Sunday, November 13, 2011

Does Eating Extra Protein Result in High Blood Sugar?

Even though we're using "advanced carb counting" for Karl's meals, the calculations are incomplete. For example, our diabetes educator and many sources of diabetes information point out that protein will digest partly into glucose, and a "big protein meal, like eating a large steak, will cause a rise in blood sugars," but what to do about this? Most sources are strangely silent.

I've read many times that when diabetics deviate from their normal meal plan -- pizza is often mentioned -- they get high blood sugars even when they do everything "right." So it seems to me that we need a method that's better than "advanced carb counting."

Diabetics on very low-carb diets know that their blood sugars rise more after a meal than the small levels of carbs would indicate, and Dr. Bernstein talks about giving insulin for protein in his book, Dr. Bernstein's Diabetes Solution: The Complete Guide to Achieving Normal Blood Sugars (which has been released in a new edition just this month). He doesn't have as much detail as I'd like, because his approach involves eating the same amounts of protein and carbs with every meal, so his description is a little simplified.

There is whole book about this very topic, or at least I think there is: T.A.G.: A Diabetic Food System, by Mary Joan Oexmann, which covers the effect of protein and fat on blood sugar (in addition to carbs), and what to do about it. Like most interesting books, this one is out of print, but I've ordered a used copy and look forward to reading it.

There's a discussion forum for folks using the TAG system, and I'm starting to absorb the info there:

As I understand it. the T.A.G. system tells you to consider the carbs, protein and fat in a meal. A gram of protein is considered to be equivalent of 0.6 grams of carbs, and a gram of fat is considered to be equivalent of 0.1 grams of carbs.

In a meal with significant amounts of protein or fat, this gives a number much larger than the grams of carbs alone. For example, Karl's current low-carb peanut-butter sandwiches have only 19 grams of net carbs, but the TAG value is 35. If one unit of insulin is the right amount for this sandwich, then, using carb counting, Karl's carb ratio is around 19, but his TAG ratio is around 35. Or something. I need to read the book!

I'm also looking for research on the subject. No doubt the bibliographies in the two books will be helpful.

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