got converted to glucose, I think it was 50% for protein, and 10% for fat, but I can't find the link. If someone can give the link, it may be worth showing it to your nurse, she's obviously never come across the concept of protein being converted to glucose.

 

[everydayupsanddowns]

I have seen people needing to pay more attention to protein when carbs are low, but it also seems to be very individual - and sometimes specific-food related. Eggs (with little/no accompanying carb) which cause a significant BG hike seems to be a thing for several people.

 

[Amity Island]

A quick search on this site for 'Bolus for protein' turned up several pages, it might be worth having a browse through. Unfortunately, because people differ so much, it may be a question of trial and error for you. I know that if I have scrambled egg on its own for breakfast at 8am, I need a unit of insulin around 11am, but that's me, it may not be the same for you.
Somewhere on here, someone posted a chart of how much protein and fat got converted to glucose, I think it was 50% for protein, and 10% for fat, but I can't find the link. If someone can give the link, it may be worth showing it to your nurse, she's obviously never come across the concept of protein being converted to glucose.

Thanks very much for your reply. I too did the quick search, but like yourself couldn't find the link to the chart. I hope someone posts a link to it as that would be a good starting point.

 

[Amity Island]

I have seen people needing to pay more attention to protein when carbs are low, but it also seems to be very individual - and sometimes specific-food related. Eggs (with little/no accompanying carb) which cause a significant BG hike seems to be a thing for several people.

Hi thanks very much for your reply. It's not straight forward the mechanisms of the body and trying to mimic it though artificial insulin. Just when you get the carbs sorted, the proteins start rearing their head!

 

[everydayupsanddowns]

Hi thanks very much for your reply. It's not straight forward the mechanisms of the body and trying to mimic it though artificial insulin. Just when you get the carbs sorted, the proteins start rearing their head!

The graphs I’ve seen for protein conversion seem to suggest approx 50% over 4ish hours. And fats slightly lower proportion over longer. Not sure of their provenance or accuracy, but I found them an interesting guide.

http://www.diabetes-support.org.uk/info/?page_id=438

 

[Amity Island]

Hi

The graphs I’ve seen for protein conversion seem to suggest approx 50% over 4ish hours. And fats slightly lower proportion over longer. Not sure of their provenance or accuracy, but I found them an interesting guide.

http://www.diabetes-support.org.uk/info/?page_id=438

Hi, thanks for putting the link up, that's really helpful.
What I find is, the protein has little affect on blood glucose if eaten as part of a balanced meal with carbs, it is only after the meal that it starts to have an affect. Protein however eaten on it's own does have an effect on blood glucose as shown in the graph for me. I will start experimenting with protein only meals to try and get "my" insulin ratios, then apply these to after meals which contain proteins.

 

[trophywench]

I can't give the exact provenance of the info Mike however it was a piece of info obtained by Terry G when he was building the original DSF website and certainly has seemed to be borne out by various forum members experience, having tried it when they were apparently having similar difficulties.

I don't know if it was from his own hospital clinic, a past one, from the DAFNE course he went on, or where. He was in touch with the Tech sections of various insulin manufacturers for various info and all sorts of publications, places and people he'd had contact with over the years in his line of work and/or from being a T1.

 

[Lanny]

Ah! Interesting, @everydayupsanddowns! Thanks for posting that link.

I haven’t noticed any problems with protein but, I’m still eating quite a bit of carbs despite having cut down a bit. I’ve been having trouble with fats though, particularly cheese & double cream! Im finding prolonged, sustained high BS 5/6 hours after meals, that impact on the rest of the day! I’ve tried various split doses of Novorapid to no avail! Gave up & stopped eating cheese & double cream! Decided to ask hospital dietian when I see her 24/04/18!

 

[Lanny]

Have just printed the graph out to add to my Food, Blood Sugars, Insulin Doses, Thoughts, Feelings & Questions Diary, to show dietian! Because I specifically noted down several times the problems with cheese & double cream!

Hadn’t realised that fats take so long to convert & peak: between meals usually 4-6 hours! But, the impact on the rest of the day has been a lot!