Beyond Carbs in Type 1 Diabetes
In its 2017 update to the Standards of Medical Care in Diabetes, the American Diabetes Association included a new recommendation to assess the amount of fat and protein in meals, in addition to carbohydrate counting, to determine insulin dosing for people with type 1 diabetes on flexible insulin schedules.
"Although carbohydrate is the main nutrient that affects blood sugar, this new guideline recognizes that the protein and fat in foods also have an impact," says Denise Arthurs, MS, RD, at Frances Stern Nutrition Center at Tufts Medical Center. "When a carb-containing meal is higher in fat and protein, that can delay how long it takes blood sugar to peak after eating, and protein may contribute to the rise in blood sugar, with varying effects depending on how much you consume."
If you have type 1 diabetes, are on a flexible insulin schedule and have mastered carbohydrate counting, consult your endocrinologist to determine whether there is a need to reassess how your insulin dosage and timing are determined based on your intake not only of carbohydrate, but also fat and protein.
To learn more: Diabetes Care, January 2017