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      August Rossano likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      I answered "No time," but I live in France, where we have a single provider. I receive a prescription from my doctor and go to the pharmacy monthly to have it filled. (Pump peripherals are provided by a separate supplier.) "Appeals" do not exist here since the doctor will only prescribe medicines that are reimbursed. And no, I have never needed a treatment that wasn't covered.
    • 1 minute ago
      August Rossano likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      Much too much time! Part of it, I know, is my own fault, for not keeping anxiety at bay when I have to sort out which plan will work best, annually. But it is something I dread, every single year. When I call to get some help understanding, the people are almost always very nice, but I have had times when the information was incorrect or not explained clearly. I usually commiserate with the person on the phone for having such an annoying system, and agreement seems to rule the day. But I never chose to make sorting out insurance management a career!
    • 3 minutes ago
      August Rossano likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      I selected 6 hours. So far, I have spent 6 weeks trying to get a new pump. I decided to look for a new pump in mid-December as my 770G warranty expired on January 3. I wanted to go hoseless with the Omnipod and the Dexcom 6. I contacted Dexcom and they sent me to the medical distribution company ASPN, and they could do the Omnipod but only with pharmacy part D with the Dexcom 6 sensor on DME My part D pharmacy plan had Omnipod as tier 6. $155.56 co pay and $150/month. The omnypod is not available as DME. I called INSULET the mfgr of omnipod. They told me they only supply via pharmacy plan to get more T2d's to sign up. Verses 100% DME coverage, part D coverage that was a non-starter. I contacted another supply company CCSmed. They could do both Dexcom 6 and tslim x2. Ineeded a Endo visit to get the notes and Rx. I had my Endo visit on Jan 20. Still waiting for CVSmed. Been waiting for 5 weeks now. Just called CCSmed and they got the endo notes and Rx but Medicare wanted to know who paid for my 770G 4 years ago. Fortunately, that was private/company. My new pump should now ship tomorrow. Finally.
    • 3 minutes ago
      August Rossano likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      The beginning of the year is always a bit iffy when you're on Medicare. Even though I've already paid my annual deductible, my pharmacy can't see that, so I must wait until it shows up on my Medicare account before I order new insulin. I always try to have plenty of insulin on hand at the end of December so it's not an issue. The organization I get my pump equipment from has a lot they must do because of Medicare, as well, and that can get time consuming. All-in-all, I'm lucky to have the time, energy and patience to deal with it, and I know up front these time-consuming moments are to be expected. If I wasn't retired, it'd be more of an issue.
    • 3 minutes ago
      August Rossano likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      I said 8+ and the reason, as for so many others, can be summed up in a phrase: transitioning to Medicare.
    • 39 minutes ago
      Wanacure likes your comment at
      On a scale of 1-5, how satisfied are you with your current insulin delivery method (pump, pens, syringes, inhaler, etc.)? 5 = the most satisfied, 1 = the least satisfied
      I’m a reasonably satisfied MDI user with Lantus and Fiasp. I’ve looked into getting a pump but honestly, until I find one that does everything I want, I’ll probably hold off. My wish list for a pump: 1) no tubes 2) works well with Fiasp 3) controls that allow me to stay at my target of 70-90 mg/dl all night long.
    • 50 minutes ago
      Wanacure likes your comment at
      On a scale of 1-5, how satisfied are you with your current insulin delivery method (pump, pens, syringes, inhaler, etc.)? 5 = the most satisfied, 1 = the least satisfied
      MDI for the past 60 years and do not see any alternative that I would prefer. The needles for my pens are so thin and sharp that they are painless (a far cry from the lancets I once used). chiefly, I am glad not to have to deal with setting up a pump and. Although I love my libre, I am not good candidate for having devices affixed to me. If my insulin delivery got interrupted they way i have interrupted my cgm service, I would have been in trouble. Furthermore, I have a track record of having both mechanicall and electronic things malfunction. (Seriously, I sometimes act as a beta-tester for technology folks. Maybe I push to many buttons?)
    • 1 hour, 2 minutes ago
      Wanacure likes your comment at
      On a scale of 1-5, how satisfied are you with your current insulin delivery method (pump, pens, syringes, inhaler, etc.)? 5 = the most satisfied, 1 = the least satisfied
      I've had Tandem x2 and Dexcom since September. Previously on Medtronic for around 15 years. Grew to HATE the sensors and switched before the warranty on my last Medtronic was up. So far, I absolutely LOVE the Tandem and the Dexcom. I'm disappointed, however, in the amount of waste and plastic that this pair creates. Of course there will always be plastic waste from any pumps/sensors, but the amount of non-reusable stuff for insertions is ghastly.
    • 1 hour, 3 minutes ago
      Wanacure likes your comment at
      On a scale of 1-5, how satisfied are you with your current insulin delivery method (pump, pens, syringes, inhaler, etc.)? 5 = the most satisfied, 1 = the least satisfied
      Have your doctor prescribe the syringes with .5 unit increments instead of the 1 unit syringes. Not quite a .1 unit which you are hoping for, but .5 is better than 1 unit increments.
    • 2 hours, 19 minutes ago
      Ahh Life likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      I answered "No time," but I live in France, where we have a single provider. I receive a prescription from my doctor and go to the pharmacy monthly to have it filled. (Pump peripherals are provided by a separate supplier.) "Appeals" do not exist here since the doctor will only prescribe medicines that are reimbursed. And no, I have never needed a treatment that wasn't covered.
    • 4 hours, 10 minutes ago
      ConnieT1D62 likes your comment at
      In your own words, how would you describe the feeling of a severe low?
      Nothing short of terrifying. I often go into seizures, having no idea where I am, who anybody, or even if I’m alive or dead. I’ll feel like I’m falling or hurtling toward something. At home I feel like my house is tilting. Im leaving a lot out but these are some of the scariest things.
    • 4 hours, 15 minutes ago
      Modee likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      Most of Europe has the right idea! Is it a good health system for you overall? The US may be too large to implement a national system, but that doesn't hold states back (as long as there is federal money to help).
    • 4 hours, 15 minutes ago
      Modee likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      I answered "No time," but I live in France, where we have a single provider. I receive a prescription from my doctor and go to the pharmacy monthly to have it filled. (Pump peripherals are provided by a separate supplier.) "Appeals" do not exist here since the doctor will only prescribe medicines that are reimbursed. And no, I have never needed a treatment that wasn't covered.
    • 4 hours, 17 minutes ago
      Modee likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      I said 8+ and the reason, as for so many others, can be summed up in a phrase: transitioning to Medicare.
    • 4 hours, 19 minutes ago
      Modee likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      PUMP USERS: Just in case nobody has told you, if you use a pump, Insulin is considered durable medical equipment, which can save a lot of money, even with the new price cap
    • 4 hours, 27 minutes ago
      Samantha Robinson likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      Just spent an hour and a half on the phone with insurance the other day trying to switch to Dash pods and nothing was accomplished....
    • 4 hours, 33 minutes ago
      beth nelson likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      Normally, no time spent but I changed insulins so I wanted to verify everything with my insurance company before asking my endocrinologist to write a new script.
    • 4 hours, 34 minutes ago
      beth nelson likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      I answered "No time," but I live in France, where we have a single provider. I receive a prescription from my doctor and go to the pharmacy monthly to have it filled. (Pump peripherals are provided by a separate supplier.) "Appeals" do not exist here since the doctor will only prescribe medicines that are reimbursed. And no, I have never needed a treatment that wasn't covered.
    • 4 hours, 35 minutes ago
      beth nelson likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      I said 8+ and the reason, as for so many others, can be summed up in a phrase: transitioning to Medicare.
    • 4 hours, 52 minutes ago
      Jeff Marvel likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      I expect that we’ve all had that feeling about how stupid payers can be when it comes to T1D.
    • 4 hours, 52 minutes ago
      Jeff Marvel likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      Seriously depends on when you ask. The past 3 months have only been an hour or two, but if you'd asked this same question last September it would've been over 8 as I dealt with the annual "Yes I need a Dexcom and Omnipod again" red tape with my insurance/providers/doctor's office. I am counting the time on hold as well, but still - pretty ridiculous that insurance thinks Type 1 is going to magically go away just because it's been a year. I wish!
    • 4 hours, 52 minutes ago
      Jeff Marvel likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      The last 3 months have been filled with frustrating phone calls now that I switched back to traditional Medicare from a Medicare Advantage plan. I have been fighting to get strips authorized in addition to CGM- they did not authorize them because I had no proof that I had a meter!! Crazy making! I had to write an appeal letter in order to get them, but finally got it worked out. I also had some pump replacement issues, trouble getting insulin, etc.
    • 4 hours, 53 minutes ago
      Jeff Marvel likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      I answered "No time," but I live in France, where we have a single provider. I receive a prescription from my doctor and go to the pharmacy monthly to have it filled. (Pump peripherals are provided by a separate supplier.) "Appeals" do not exist here since the doctor will only prescribe medicines that are reimbursed. And no, I have never needed a treatment that wasn't covered.
    • 4 hours, 53 minutes ago
      Jeff Marvel likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      Much too much time! Part of it, I know, is my own fault, for not keeping anxiety at bay when I have to sort out which plan will work best, annually. But it is something I dread, every single year. When I call to get some help understanding, the people are almost always very nice, but I have had times when the information was incorrect or not explained clearly. I usually commiserate with the person on the phone for having such an annoying system, and agreement seems to rule the day. But I never chose to make sorting out insurance management a career!
    • 4 hours, 53 minutes ago
      Jeff Marvel likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      I said 8+ and the reason, as for so many others, can be summed up in a phrase: transitioning to Medicare.
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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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    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
      5 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.

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

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

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

      I also douse for 60% of the protein count.

      1
      5 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
      5 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
      5 months ago Log in to Reply
    7. Nevin Bowman

      I see nutritionists have failed the diabetic community again šŸ™

      3
      5 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
      5 months ago Log in to Reply
    9. Missy Kirchem

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

      1
      5 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.

      5 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
        5 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
        5 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

        5 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.

      5 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
      5 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
      5 months ago Log in to Reply
    14. Marla Peaslee

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

      1
      5 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
        5 months ago Log in to Reply
    15. Janice Bohn

      I use the 8grams of protein = 1 carb

      1
      5 months ago Log in to Reply
      1. KSannie

        Same here

        1
        5 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
        5 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

        5 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.

      5 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
      5 months ago Log in to Reply
      1. ConnieT1D62

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

        5 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.

      5 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
      5 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
      5 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
      5 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.

        5 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

      5 months ago Log in to Reply
    23. lis be

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

      5
      5 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
      5 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
      5 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.

      5 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. šŸ™‚
      Inhaled works so fast it eases the pressure (for me) of having to be so exact after years of liquid insulin dosing.

      4
      5 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
        5 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.

      5 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
      5 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.

      5 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
        5 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
        5 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
      5 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.

        5 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.

      5 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.

      5 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
      5 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.

      5 months ago Log in to Reply
    36. sweet charlie

      I dont play the bolus game at all…

      1
      5 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.

      5 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
      5 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
        5 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… šŸ™‚

        5 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
      5 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
      5 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?

      5 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

        5 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

      5 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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