Salad and sugar levels?

[LibreLlama]

Hi everyone, please can I ask for your opinions and advice on something I have been experiencing?

Just to set the scene - I have been diagnosed with Type 1 diabetes for 14 years. I am on a Basal Bolus regimen and use Humalog as my fast acting insulin and Levemir as my background, which I split into an am and pm dose.

I generally have good blood-glucose control with the odd blip, something I’m sure many of you experience. I eat a well-balanced diet with plenty of salad, vegetables, fish, chicken etc. I hardly eat any red meat and keep my carbohydrate and calorie intake within the daily recommended levels. I am not overweight and have a very good HbA1c.

I try to eat a lot of salad and fish etc. for my main meals, which is understandably very low carb, however I consistently experience high post-prandial blood-glucose levels. This is something I initially thought was an anomaly, but it keeps happening and I’m confused as to why. For instance this was the situation yesterday and my meal –

Lunchtime at 1pm – chicken soup and a granary role followed by an apple. I tested and dose adjusted.

Nothing to eat until dinner time at 7pm. My pre-dinner blood-glucose test and reading was 5.7mmol. Perfect

Dinner was a portion of mozzarella and plum tomato quiche, baby lettuce leaves, celery, tomato, cucumber, olives, red pepper, spring onion, a very small piece of grated whisky cheddar cheese, 6 tortilla chips and mayo, salt and pepper and a drizzle of extra virgin olive oil. I had a glass of water as my drink. I dose adjusted correctly for the pastry in the quiche and tortilla chips, taking into consideration the effect of the fat in the oil and cheese. What could go wrong?

My blood-glucose level three hours later was 16mmol. I took a corrective dose of 2 units of my Humalog plus a half unit extra, which should have brought my levels down to around 8mmols, but two hours later my blood-glucose level was still 15mmol, so I took a further corrective dose of 1 unit and this morning was still at 11mmols. I can’t figure out why this would happen with such a low carb meal of salad and vegetables, but it happens every time I have a similar meal, even with fish and chicken rather than something like quiche.

I will make an appointment with my consultant and dietitian, but in the meantime please heeeelp.

Do any of you experienced similar problems?

[Activity2004 Administrator]

The fish and chicken take LONGER TO GET DIGESTED and last longer in the system-- even if they don't get considered carb-related foods.  This happens every so often when I eat them!😀

Let us know what your doctor says.

How's the rest of your day going so far?

[LibreLlama Volunteers in reply to Activity2004]

Thanks, I've heard protein can affect sugar levels, but not sure how. The chicken and fish are usually steamed or lightly pan fried, and according to the Eatwell plate and NHS and goverment guidance they are protien foods that contain zero carbs, so how can this affect the blood-glucose levels? It's a mystery.

My day is going great. How about you? 

Yes, I'll let you know what my doc says. 

I'm going to start wearing the Abbott Freestyle Libre very soon, so that should also give some indication of what is happening. 

[Activity2004 Administrator in reply to LibreLlama]

Is that like DEXCOM?

The protest hangs around for longer periods of time.  Carbs. are used up faster with fruit, vegetables, etc..

My day was busy, but hectic.  I'm sure you can guess why!😀

Sorry for being so late getting back to you.  Will check out the e-mails.

[LibreLlama Volunteers in reply to Activity2004]

It's a CGM style sensor that you wear for 14 days. Instead of taking a blood sample it takes interstitial fluid and measures your BG level from that. You use a handset that you just need to wave across the sensor for a visual reading. The sensor and handset record 24/7 levels with trends and graphs etc. Its awesome. Search Abbott Freestyle Libre on Google and you can see what it is. 

[Activity2004 Administrator in reply to LibreLlama]

So, it's like the DEXCOM WITHOUT WANDS.  Different!  Will look into it.  Thanks.

[oceantragic in reply to Activity2004]

without wands?

[Activity2004 Administrator in reply to oceantragic]

Wands/receiver.

[oceantragic]

If this was happening consistently to my daughter (T1) then I would presume that either we are miscalculating the carbs, or the insulin:carb ratio needs tweaking lower, or we're not bolusing for the protein.

For her 50% of the protein converts to glucose around the 2-4 hour mark, we see the rise on the Dexcom/xDrip/Nightscout, so she will bolus accordingly. If she wasn't using the CGM that day - we self fund so can't afford full time use - and she was having a heavy protein meal then she'd tried any take account of the protein/glucose rise.

The Libre will be brilliant at showing you what's really going on and it would be worth having a meal heavy in protein so you can see what happens to your glucose and how many hours after you've eaten.

[LibreLlama Volunteers in reply to oceantragic]

Thanks Oceantragic. I had heard that protein can have an effect on BG levels, even though that seems illogical. I will do some further testing / process of elimination and see what happens. Yes, the Libre is going to be so helpful to highlight trends and see what is happening to my levels in relation to different food choices. I'll report back  

[oceantragic in reply to LibreLlama]

maybe the rough graph on here might help: lchfliving.org/why-lchf-works/

Sadly logic and diabetes rarely go together, well at least not twice in a row.

[cherv in reply to LibreLlama]

My husband is keto and does not eat carb. of any type or fruit loves veggies. Once and a while I will eat like him his diet, I'm very thin need high carb's very high. I can give evidence that of my eating protein does have an effect on BS. We all have different referent reaction to food.

[LibreLlama Volunteers]

Thank you everyone for your help. It's most appreciated and good to know I'm not going bonkers. I will do some further testing with different proteins and foods and report back. It'll be good to see the trends and results from the Libre too. Oh the joys of living with diabetes :o) 

[Activity2004 Administrator in reply to LibreLlama]

Sounds good.