Do you bolus for protein?

I have heard from two different groups of people on this one.  One group that does not bolus for protein at all, and another who boluses for a portion of their protein.

Somewhere in the big “diabetes info” vault of my brain, I think I can recall something about 60% of the protein you eat gets metabolized into carbs over an extended period.  Does that sound familiar to anyone?

When you eat a meal with a lot of protein, do you find your blood sugars go up much later?  I do.  I think that I need to experiment with bolusing for a portion of the protein, and running that bolus over an extended time.

So, now the meal math gets even more complex (because more complication in my life is exactly what I need, right?).  So we’ve got X% of the protein grams, bolused for over X amount of time, then 100% of the carb grams (minus fiber, if that’s your thing too), plus or minus some insulin based on your current blood sugar.

Is it worth it?

What do you do?

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30 thoughts on “Do you bolus for protein?

  1. My BG goes up when I eat protein only. Been fighting with my DE about this for years. For me there’s evidence. For others, maybe not. The DE is finally convinced!
    If your BG doesn’t go up with a couple of eggs, or a steak, then don’t bolus. That’s easy, isn’t it?
    I’m also one who goes high during exercise, contrary to what most books say. I have to raise my bolus, and then 6 hours later, lower it or watch for lows.
    Everyone’s different.

  2. I wish I were a mathematician and that what worked one day would work again the next day! That’s not too much to ask is it?
    Honestly, I guess a lot. And usually I get high after pizza. I’ve given up on burritos, but I just can’t give up pizza. Every now and then it’s worth the high bs.
    But my mind is still spinning… Let me know if you find something that works!

  3. I am not very senstitive to insulin, and I sure do need to bolus for protein – especially if the meal is low carb and I eat a good amount of protein. I find that chicken hits me at 7 hours pp and steak hits me harder and later, at 8-9 hours. With no bolus, and a steak-only meal, a large ribeye can send me from 100 to 300. So I don’t do a dual wave, I actually do a regular bolus later on. I don’t do a percentage but bolus 1:10 on grams of protein if I have a good estimate of what I eat or otherwise guess.

  4. That is a good question Sarah. I guess in my case (my diet is “weird”), most of my protein comes from things with nutrition labels, so I would have a “grams” figure to work with rather than ounces.

  5. OK! I’m the new kid on the block, but in my short 3 yrs. with T1D, I will up my insulin when eating a larger meal, even if it is protein. When I eat small amounts I bolus for carbs (sometimes minus fiber) only. For large meals I usually give the correction as recommended by my pump, then add a temporary basal rate of 120-150 percent, for a smooth trickle for 30-60 minutes to catch any delayed rise. If my CG sensor line looks like it is dropping too much, I can cancel the temporary basal rate or drop it to say, 60 percent to bring me back where I started. I use this method because it gives me wiggle room to be more active after I eat. I use square boluses, too. I weigh everything, count everything because I’m such a SLOW learner! Fortunately, I love technology, but I’m working on being faster to figure things out. Overall, protein isn’t a very big bump on my radar…yet!

  6. Interesting answers by all.
    I don’t usually bolus extra for fat or protein with a mixed meal, but I do extend the duration of the bolus with excessive amounts of either.
    If I am eating protein only, I bolus for 50% extended, because I have seen relatively large spikes from egg whites alone (and nuts). As everyone mentioned before, YDMV.

  7. Hmm, I’ve been Type I for 28 years and have never bolused for protein, so it can’t be *that* big of an effect!
    … Then again, my BG did rise after I ate scrambled eggs for breakfast… Agh!

  8. hmmmm.i dont/didnt i have a big headache from thinking.i think from my thoughts i dont want anymore info!!!
    lol.the info age is killing going back to the 80s

  9. Isn’t it just crazy sometimes being our own human guinea pigs? I haven’t bolused for protein, but do remember my dietitian showing me how I could experiment and figure out how it affected me with some very regimented eating and lots of testing….which I of course never did. Also learned about glucogenesis in a nutrition class I took, so I don’t doubt that we need to bolus something for protein. Great for the text books, but food loses much of its appeal when it’s part of an experiment that is followed my multiple finger sticks and analysis. Maybe I’ll give it a try now that I have a CGM and can at least skip all the finger sticks. Good luck, and if you figure out the magic formula, please share 🙂

  10. Scott,
    You forgot to mention the exact positioning of the Earth as well as barometric pressure at the time of said bolus. Also wind direction and speed could also be helpful. 😉
    Mr. Cynical 2009
    In all seriousness, for me I haven’t bolused for protein, and lipids certainly seem to slow down digestion for me but I haven’t bolused for those either. Take these statements for what they are worth given above comments.

  11. Hmm, never heard of checking for protein and have never bothered myself. Though – purely for scientific research you understand – I’ll buy a huge steak from the local butchers this weekend, consume it without adding any extra insulin and then report back.
    Yay, steak!

  12. This is something I have been wondering about reccently….
    I was wondering when you say you bolus for 50% or 60% of protein- what exactly do you mean. I realize that this sounds like a ridiculous question but I have been thinking about starting to bolus for protein but I am not sure where to start.
    Protein normally measured in ounces- or do you still use grams when talking about protein. For example you weigh the protein in grams and then use your carb ratio for the 50/60% of the protein weight? Is that correct? I am looking for a starting point. Going to have to do some trail and error but wondering what works for others

  13. I never thought about this, and the other day I had scrambled eggs with cheese for breakfast. I didn’t bolus because, duh, no carbs, but my blood sugar went up to 141 from 103 when I tested a couple hours later. I couldn’t figure it out at the time, but this makes sense! Thank you 🙂

  14. Scott – great post.
    I fall under the ‘never bolus for protein’ category. I wonder if that may be part of my problem with some unexplained highs. I typically only bolus for carbs and might (emphasize “might”) adjust for fiber. I eat a lot of protein too because it doesn’t mess with my BS like carbs do and it fills me up.
    Seriously, why isn’t this just common knowledge for all diabetics. Diabetes has been around for a long time and there should be scientific data on what to bolus for and what is really (I mean really, not iffy or sometimes) FREE food.
    I’m going on a water diet…

  15. Scott,
    I bolus for protein about 50% of its worth. Seems to work for me. I used to eat a “protein only” dinner and not bolus–then I would be high and frustrated. (I thought the point of low carb/no carb was to not have to deal with insulin bolusing) .
    It took me a while to figure out what worked for various proteins.
    Dam Diabetes. It’s tricky. No easy answers for this disease.

  16. I only bolus for carbs.
    For pizza and all the extra fat I will increase my basal for the next 3 hours.
    My famous quote works appropriately here.
    Every day is different and it is not an exact science.

  17. I agree with CALpumper, and others, we are all affected a bit differently, but in general, for me it is the amount of fat in the protein that I am most concerned about. I do bolus a bit for the protein itself, but definitely consider the effect (usually a delayed rise) in my bg level.

  18. Uh, me so confused.
    I thought it depended on the “type” of protein. Of course lean protein (lean fat) – chicken, pork, fish — good for you and not much fat.
    Anything Fried, well, that delays absorption anywhere from 2 to 3 hrs later, after the fact. Ugh.
    SO frustrating.
    I can say for Each person, Each body — it is trial and error as we test each food and how it affects our bg.
    Can’t I just eat and Not think please??? I don’t Ever, ok ok, I digress, I have just eaten But I do know better.
    Anywho – off to eat my version of chicken quesadilla and watching “So You Think You Can Dance.”
    Oh and I just might bolus. 😉

  19. Hmm…this is a new one for me. I have never bolused for protein although, when I have protein with my meals, my sugars tend to be a bit more stable (due to the slower digestion process). Also, if I’m running borderline low (steady around 3.9 or 4 mmol/L), I’ll sometimes have some cheese or nuts and that seems to reduce shakiness and bring my sugar up just a bit – though not enough to bolus (if my sugar isn’t plummeting, having juice at this level will send me skyrocketing). I guess this is another one of those idiosyncratic diabetes issues. Good luck with the experimentation. I’m going to start paying more attention as well.

  20. Scott,
    I count carbs, and nothing else, for me that works. I’m T2, perhaps that makes a difference.
    In fact, for me it works so well I would be afraid to try anything else, “if it ain’t broke, don’t fix it” applies to me.
    Best wishes,

  21. As I recall from HS and AP bio, everything metabolizes down into carbohydrates. The body then uses those carbs (plus the extra nitrogen from protein, plus the assorted trace minerals) to maintain, build, and energize the various cells in the body.
    Now, how much of the breakdown and rebuilding is insulin-moderated… that’s something we didn’t learn.
    Depending on your nutrient intake patterns and nutrient needs, the longer digestion process for fats and protein may be mediated by your basal insulin — then again, it may not be. Test, log like hell, consult your medical team, and adjust as needed.

  22. I dont have a problem with Protein, but Maddison does! Often I will give her a “cheese stick” before bed (or I used to before I realized the problem!) to maintain blood sugars after swimming etc….she always goes high. (7g protein, no bolus) I know ALOT of parents at CWD have pinpointed protein to a science, much easier to do when its your child with “D” becuase you care THAT MUCH about getting every-single food right 🙂
    Fat gets me every time, Maddison too…..
    Anyway….the protein conversion I learned from the parents at CWD was to bolus 60% of the protein. Damn, as if it weren’t hard enough!

  23. Thanks Erica! You are right – I DID forget to mention fat! From what I understand, fat never metabolizes into anything that affects the BG, but does slow down the carbs. Is that what everyone else understands too?

  24. That’s a great question! 🙂 When Tristan was first diagnosed, we were told as an example that peanut butter was free because it was so high in protein. When he went on the pump and we saw a dietitian, we were told that we should correct for the peanut butter. So even if peanut butter has 7g of protein and the carb is 7g, we correct for 7g of carbs. So we never look at protein when correcting.
    But of course, now you have me questioning myself! 🙂 LOL I will ask the next time that we see his diabetes team

  25. Scott,
    You forgot to mention fat and how that plays into the absorption of the carbs!!
    I have no answesr to your questions, only that it makes me head spin and also makes me think that the people who can just count carbs, bolus and go, are either lying or their body works in a very different way than mine does.
    Thanks for this post.