Insulin Resistance, and Bolusing for Protein

Last night I had Duck for dinner. Roast duck. With a side of Chicken salad.

It’s not often that I have a meal completely free of carbs. Or a meal that is Duck. But my blood sugar levels were looking decent, so I decided to opt out of having anything else after dinner. I set an extended bolus on my insulin pump for the protein portion of my meal (I usually bolus for 50% of the protein amount over 2 hours), and sat down to watch the latest episode of A Place to Call Home.

As my blood sugar level climbed into the 8s, I decided to give a correction bolus with my pump, overriding the insulin on board subtraction. As I sat on the couch for the next hour, I watched my blood sugar level continue to climb into the 9s and 10s, before finally levelling off at 11.

Although very tempted to give another correction bolus, I decided to wait until an hour had passed and that extended bolus had definitely kicked in. When I checked my reading again at the end of the episode, I was hovering at around 15 with upward trend arrows.

At this point, I gave up all logic and set a temporary basal rate of 200% on my pump. I gave another correction bolus, once again overriding my pump’s insulin on board subtraction.

I’ve been experimenting with the effect of protein on my blood sugar levels quite a lot in recent weeks. This means I am weighing the meat on my dinner plate, and paying attention to the nutrition info on my can of tuna or bag of Burgen Pumpkin Seed Bread. Most of the time, an extended bolus over 2 hours for 50% of the protein seems to do the trick for me.

I thought my protein bolus last night was very generous. My duck pieces were fairly small, and I didn’t think that the protein on my plate would add up to much at all. Yet it strangely led to hours and hours of insulin resistance that only temporary rage-basal rates could bring down.

So what was the difference?

According to this very useful article (thanks, Google), this meal was consumed in the absence of carbohydrate.

To quote the article “Protein’s effect on blood glucose is minimal when it is included as part of a complex meal. But when protein is consumed in the absence of carbohydrate, upward of 50% of the protein may be converted into glucose within a few hours, resulting in a moderate blood glucose rise.”

I am consciously trying to incorporate more protein in my diet. Eggs for breakfast. Almonds for morning tea. Steak or tuna with lunch. Not so much as a way to forgo carbs, but more as a way to build my energy levels. But I almost always eat my protein with a source of carbohydrate. A slice of toast, or a piece of fruit.

I understand that people on Low Carb High Protein diets would likely combat the insulin resistance with increased basal rates. But because my diet is not purely protein, I think I need to make sure that there are some carbs next to the protein on my plate.

3 thoughts on “Insulin Resistance, and Bolusing for Protein

  1. Yet another one of your posts thats made me feel not so alone in my struggles :-). I too will check constantly, blous , get frustrated and crank all the settings up on my pump in an attempt not to let my diabetes win. Right now I’m running my basal about 25% higher than normal. I think it’s my lady hormones but it could also be the fact that I’m wearing a pink sweater (joke).

    Cheers,

    Caroline

  2. Duck is super delicious and VERY high in fat – which partly explains its deliciousness! When you eat it – you have are dealing with both protein and fat. When I eat a meal high in fat like that I will bolus over 6 hours – to avoid going to bed with a good BGL and waking up (very) high the next day. Duck is one of the fattiest meats you can get – if you roast one you will be amazed.

    It is all about experimenting and learning. Thai food is super yummy but really challenging when dealing with the coconut curries – as they are loaded with fat. It is all a massive learning experience. Keep trying – you will just keep on getting better at it!
    You are absolutely on the right track with reducing your carbs – and by choosing low GI carb foods. I deliberately reduce or avoid foods that I know are high GI – unless I have the time to send my BGL low and falling before I eat them.

    Keep experimenting and learning – that way you regain control and your confidence will grow. Your curiosity and desire to learn and experiment is terrific!

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