Type 1 diabetic — how do you hit higher protein without spiking insulin resistance?
Type 1 for 12 years, 34M, using a 770G pump with CGM. Trying to add some muscle over the next year (currently skinny-fat at 172 lb / 5'10).
My endo suggested aiming for 1.6 g/kg protein — so about 125 g/day. But I've read in multiple places that very high protein diets can worsen insulin resistance in T1s, and that gluconeogenesis from excess protein can cause weird delayed blood sugar rises.
Anyone else threading this needle? Does 1.6 g/kg actually cause issues, or is that mostly theoretical? How are you dosing for protein-heavy meals? Splitting insulin? Extending the bolus?
T1 for 22 years. I've been running 1.5-1.8 g/kg for about 8 years during lifting seasons. The "insulin resistance worsening" thing is overstated. What's real is that protein requires some insulin for amino acid disposal — typically 50-60% of the bolus you'd need for an equivalent carb load, spread over 3-5 hours.
Extended bolus is your friend. On my 770G I use a 50/50 split over 4 hours for meals above 40g protein. Works beautifully.
Another T1 lifter here. Dose protein at roughly 0.3-0.5 units per 10g of protein above your baseline, extended 3-5 hours. The CGM will tell you if you got the split right. After a few weeks you learn your personal ratio.
Evidence summary for anyone lurking: the "very high protein causes insulin resistance" line comes from some old T2 studies and a few rodent papers. In T1 specifically, the clinical evidence does NOT support it at 1.4-1.8 g/kg ranges. Above 2.5 g/kg there's some weak signal. At 1.6 g/kg you're fine physiologically; the dosing logistics are the real puzzle.
One thing nobody has mentioned: distribute protein across meals. Four 30g doses across the day is far easier to manage than one 120g dinner. The spread smooths both the MPS signal AND the insulin requirement.
Okay this is all gold. Starting today: 4x 30g spread across the day (breakfast, lunch, afternoon shake, dinner), extended bolus 50/50 over 4 hours for anything above 35g, CGM to adjust ratios.
@T1_Thomas one thing I wish someone had told me earlier — your basal needs will probably DROP slightly as you add muscle over months. Muscle is insulin-sensitive tissue. Don't be surprised if you're chasing lows 3 months in and have to reduce basal 10-20%. Good problem to have.
Adding as non-T1 but sports-nutrition adjacent: creatine monohydrate 3-5g/day is safe in T1 (no kidney complications in the T1 literature) and gives you a measurable strength boost. Cheap intervention.
Second the creatine point. Also — don't skip carbs pre-workout. Lifting fasted as a T1 is a great way to go hypo mid-set. 15-25g fast carbs + a small bolus covers you for a 60-min session.
6-week update: protein spread is working. Had to adjust extended bolus split to 40/60 (front-loaded slightly more) for dinner specifically. Gained 3 lbs on the scale, CGM time-in-range actually improved from 68% to 74%. Pump is great. Endo is happy. Thanks all.