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-   -   why the increase? (https://www.diabetesforum.com/diabetes-diet-nutrition/87665-why-increase.html)

pctm 01-21-2017 06:15

why the increase?
 
i'm confused about why when i eat hard boiled eggs
with mayo my blood sugar increases from 87
to 114 in an hour?
and why does coffee with suralose- 3 pks
and a tbsp of cream put me in the 140's?
do i need insulin with these?
i understood that eggs and mayo would cause
no increase in blood sugar?
im aiming for less than 140 in an hour
and less than 120 in two hours
what should i be expecting or looking for?
and other protein foods cause a rise too sometimes
putting me over my goals
is it too much protein?
am i expecting too much?

VeeJay 01-21-2017 14:57

Are you taking any meds, such as metformin? A conservative approach would be to add it to your toolbox. You could re-evaluate your diet, increase fats and decrease protein (down to what you actually need) and see how that does.

While being diet-controlled is a good thing, it sometimes isn't enough if one's pancreas isn't making enough to counter insulin resistance. Taking insulin could be a good thing if you need it.

Have you discussed this with your doctor? and do you think s/he would order the antibodies test that would indicate Type 1 (1.5/LADA).

pctm 01-21-2017 17:09

Quote:

Originally Posted by VeeJay (Post 1188225)
Are you taking any meds, such as metformin? A conservative approach would be to add it to your toolbox. You could re-evaluate your diet, increase fats and decrease protein (down to what you actually need) and see how that does.

While being diet-controlled is a good thing, it sometimes isn't enough if one's pancreas isn't making enough to counter insulin resistance. Taking insulin could be a good thing if you need it.

Have you discussed this with your doctor? and do you think s/he would order the antibodies test that would indicate Type 1 (1.5/LADA).


i take lantus and novorapid
but i dont use the rapid for things like
eggs or cheese or meat or nuts
i tried different meds but couldnt tolerate
the side effects
i'd like to eat more meals/food that doesnt
require the rapid
im having trouble adding more fat because i
cant think of ways short of just eating the fat
as far as i know im eating high fat foods
such as bacon mayo nuts
i dont know how to add other ones in
i'm not sure if my dr would order that test or not
i can ask and see

VeeJay 01-21-2017 19:54

I have no expertise with insulin, so can only comment on what seems to me to be logical to use the rapid if you need it, irregardless of what you have eaten. I also have read how important it is to get basal dosing correctly regulated and dosed.

Do you have one of the books on insulin use for reference? such as Using Insulin, or Think Like a Pancreas (can't find my reference document with the authors, sorry).

pctm 01-22-2017 00:39

Quote:

Originally Posted by VeeJay (Post 1188297)
I have no expertise with insulin, so can only comment on what seems to me to be logical to use the rapid if you need it, irregardless of what you have eaten. I also have read how important it is to get basal dosing correctly regulated and dosed.

Do you have one of the books on insulin use for reference? such as Using Insulin, or Think Like a Pancreas (can't find my reference document with the authors, sorry).

i have both books but didnt find enough info.
on dosing for protein and fat and i found their recommended
goals very high
i have a cde i can ask questions from but shes heavily
into the carbs and waving the fat and protein on top
i did buy some new fat items today tho to try out
to be able to hopefully cut back on the excess protein

how do ppl handle dosing for protein?
wait an hour then dose for half the amount?

Daytona 01-22-2017 17:24

Hi pctm!

There are a couple things that are helpful to understand. I'm going to give some high level generalities here but I strongly recommend that you pick up Think Like a Pancreas, as a book can go into much better detail than I can in a post! :)

1. A blood sugar meter isn't perfectly consistent or accurate. Depending on your meter's age, even when in perfect working order, it is allowed to be up to 20% off. So if you blood sugar is about 110, 20% is 22, so it could be between 88-132. So if you are just using finger sticks an hour apart, a difference of 27 points may not be as significant as it seems.

If you are on a CGM (continuous glucose monitor), then it would be easier to tease out if you blood sugar really started rising, when, how long and if it stayed there long.

2. There are many ways for food to affect your blood sugar. A meal with primarily carbohydrates usually raises it within an hour and that's what you are mostly addressing when you bolus for a meal. If your meal is predominantly protein and fat, then your body may convert some of the protein and fat into glucose, and you could see the spike between 3-5+ hours later. Things like pizza, which are a more even split of both in large quantities can cause two spikes, one early and another later, which is where a split bolus (50% before eating, and the rest 2 hours later) can come in handy.

All of these numbers are dependent on your own digestive speed. As you gain experience with how different foods impact your blood sugar, you can say "For this meal, I'm going to pre-bolus 20 minutes before, but for that one, I'll wait an hour after eating".

If you want to bolus for protein (personally if I were only seeing a 20-something rise, and I was going to be active in the next few hours, I may not), you will need to do some testing to determine how much and when. It is very much specific to your own body and digestion.

If your body is still making insulin, then protein dosing formulas out of the books targeted for type 1 diabetics may be too much for you. So try out a few low-carb meals, just bolus for the carbs and then take note of when your blood sugar rises and by how much from the rest. Then you can use that come up with an appropriate protein bolus.

For example, if you have read online about this, you may have seen others saying that they bolus for 50% of the protein at 2 hours after the meal. If I did that, I would have serious lows. In fact many have found that eating even nominal amounts of carbs will prevent their body from converting an appreciable amount of protein into glucose, so by adding a 20g dinner roll, they can avoid dealing with the complexities entirely.

Sorry, an answer of "it depends" isn't immediately helpful to you but I hope it gives you more context to experiment and find a dose that works for you.

pctm 01-23-2017 17:08

Quote:

Originally Posted by Daytona (Post 1188393)
Hi pctm!

There are a couple things that are helpful to understand. I'm going to give some high level generalities here but I strongly recommend that you pick up Think Like a Pancreas, as a book can go into much better detail than I can in a post! :)

1. A blood sugar meter isn't perfectly consistent or accurate. Depending on your meter's age, even when in perfect working order, it is allowed to be up to 20% off. So if you blood sugar is about 110, 20% is 22, so it could be between 88-132. So if you are just using finger sticks an hour apart, a difference of 27 points may not be as significant as it seems.

If you are on a CGM (continuous glucose monitor), then it would be easier to tease out if you blood sugar really started rising, when, how long and if it stayed there long.

2. There are many ways for food to affect your blood sugar. A meal with primarily carbohydrates usually raises it within an hour and that's what you are mostly addressing when you bolus for a meal. If your meal is predominantly protein and fat, then your body may convert some of the protein and fat into glucose, and you could see the spike between 3-5+ hours later. Things like pizza, which are a more even split of both in large quantities can cause two spikes, one early and another later, which is where a split bolus (50% before eating, and the rest 2 hours later) can come in handy.

All of these numbers are dependent on your own digestive speed. As you gain experience with how different foods impact your blood sugar, you can say "For this meal, I'm going to pre-bolus 20 minutes before, but for that one, I'll wait an hour after eating".

If you want to bolus for protein (personally if I were only seeing a 20-something rise, and I was going to be active in the next few hours, I may not), you will need to do some testing to determine how much and when. It is very much specific to your own body and digestion.

If your body is still making insulin, then protein dosing formulas out of the books targeted for type 1 diabetics may be too much for you. So try out a few low-carb meals, just bolus for the carbs and then take note of when your blood sugar rises and by how much from the rest. Then you can use that come up with an appropriate protein bolus.

For example, if you have read online about this, you may have seen others saying that they bolus for 50% of the protein at 2 hours after the meal. If I did that, I would have serious lows. In fact many have found that eating even nominal amounts of carbs will prevent their body from converting an appreciable amount of protein into glucose, so by adding a 20g dinner roll, they can avoid dealing with the complexities entirely.

Sorry, an answer of "it depends" isn't immediately helpful to you but I hope it gives you more context to experiment and find a dose that works for you.

thankyou for the info.
i will go read the book again too

pctm 01-24-2017 04:45

right now my insulin to carb ratio is 3 to 1
and getting close to 2 to 1
what happens when a person is worse than 1 to 1?
and can i stop it from going that bad?

ive cut carbs drastically and in the process of cutting
back on protein and adding more fat
exercise isnt an option with my other health conditions
i use lantus and rapid and unable to use the other meds
what else can be done?

mbuster 01-24-2017 06:50

Monitor your BG closely as you cut carbs, a reduction in insulin may be necessary. Not sure about how to control what one's I:C ratio does, but reducing carbs is definitely a step in the right direction and will minimize how much insulin you have to take. Too much insulin in circulation is not a good thing.

Your own natural insulin production may be tapering off, thus the need for more exogenous insulin.

Daytona 01-24-2017 14:51

Quote:

Originally Posted by pctm (Post 1188689)
what happens when a person is worse than 1 to 1?

An insulin to carb ratio of 3 to 1 means that for every 3 grams of carbs one requires 1 unit of insulin. If one goes beyond 1:1, then it could look like this: an insulin to carb ratio of 1g : 3U, or for every one gram of carbs, one requires 3 units of insulin. There are more highly concentrated forms of insulin, such as Humalog U200 and U500 which are used when someone needs a very high amount of insulin every day.

I want to step back though and say that these are all questions that you need to be working through with your doctor. If you aren't already seeing an endocrinologist, then that is your next step. If you are, bring up your concerns and work with them to understand what the plan is. If your endo doesn't help you, get a better one.

There are many diseases and medications that can increase your insulin needs. Drastically cutting carbs can help reduce your insulin requirements (which must be done carefully as mbuster noted!) but depending on everything else in the picture, it may not be enough.


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