Faprocar? Profaca? Carprofa? Huh? June 11, 2013Posted by laosita in diabetes.
Tags: Endo, goals
“Okay, so tell me what I just said.”
Never once has a doctor asked me to repeat whatever he just told me. My face must have given me away because he said, “It’s complicated; a lot of people don’t get it.” I did as requested, and nailed it.
“Good,” he said with approval, “let’s see if that helps.”
What was it that I was repeating? A new meal calculation to bolus for protein. Protein + fat bolusing (profa? This needs a name). I’d coasted along with my 1:10 insulin:carb ratio (inject one unit of insulin for every 10 grams of carbohydrate). Pretty simple – I often do the calculation in my head, round up and manually bolus.
But that wasn’t working out quite right, so we added a second part to the equation: fat + protein. The sum of that gets a 1:20 ratio. This sounded like an interesting plan of attack, and I am willing to do the extra math for now. Last week’s lunch was a lettuce and hummus sandwich.
Hummus: Fat 3g, Protein 2g, Carbs 5g, Fiber 1g.
Ezekiel 4:9 Bread (1 slice): Fat 0.5g, Protein 4g, Carbs 14g, Fiber 3g.
The carb (1:10) ratio uses total carbs – total fiber.
For this sandwich, (2 x (14 – 3)) + (5 – 1) = 26. 26 at a 1:10 ratio means 2.6 units.
The profa (1:20 ratio) uses total fat + total protein.
So, (2 x (.5 + 4)) + (3 + 2) = 14. 14 at a 1:20 ratio means 0.7 unit.
Total lunch bolus for what I’m eating (forget exercise or blood glucose corrections) = 2.6 + 0.7 = 3.3 units. Cool.
But, during my endo appointment it slipped my mind that I consciously shop low carb, high protein for a variety of reasons that work for me. Now I have to count protein into my insulin ratios as well? I felt unsettled.
When I look at a nutrition label, I first look at carbs. High carb items usually return to the shelf. Next, I look at protein (I’m still trying to remember to consider fiber). In my mind, the higher the protein without crazy calorie count is a food win. Except now I feel deflated about adding protein.
It seems in diabetes, large numbers often equate to failure, trouble, guilt and exasperation. A low-carb fake chicken breast (vegetarian active chick here) with 15 g of protein adds more insulin, so I question if it’s worth eating. I know that will barely add one unit, and with most meals it won’t be more than a half unit, but it’s yet another number. Another consideration. Another math problem. Another judgment. Another emotional hurdle.
And homemade food? Ha. I’ll let you know how the math is working on that in a year or so.