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Re: [IP] delayed BS rise

Wayne Mitzner wrote:
> Vicki, I've noticed the same thing after big restaurant meals.  My
> interpretation is different from Randall's.  I think it is related to the
> protein.  As much as 50% of protein can get converted ot sugar, and this
> takes several hours.  When I eat out, there is often a lot of protein,and I
> usually don't figure this into my boluses.  For example a 1/4 pound burger
> is about 115g--if half of this gets eventually converted to sugar, that
> would require in my case about 4 U of insulin.  And if I didn't take that
> insulin, my BS would go up almost 200 mg/dl.  Now about that 8 oz filet
> mignon.....
>          I don't know if the increased fat can slow carbohydrate absorption
> down for the length of time needed to explain what I experience (often 6- 8
> hours after eating), but as they say YMMV.
> - -wm

Wayne, I agree 100%!
Over the years I've always suspected, but have never been able to
quantify (or get a doctor to agree), that a high protein meal causes a
big rise in bg some hours later. This is not high fat delaying the
digestion of carb, but protein being turned into carb several hours
later, and requiring even more insulin.

The Minimed book ("Insights from the Experts") states in its "Can
protein effect blood glucose?" section:
"Sources suggest that 50 to 70 per cent of protein can be... converted
into glucose... However, few controlled studies in diabetic persons have
been done to quantify the effects... The apparent effect of protein on
blood glucose seem to occur some hours after eating."

In other words, you've got to work it out for yourself. But knowing that
this could be an effect is half the battle.

So what do you do after that late night steak house blow out?

1) Run a v high bg at 4am and feel awful...
2) Take an extra square-wave bolus at 3am and run the risk of a bad hypo
while you sleep, and feel awful...
3) Get up every hour through the night and check your bg, so get no real
sleep and feel awful...
4) Not have the steak in the first place, and feel awful!!!!

Tricky. Probably a mixture of 1 2 & 3 is best. Increase your night time
insulin, but aim a bit high, and get up once or twice to check
everything's going fine.

A lot of people have posted stories of big highs after high fat/protein
meals (which often go hand in hand). So bare in mind that more than half
of the protein MAY hit you as glucose some hours later.

Oh the joys of tight control.


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