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    • 6 seconds ago
      Becky Hertz likes your comment at
      Multiple daily injections users: Do you use a diabetes-specific app on a smart phone to track your insulin dosing? Share what works best for you in the comments!
      I record some in my phone, mentally record some, and take photos of my dexcom serial numbers. It was getting confusing using multiple places. I found a workbook on Amazon that allows me to keep all records for a year in one place. It is a good backup for keeping records and taking it with on doctor appointments. Here is the link if anyone is interested: https://www.amazon.com/Diabetes-Workbook-Journal-Annual-Management/dp/B0BT72XJV8/ref=sr_1_1?crid=3QCWJHUYYFVA8&keywords=juli+publishing+diabetes&qid=1685976284&sprefix=juli+publishing+diabetes%2Caps%2C272&sr=8-1
    • 31 minutes ago
      Jubin Veera likes your comment at
      Multiple daily injections users: Do you use a diabetes-specific app on a smart phone to track your insulin dosing? Share what works best for you in the comments!
      I note my insulin dosage, both long and short term, using the events option in my Dexcom G6 app.
    • 1 hour, 22 minutes ago
      Sue Martin likes your comment at
      Multiple daily injections users: Do you use a diabetes-specific app on a smart phone to track your insulin dosing? Share what works best for you in the comments!
      I use an InPen. Tracts my doses and gives report just like a pump. IOB total insulin etc.
    • 2 hours, 44 minutes ago
      Kris Sykes-David likes your comment at
      Multiple daily injections users: Do you use a diabetes-specific app on a smart phone to track your insulin dosing? Share what works best for you in the comments!
      I’m looking for an app that reminds me of basal doses that keeps the time static as you change time zones. For example, I recently travelled to London. My normal basal dose is at 8 PM at home but currently 1 AM in the UK. The Apple Health app reminded me to take it at 8 PM London time instead of 1 AM. I really just want an app that reminds me at the same time my body is set at without making me think about it.
    • 3 hours, 4 minutes ago
      beth nelson likes your comment at
      Multiple daily injections users: Do you use a diabetes-specific app on a smart phone to track your insulin dosing? Share what works best for you in the comments!
      I’m looking for an app that reminds me of basal doses that keeps the time static as you change time zones. For example, I recently travelled to London. My normal basal dose is at 8 PM at home but currently 1 AM in the UK. The Apple Health app reminded me to take it at 8 PM London time instead of 1 AM. I really just want an app that reminds me at the same time my body is set at without making me think about it.
    • 3 hours, 52 minutes ago
      Mick Martin likes your comment at
      In the past 12 months, have you experienced nausea and/or vomiting as a symptom of high blood glucose levels?
      Echo Mick Martin. Gastroparesis? Try ondonestron (sp?) one of the 10 best medicines ever invented. Also, "a forever learning curve" and "If in doubt, pull it out."
    • 19 hours, 48 minutes ago
      KarenM6 likes your comment at
      In the past 12 months, have you experienced nausea and/or vomiting as a symptom of high blood glucose levels?
      "It's a forever learning curve" - so very true
    • 19 hours, 55 minutes ago
      KarenM6 likes your comment at
      For pump users: In the past 3 months, have you had issues with insulin delivery due to a bent cannula or occlusion?
      I hesitate to bring this up but I am quite sure this happens more than people realize. I use a tubed pump and small amounts of total daily insulin and have checked the tubing for YEARS for bubbles. YES, they are difficult to "notice" unless you have a good light behind the clear tubing because the insulin is also colorless. I detach and check the tubing in the morning and before bedtime if not before the evening meal...I'm talking about significant bubbles----8-10-or12 inches in length can appear and you would NOT notice them unless you were looking. I wonder how many people wonder why their blood sugar is occasionally high and it's being caused by a significant bubble...NO, not the champagne sized version that's often mentioned to "ignore." The pump company I deal with tried to get me to switch to injections instead but I am an EXPERT with the bubble situation. Also, comments over the years that I am probably not filling the reservoir correctly, etc....just plain silly. I am NOT new at this...LOL!!!
    • 20 hours, 20 minutes ago
      KarenM6 likes your comment at
      In the past 12 months, have you experienced nausea and/or vomiting as a symptom of high blood glucose levels?
      I said yes to nausea, occurred with a bad pump site insertion and rising BG over the next 4 hours. I picked it up early w CGM notification and realizing that it was very unusual for me to have rising BG at that time of the day (morning) when on Control IQ pump. The severity was delayed because I had given a breakfast meal bolus via the prior site before the change, so BG was rising after 3 hours, and I knew something was not right. I think this is an important clue for pumpers- when I see people get in trouble w bad sites or insertion failures, the thought process usually is- I just put a new site in, it must be ok- or maybe it does not occur to people that the pump site could have failed--when it should be- did the insertion fail? ----If in doubt, pull it out!----- I pulled the site and could see the cannula was bent, so I know what happened and injected w a syringe, put a new site in, and was better in a 3-4 hours.
    • 1 day ago
      Janis Senungetuk likes your comment at
      In the past 12 months, have you experienced nausea and/or vomiting as a symptom of high blood glucose levels?
      I said yes to nausea, occurred with a bad pump site insertion and rising BG over the next 4 hours. I picked it up early w CGM notification and realizing that it was very unusual for me to have rising BG at that time of the day (morning) when on Control IQ pump. The severity was delayed because I had given a breakfast meal bolus via the prior site before the change, so BG was rising after 3 hours, and I knew something was not right. I think this is an important clue for pumpers- when I see people get in trouble w bad sites or insertion failures, the thought process usually is- I just put a new site in, it must be ok- or maybe it does not occur to people that the pump site could have failed--when it should be- did the insertion fail? ----If in doubt, pull it out!----- I pulled the site and could see the cannula was bent, so I know what happened and injected w a syringe, put a new site in, and was better in a 3-4 hours.
    • 1 day ago
      Richard Wiener likes your comment at
      In the past 12 months, have you experienced nausea and/or vomiting as a symptom of high blood glucose levels?
      I said yes to nausea, occurred with a bad pump site insertion and rising BG over the next 4 hours. I picked it up early w CGM notification and realizing that it was very unusual for me to have rising BG at that time of the day (morning) when on Control IQ pump. The severity was delayed because I had given a breakfast meal bolus via the prior site before the change, so BG was rising after 3 hours, and I knew something was not right. I think this is an important clue for pumpers- when I see people get in trouble w bad sites or insertion failures, the thought process usually is- I just put a new site in, it must be ok- or maybe it does not occur to people that the pump site could have failed--when it should be- did the insertion fail? ----If in doubt, pull it out!----- I pulled the site and could see the cannula was bent, so I know what happened and injected w a syringe, put a new site in, and was better in a 3-4 hours.
    • 1 day, 1 hour ago
      Ahh Life likes your comment at
      In the past 12 months, have you experienced nausea and/or vomiting as a symptom of high blood glucose levels?
      I began playing Pickleball last year in March. When the temperatures started to rise the extra effort my body was experiencing because of the heat got my body hormones out of balance and I began experiencing nausea, higher heart rates and feeling very uncomfortable. I soon realized that I cannot play when is too hot or I’ll end up with ketones. Any new activity when on. Insulin requires adjustments. It’s a forever learning curve. Adding to the heat, last year I was having some absorption problems by the overuse of my abdomen. I have now move the infusion sites to my upper front side and it’s working much better.
    • 1 day, 1 hour ago
      Kristine Warmecke likes your comment at
      In the past 12 months, have you experienced nausea and/or vomiting as a symptom of high blood glucose levels?
      I said yes to nausea, occurred with a bad pump site insertion and rising BG over the next 4 hours. I picked it up early w CGM notification and realizing that it was very unusual for me to have rising BG at that time of the day (morning) when on Control IQ pump. The severity was delayed because I had given a breakfast meal bolus via the prior site before the change, so BG was rising after 3 hours, and I knew something was not right. I think this is an important clue for pumpers- when I see people get in trouble w bad sites or insertion failures, the thought process usually is- I just put a new site in, it must be ok- or maybe it does not occur to people that the pump site could have failed--when it should be- did the insertion fail? ----If in doubt, pull it out!----- I pulled the site and could see the cannula was bent, so I know what happened and injected w a syringe, put a new site in, and was better in a 3-4 hours.
    • 1 day, 1 hour ago
      Becky Hertz likes your comment at
      In the past 12 months, have you experienced nausea and/or vomiting as a symptom of high blood glucose levels?
      I said yes to nausea, occurred with a bad pump site insertion and rising BG over the next 4 hours. I picked it up early w CGM notification and realizing that it was very unusual for me to have rising BG at that time of the day (morning) when on Control IQ pump. The severity was delayed because I had given a breakfast meal bolus via the prior site before the change, so BG was rising after 3 hours, and I knew something was not right. I think this is an important clue for pumpers- when I see people get in trouble w bad sites or insertion failures, the thought process usually is- I just put a new site in, it must be ok- or maybe it does not occur to people that the pump site could have failed--when it should be- did the insertion fail? ----If in doubt, pull it out!----- I pulled the site and could see the cannula was bent, so I know what happened and injected w a syringe, put a new site in, and was better in a 3-4 hours.
    • 1 day, 18 hours ago
      Wanacure likes your comment at
      Have you developed lipohypertrophy due to repeated injections/infusions of insulin? Lipohypertrophy is a term to describe hardened lumps of body fat just under the skin that resulted from repeated insulin injections/infusion sites. If so, share how you’ve handled lipohypertrophy in the comments!
      After 62 years I have skin issues everywhere. I am an avid at rotating every time I change my infusion set. When I was on multiple daily injections, up to 9 per day, I had massive skin hardening. Since on the pump it’s not nearly as bad that’s been 33 years. I take very little insulin my daily basal comes out to 9 units over 24 hours I eat two meals that I count carbs for and try to keep at a minimum of 30-40 per day. Everything is going well. Rotation is key
    • 1 day, 18 hours ago
      Wanacure likes your comment at
      Have you developed lipohypertrophy due to repeated injections/infusions of insulin? Lipohypertrophy is a term to describe hardened lumps of body fat just under the skin that resulted from repeated insulin injections/infusion sites. If so, share how you’ve handled lipohypertrophy in the comments!
      I use a pump and have had issues with insulin absorbtion. It seems I have a lot of them on the side I primarily use for infusion sets. I recently switched to the other side of my abdomen and dropped more than one point on my a1c.
    • 1 day, 19 hours ago
      Wanacure likes your comment at
      Does your T1D healthcare provider suggest new medications or devices that they think would be beneficial to your T1D management during your appointments?
      When I first started with my current Endo we would discuss the released and upcoming products and I would tell her about the 'off-market' applications and devices, we both learned from each other. But she was so good with helping me transition to the Dexcom and then the Tandem after Animas was pulled from the Market. She followed my Dex and even finer tuned my Basals and early this year I got an "unbeleivable" 5.4 A1c and we are both extremely happy!
    • 1 day, 19 hours ago
      Wanacure likes your comment at
      Does your T1D healthcare provider suggest new medications or devices that they think would be beneficial to your T1D management during your appointments?
      Yes. But then I self-selected when choosing an endocrinology clinic that pursues cutting-edge advances 40 years ago. Cutting-edge is a phrase that is also often called bleeding-edge because it is often experimental, hit or miss on results, and very expensive. I am convinced the “bleeding” refers to $$$.
    • 1 day, 19 hours ago
      Wanacure likes your comment at
      Does your T1D healthcare provider suggest new medications or devices that they think would be beneficial to your T1D management during your appointments?
      not anymore, and I am happy about it! Most of the time they were recommending things that had been recently pitched to them by a pharmaceutical salesperson or a durable medical supplier. The doctors would give patients the "free samples" and it was often not the best fit, then after the "free" supply ran out, the prices were exorbitant. Maybe it still happens, but I haven't seen it for a while.
    • 1 day, 19 hours ago
      Wanacure likes your comment at
      If you have never used an insulin pump with automated insulin delivery (also known as a hybrid closed-loop pump), what are some of the reasons you’re reluctant, or obstacles you’ve encountered? Please select all that apply.
      The need for better CGM accuracy is a big consideration for me. Also my control is pretty good right now (a1c in the low 6 range). Although I am tempted by the sleep and exercise modes which would be very helpful since I’m getting back in to exercise. So…I keep sitting on the fence…
    • 1 day, 19 hours ago
      Wanacure likes your comment at
      If you have never used an insulin pump with automated insulin delivery (also known as a hybrid closed-loop pump), what are some of the reasons you’re reluctant, or obstacles you’ve encountered? Please select all that apply.
      I don’t want to change from the Omnipod Dash to Omnipod 5 because the minimum target blood glucose is level is higher than where I like to keep it. My A1C is currently 5.0.
    • 1 day, 19 hours ago
      Wanacure likes your comment at
      If you have never used an insulin pump with automated insulin delivery (also known as a hybrid closed-loop pump), what are some of the reasons you’re reluctant, or obstacles you’ve encountered? Please select all that apply.
      For the last 5 years, the highest HbA1C I've had was 5.3. For the last 3 years the high, low, & average have been 5.2, 4.7, & 4.9. I'm not willing to go to an AID that sets a target of 6 to 7.
    • 1 day, 19 hours ago
      Wanacure likes your comment at
      If you have never used an insulin pump with automated insulin delivery (also known as a hybrid closed-loop pump), what are some of the reasons you’re reluctant, or obstacles you’ve encountered? Please select all that apply.
      I do MDI. For the last 7 years my A1C has averaged around 4.8. I have no reason to believe that a closed loop automated system could do that well.
    • 1 day, 19 hours ago
      Wanacure likes your comment at
      If you have never used an insulin pump with automated insulin delivery (also known as a hybrid closed-loop pump), what are some of the reasons you’re reluctant, or obstacles you’ve encountered? Please select all that apply.
      There are many reasons, as well as "something else." My arthritic fingers do not serve me well with a cell phone. I have trouble putting the needle covers back on to my insulin pen needles. If I had to take care of all the fine muscle issues associated with setting a pump up, I would probably require assistance. I am also not drawn to the issues I hear about tissue damage at the infusion sites, or knowing whether everything is seated properly and the insulin is actually flowing. Finally, I just have some kind of negative karma with electronics. I have worked as a lab biochemist. Somehow, I find the weaknesses of every machine in the lab. (the ideal industrial beta-tester) Having said that, what I hear about the numbers achieved with the tandem CIQ gives me pause to consider.
    • 1 day, 19 hours ago
      Wanacure likes your comment at
      If you have never used an insulin pump with automated insulin delivery (also known as a hybrid closed-loop pump), what are some of the reasons you’re reluctant, or obstacles you’ve encountered? Please select all that apply.
      Like others, the "closed loop" runs me too high - even the target bg is too high for me. I use the TandemX2 with BIQ integrated wqith my Dexcom G6. I also appreciate - and use - the temp basal function often. I would lose that with CIQ. L:ike Nilla Eckstrom (I think?) I like to be between 80-90, with maybe up to 120 after I eat.
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    When counting your carbs before bolusing, do you factor the amount of protein into your calculation at all? If so, share how in the comments!

    Home > LC Polls > When counting your carbs before bolusing, do you factor the amount of protein into your calculation at all? If so, share how in the comments!
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    Sarah Howard

    Sarah Howard (nee Tackett) has dedicated her career to supporting the T1D community ever since she was diagnosed with T1D while in college in May 2013. Since then, she has worked for various diabetes organizations, focusing on research, advocacy, and community-building efforts for people with T1D and their loved ones. Sarah is currently the Senior Marketing Manager at T1D Exchange. Sarah and her husband live in NYC with their cat Gracie. In her spare time, she enjoys doing comedy, taking dance classes, visiting art museums, and exploring different neighborhoods in NYC.

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    58 Comments

    1. George Lovelace

      I used to when on an Animas with High Protein Meals but with Tandem CIQ I no longer need to

      2
      10 months ago Log in to Reply
    2. karolinamalecki7@gmail.com

      I tend to count it more for dinner because I’m less likely to do
      Activity after. If I’m active during the day, I don’t account for it in my lunch bolus.

      10 months ago Log in to Reply
    3. Lawrence S.

      No. When I count carbs … I count only carbs.

      2
      10 months ago Log in to Reply
    4. Jeff Perzan

      I also douse for 60% of the protein count.

      1
      10 months ago Log in to Reply
    5. Chris Albright

      Yes when the meal is high in protein/fat. Normally bolus post meal since these nutrients usually are delayed regarding BG interaction.

      4
      10 months ago Log in to Reply
    6. Sherolyn Newell

      I adjust for fat, but not protein. The small amount of butter it takes to grill a sandwich requires me to add 10 grams to the sandwich carbs.

      1
      10 months ago Log in to Reply
    7. Nevin Bowman

      I see nutritionists have failed the diabetic community again 🙁

      3
      10 months ago Log in to Reply
    8. Ms Cris

      Always. I found that every 8g of protein=1carb equivalent. I add that up to my total carbs, and that % is my extended bolus over 1-2hrs, depending on fat in my meal.
      At home, I weigh out all my meals. Tedious, but the control is worth it. And I’m better at estimating when eating out! That allows me to treat myself on occasion, too: the cake at birthdays are excursions that have less impact in the grand scheme.

      3
      10 months ago Log in to Reply
    9. Missy Kirchem

      I add 1/2 of the grams of protein to my carb grams

      1
      10 months ago Log in to Reply
    10. P-O Heidling

      As I eat keto/LCHF (<20 grams of carbs/day) I don't count carbs for every meal. Instead I have banned certain foods that I know include too much carbs. The foods remaining are seldom of any problem since the total amount of carbs is very small. I almost always take 2 units of Humalog to every dinner I eat. Makes my life very easy. No counting, no decision making; just bolus and eat.

      I need to "overeat" a lot before the protein has an impact on my bg, but when this occasionally happens (like at Christmas, a summar party etc), I add an extra unit of insulin due to the extra protein. But no counting. Just a visual estimation.

      10 months ago Log in to Reply
      1. Patty Harris

        I do much the same as you. I try not to exceed 25 grams at a meal and consume some keto.

        1
        9 months ago Log in to Reply
      2. Wanacure

        Do you lift weights or do resistance exercises? Has going ketogenic caused you to lose muscle mass? Does it interfere with your aerobics or yoga or Pilates?

        1
        9 months ago Log in to Reply
      3. P-O Heidling

        Wanacure:
        No I don’t lift weights in a gym or similiar. But my house is from 1907, including a large garden, so that has demanded me to do a lot of “muscle resistance work”.
        Besides of that now exercise more than every in my life. The last 3 years I in average spend more than 10 hours/week in different kinds of physical activities. Daily long walks, running (16 miles/week), badminton, and more. So I have more muscles now than 25 years ago (current age is 52). Since I never go “low” in my bg anymore, exercising is no longer a problem, compared to before when I ate a more traditional type of diet (like the SAD diet). Switched to low carb/LCHF 12 years ago.
        See an old article at DietDoctor, https://www.dietdoctor.com/overall-now-completely-new-life

        9 months ago Log in to Reply
    11. Gerald Oefelein

      My understanding is that 40% of meal protein is converted into carbohydrates, so I include 40% of protein only if the meal has a significant amount of protein.

      10 months ago Log in to Reply
    12. Amanda Barras

      Only when I’m eating low carb and have to bolus for the proteins to stop from growing high. If it’s a zero carb meal, I still have to bolus for what gets converted.

      2
      10 months ago Log in to Reply
    13. Patricia Kilwein

      When counting carbs I check for fiber amount. If it’s high enough content I deduct that amount from carb count. The fiber amount has to be pretty good amount tho.

      3
      10 months ago Log in to Reply
    14. Marla Peaslee

      I calculate any type of bean protein into my total carb count.

      1
      10 months ago Log in to Reply
      1. Mark Schweim

        “Bean protein”??? Beans contain more carbs than protein. But they are usually relatively low carb so even with canned baked beans, most of the carbohydrate content is because of the sauce added to the baked beans and the sugar content of that sauce.

        1
        10 months ago Log in to Reply
    15. Janice Bohn

      I use the 8grams of protein = 1 carb

      1
      10 months ago Log in to Reply
      1. KSannie

        Same here

        1
        10 months ago Log in to Reply
      2. Anneyun

        Thank you! I have never heard this. Do you count fats as carbs too? What ratio?

        1
        10 months ago Log in to Reply
      3. P-O Heidling

        That is similar to the recommendation by dr Jake Kushner, see this YT clip https://www.youtube.com/watch?v=FInnC6IMo9g&t=1007s

        9 months ago Log in to Reply
    16. Mary Boudousquie

      I count meat protein if it has a higher fat content. I don’t count lean proteins.

      10 months ago Log in to Reply
    17. Drina Nicole Jewell

      I always count protein/fats and used to bolus for it about an hour and half to two hours after I ate for it. Now I use R insulin and take it about 30 minutes after I eat.

      1
      10 months ago Log in to Reply
      1. ConnieT1D62

        Why, may I ask, do you bolus after you eat?

        10 months ago Log in to Reply
    18. sheffdiane

      I only count carbs for protiens that have fillers like sausague or sugars that may be added like meatloaf.

      10 months ago Log in to Reply
    19. Jim Cobbe

      I increase/decrease only when anticipated protein intake is much more/less than normal; for relatively small deviations from normal, I make no adjustment.

      2
      10 months ago Log in to Reply
    20. kj.mercer

      If eating high protein I calculate 25% of pro and fat as carb. Also just add a few carbs on if high in fat

      1
      10 months ago Log in to Reply
    21. Carol Meares

      When I eat a regular low carb menu, which is often, the amt. of protein and fat is important to figure in. I try to just eat an amount of food that results in a bolus of 3-4 pre bolus and more later if needed, 1-2 units, sometimes as much as 3. It is more of a gut feeling, portion evaluation, and type of food observation rather than counting anything in real numbers.

      4
      10 months ago Log in to Reply
      1. Wanacure

        Sometimes we learn by trial and error. Though I rely on labels and supposedly objective analysis of foods, they sometimes just do not correlate with each other. And sometimes my body tells me something different.

        9 months ago Log in to Reply
    22. RegMunro

      After 55 years I’m still a very poor calculator of what bolts is needed when I’m in trouble But as we eat Banting protein and fat is very important

      10 months ago Log in to Reply
    23. lis be

      I’ve never figured out the right amount to bolus with protein!

      5
      10 months ago Log in to Reply
    24. TEH

      I selected “sometimes”. I rarely eat just a protein food. Most protein foods have some carbs in them. Example is yogurt. Even “no sugar” brands have 7 to 10 g of carbs. I depend on the label.

      3
      10 months ago Log in to Reply
    25. kristina blake

      I usually do include protein and fat in my bolus for meals. I also frequently use extended bolus to acomodate the non-carb items.

      1
      10 months ago Log in to Reply
    26. Eva

      Yes put only if it exceeds a curtain amount. For example, if consuming 4oz of protein then no extra bolus is needed. If consuming say 8oz, I give an extra .5 unit immediately and somewhere between .5 – 1 unit spread over 3 hours.

      10 months ago Log in to Reply
    27. Dave Akers

      I don’t have the time or energy to do all this counting. With TIR as a new and popular metric, I use it to my advantage and not worry about minute details anymore. I don’t care if I’m 120 after a meal or 170 after a meal. If I’m 170, I just inhale a 4u and be on my merry way!
      Gotta pack kids lunch, make breakfast, brush their hair, get myself lookin’ pretty and get off to work. 🙂
      Inhaled works so fast it eases the pressure (for me) of having to be so exact after years of liquid insulin dosing.

      4
      10 months ago Log in to Reply
      1. Patty Harris

        Just wish they would come out with a 2 unit. I don’t weigh enough to take 4 unit.

        1
        9 months ago Log in to Reply
    28. Yaffa Steubinger

      I’m a plant-based eater so I eat a high carb diet, low fat/protein. When I bolus before a meal, I factor the amount of fat in my calculation.

      10 months ago Log in to Reply
    29. sdimond

      I eat less than 40 grams of carbs a day. I dose Novolin-R to cover my protein plus a little Humalog to cover the startup of the meal. I don’t actually count carbs since I don’t eat the suicide diet that the ADA recommends.

      2
      10 months ago Log in to Reply
    30. Kathryn Keller

      I factor in protein for my daughter for breakfast, usually 30% as additional carbs. And once my daughter is asleep she always has a good rise, so I bolus her protein (and fat) from dinner at that point. It depends if she is eating a good amount of fat and protein for lunch if so, I usually wait and do another bolus on the rise.

      10 months ago Log in to Reply
      1. Robin Melen

        Kathryn, can I ask – you bolus for carbs only at mealtime and then again a little bit for protein/fat some time later? Like an hour later? More? Less? I’m new to all this and don’t know where to go to ask!

        1
        10 months ago Log in to Reply
      2. Kathryn Keller

        Hi Robin, For breakfast, I bolus my daughter upfront with extra for protein and fat. Sorry, I miswrote in my previous comment. I figure out 30% of the fat of the meal and 50% of the protein and add that as additional carbs upfront. For lunch and dinner, I only bolus for carbs, but then bolus again once the initial bolus starts to wear off any time from 1.5 to 3 hours later as her physical activity is a bigger factor around these meals. I highly recommend keeping a food journal in the beginning to see how different foods affect you and keep track of how much insulin you gave to improve upon it the next time you have a similar meal. After awhile, you can develop a formula that you find works best for you.

        1
        10 months ago Log in to Reply
    31. qachemist

      The protein/fat content changes when I bolus. Protein/fat affects how fast I absorb the carbs, so if I bolus before a meal with protein/fat, the insulin kicks in before I’ve absorbed the carbs, and I tend to go low.

      4
      10 months ago Log in to Reply
      1. Molly Jones

        Sounds like a similar situation. If I have only protein and/or fat, there is no need at all for bolus. If carbs are added with fat or same amount of protein, I vary between lows or extended highs. I assume digestion is the issue. When I eat high fat meat, I always use lower or extended bolus.

        9 months ago Log in to Reply
    32. ConnieT1D62

      Not usually unless the food has a higher protein & fat content – like pizza, or a mixed vegetable casserole dish baked with dairy, eggs with or without meat, chicken, or fish. It depends on how the food is prepared – whether the protein and plant based food is raw, fried, roasted, baked, or stewed.

      10 months ago Log in to Reply
    33. AnitaS

      I generally only add in proteins if I am eating a larger than normal amount of protein, as if I go to a steak restaurant or get a large burger. Those larger than home-cooked meats shoot my sugar up and it is probably because of the proteins and fats. In those circumstances, I add about 30% more insulin than I calculate normally. I also do that if I eat an egg in the morning as an egg will shoot my sugar up and keep my sugar from coming back down for hours. Because an egg really extends how long my sugar stays risen, I like to eat an egg in the morning on the days where I will be physically active for a good 3-4 hours right after breakfast as the egg keeps my sugar from dropping too quickly. . In addition to adding insulin, I extend my bolus with about 85% immediately and with 15% extended.

      10 months ago Log in to Reply
    34. Juha Kankaanpaa

      I always count protein. When eating low carb, the bolus really is to compensate for the amount of protein. The amount of carbs being small and consistent.

      1
      10 months ago Log in to Reply
    35. ellencherry

      I use a modified Warsaw method if fat and protein are high. I usually end up with one unit or so over for or five hours. It stops the late rise.

      10 months ago Log in to Reply
    36. sweet charlie

      I dont play the bolus game at all…

      1
      10 months ago Log in to Reply
    37. Amy Schneider

      I also add in my fat grams. I figure this works because I eat a high carb diet.

      10 months ago Log in to Reply
    38. Jneticdiabetic

      I only bolus for carbs. If eating high protein or high fat meal, I expect this to slow down carb absorption, so do use the extended bolus feature.
      I’m intrigued by the protein dosing being described here. I have had some persistent highs that take hours to come down after a fatty cheeseburger & fries meal. I always assumed I underestimated the carbs, but maybe not? I’m prone to lows, so am timid about dosing for non-carbs.

      3
      10 months ago Log in to Reply
      1. John Vicars

        I have been T1D for 52 years. I suffer from many complications. One of which is gastroparesis. Animal fat and protein are slow and hard to digest. Carbs and fat/protein present 2 separate and distinct peaks on cgm. I generally eat a plant based diet because it is easier and more consistent to digest. Traveling Monday and spent the night at a Holiday Inn Express. Free breakfast, so I sure wanted to get my money’s worth. Huge breakfast, 4 frozen biscuits, 3 sausage patties, large apple muffin, 3 cartons of milk. Bgl was declining and hit 95 as I started eating. Took 12.0 units of Humalog. Bgl rose to 179 and then started slow decline. I call the second rise the second wave. It started climbing and peaked at 3.5 hours. This was the impact of fat and protein. The peak was 250. It was stubborn to fall and took 7.0 units of insulin. The spike from fat and protein is significant. In individuals with normal digestion it appears with carbs. Patients are told to only worry about carbs and never analyze the impact. Because of gastroparesis I have known and bolused for it for more than 20 years. In the early days, I mixed Humalog and Humalin R, Regular. This worked great. Started pumping and used normal and extended boluses. I want you to think about something. Fat and protein produce a leak. Normal boluses work great for peaks. Basal or extended boluses produce flat lines. With a cgm, I use staggered bolused. The live data allows me to adjust on the fly. Not possible with extended boluses. Think through everything that I have told you, please.

        2
        10 months ago Log in to Reply
      2. Jneticdiabetic

        Thanks for the tips, John! I think my Dexcom and I need to do some fun meal experiments to figure this all out… 🙂

        9 months ago Log in to Reply
    39. Ruth Golmant

      I am on a very low carb diet yet still needed insulin to cover my higher protein intake. I found that I needed to bolus for a full 30% of protein grams on top of any carb to keep my sugars stable.

      1
      9 months ago Log in to Reply
    40. Melissa Childers

      Because I eat somewhat low carb, I have to dose about 50% of g protein as carbs and extend bolus for slightly higher fat meals.

      2
      9 months ago Log in to Reply
    41. Wanacure

      Many years ago I started out on an ADA exchange meal plan. There were fat exchanges, bread exchanges, fruit exchanges, meat exchanges, milk exchanges, and vegetable exchanges and free exchanges. That’s how I learned about fat grams, carbohydrate grams, protein grams in various foods. Nowadays I subtract grams of fiber from total grams of carb to get net grams of carb per serving for fruits and vegetables. Yes, fat and protein grams affect blood glucose but not as fast as net grams carbohydrate. As a kid I eventually learned to count protein as 50% of net grams carb. If I eat 1 to 2 oz of nuts or seeds at beginning of meal it’ll slow blood glucose rise. If my bg is trending low, I’ll eat carbs first then protein and fats last. On another patient site and also by a doctor I was told NOT to go ketogenic if I wanted to build or even just maintain muscle mass. One thing I know: if you increase your fats and proteins and decrease your carbs, you will be able to cut your fast acting insulin (lispro) but may have to increase your long acting insulin (glargine). Will going ketogenic cause me to lose muscle mass or make it harder to add muscle mass when lifting weights?

      9 months ago Log in to Reply
      1. P-O Heidling

        I would say no. As long as you eat enough protein (ideally animal based protein), you will not loose muscle mass. That’s just an old myth about ketogenic diets. But if you cut carbs, minimize protein and fat, you will loose muscle mass (and you will soon feel terrible).
        If you cut carbs, you must provide your body with energy from the other macronutrients and that is protein and fats.
        Please note that when you switch from eating a highcarb diet to a lowcarb diet, you might feel depleted and tired during the first weeks. If you are also currently is doing a lot of exercise, your results will go down the first months. This is due to that you must train your body to use energy from fat, instead of carbs during exercising and that might take some time. Don’t worry, this is just a transition phase, and you will also not loose any muscles during this phase. Add some extra salt to your meals, since it’s rather common to loose a lot of fluid in the beginning when switching to a lowcarb diet, and with that loss of fluid follows a lot of minerals. This lost might cause headaches or feeling tired.
        Read more about this very common issue at https://www.dietdoctor.com/low-carb/keto/flu-side-effects

        9 months ago Log in to Reply
    42. Jeff Balbirnie

      Protein is never used for the math of the dosage calculation itself. It does factor in when you are trying to severely delay a huge spike

      9 months ago Log in to Reply

    When counting your carbs before bolusing, do you factor the amount of protein into your calculation at all? If so, share how in the comments! Cancel reply

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