How to be accurate?

[lizdeluz]

Before eating, I try to calculate the carbs in my meals and inject to match. I use foodfocus.com to log my food intake afterwards and quite often find that I have MISCALCULATED and therefore my dose is inappropriate!
Those of you who are good at doing this, could you give me some advice on how to organise myself to be more accurate?

 

[forge]

I found, when I was jabbing for T2, that it was all about eating to a routine then the jabs remained the same.

 

[AlexMBrennan]

If the problem is calculating the correct dose, as you suggested, then you could either try have more consistent portion sizes (eliminating the need to do calculations because you know that you'll have the same amount each meal) or use a tool (many BG meters now come with a insulin dose wizard which recommend insulin dose based on current BG level and food eaten)

 

[jack412]

a set of measuring cups and a set of scales, some you can even enter the food you are weighing and it will tell you the carb protein and fats.
http://food-scales-review.toptenreviews.com/eatsmart-digital-review.html

something's are easier by weigh, some are easer with, 15g of carb is a 1/2 cup of this or 1/3 of a cup of that
I tend to use measuring cups when I count carbs

keep googling carb counting till you find a system that works for you

 

[ElyDave]

I found, when I was jabbing for T2, that it was all about eating to a routine then the jabs remained the same.

the thing I find is that however accurately you measure your carbs, there are also so many other factors that could affect the dose-response relationship that this is as much an art as a science. Off the top of my head now, I can think of
- timing
- site
- absorption
- coughs, colds, illness
- recent exercise
- weather
- a day with a Y in it

all of which can affect how you respond to the dose. If there are foods that you know give you an issue, or need treating differently try and work those out, for example I need to dose at least 15 minutes before I eat any significant amount of bread.

 

[noblehead]

Dave makes some good points with the above on why postprandial bg readings can vary.

Certainly weighing the food before serving will help immensely, as will getting a good carb counting book such as the Calorie Carb & Fat Bible 2014, using a half unit pen for injecting your bolus dose will also help, as your using Novorapid ask your DSN or GP for the Novopen Echo if you haven't got one already.

Carb counting courses like DAFNE are worthwhile to take and covers carb counting as well as all the points that Dave made in his post (well most ) so you should ask about enrolling on one if you not done so before, see if the following might help as it's an on-line course similar to DAFNE:

http://www.bdec-e-learning.com/

 

[PaulinaB]

How do you know you miscalculated? Your ratios may be wrong, then even if you calculated correctly, the dose would still be wrong

 

[Daibell]

Hi. I might add to ElyDave's list both fat and protein as they do have a small effect on blood sugar as well as delaying carb absorption. I think many of us find it's a large amount of guesswork so I under inject if I'm driving but go a bit higher if at home and can manage hypo symptoms more easily.

 

[yingtong]

I still use scales to weigh my portions,I have done this for over 50 year and I try not to guess as tend to guess wrongly.

 

[ElyDave]

I still use scales to weigh my portions,I have done this for over 50 year and I try not to guess as tend to guess wrongly.

I do the same, but I guess and then check with scales.

You're right though how easy it is to over/underestimate, which is a perennial restaurant problem for me.

 

[noblehead]

I still use scales to weigh my portions,I have done this for over 50 year and I try not to guess as tend to guess wrongly.

Not as long as you Yingtong (33 years) but I still weigh my carb portions at home, even though I have porridge for breakfast most mornings I still weight it out first, yet when I eat out I nearly always guess the carb value right within reason .

 

[ElyDave]

Not as long as you Yingtong (33 years) but I still weigh my carb portions at home, even though I have porridge for breakfast most mornings I still weight it out first, yet when I eat out I nearly always guess the carb value right within reason .

porridge I'm ok with now, same mug, half full = 30g, to the brim = 60g for two portions.

 

[gmitch_type1]

I use Carbs and Cals app, it's also backed by my local hospital. I find the photos of the portion size helps as it is easy to use in restaurants etc... And you don't need to worry about weighing your food etc

 

[lizdeluz]

Thank you all for your replies. I feel annoyed with myself that, after 30 years of being Type 1, I still feel like a novice when it comes to adjusting my doses. I take heart from the fact that, as @ElyDave says, it's not an exact science, is it? - there are so many variables and unforeseens, days with a Y in, as in Sh***y Day, then? And then, as @PaulinaB says, have I got my ratios right? After 30 years, I feel I should have sorted this already long ago. Still, never too late, and I'm really glad to learn from everyone on here. I will take your advice.

 

[Hooked]

Thank you all for your replies. I feel annoyed with myself that, after 30 years of being Type 1, I still feel like a novice when it comes to adjusting my doses. I take heart from the fact that, as @ElyDave says, it's not an exact science, is it? - there are so many variables and unforeseens, days with a Y in, as in Sh***y Day, then? And then, as @PaulinaB says, have I got my ratios right? After 30 years, I feel I should have sorted this already long ago. Still, never too late, and I'm really glad to learn from everyone on here. I will take your advice.

Definitely look into going on a DAFNE course, or similar at your local hospital. I found it of huge benefit after over 25 years of diabetes and my only education was from when I was diagnosed and on two injections a day.
Carbs and Cals book or app are great and I've recently discovered Myfitnesspal app where you can even scan in barcodes for carb content.
Weighing scales are a must too.
Good luck!

 

[PaulinaB]

Thank you all for your replies. I feel annoyed with myself that, after 30 years of being Type 1, I still feel like a novice when it comes to adjusting my doses. I take heart from the fact that, as @ElyDave says, it's not an exact science, is it? - there are so many variables and unforeseens, days with a Y in, as in Sh***y Day, then? And then, as @PaulinaB says, have I got my ratios right? After 30 years, I feel I should have sorted this already long ago. Still, never too late, and I'm really glad to learn from everyone on here. I will take your advice.

I think ratios can change with age? Please correct me if I'm wrong so that's one possibility, especially if your doses wrong often and your counting seems ok.

 

[lizdeluz]

I think ratios can change with age? Please correct me if I'm wrong so that's one possibility, especially if your doses wrong often and your counting seems ok.

Yes, I'm sure you're right. I keep putting off the evil day when I test my basal and the other evil days when I test my time of day boluses.

 

[ElyDave]

I forgot to add the meter error, which could be up to 20% either way, so you could calculate correctly and dose appropriately, but have errors in the measurements that suggest otherwise.

That's one reason not to make adjustments on on or two readings but to look at patterns. That was a useful learning to take away from DAFNE for me.

 

[lizdeluz]

I forgot to add the meter error, which could be up to 20% either way, so you could calculate correctly and dose appropriately, but have errors in the measurements that suggest otherwise.

That's one reason not to make adjustments on on or two readings but to look at patterns. That was a useful learning to take away from DAFNE for me.

I don't know what's the matter with me, but when I look at my results, -( and I do 6-8 tests per day!) I fail to see patterns, I just see thousands of one-offs and therefore I never feel confident to do anything but look at them.

I don't want to do myself down, but .... I think my problem stems from my diagnosis 30 years ago, believing at the time that the HPs knew best and would tell me what to do, (but of course they can't really), life was busy and I didn't have time even to do a good job of monitoring my results, and I never progressed from that approach. Still, I can start now.

 

[jack412]

@lizdeluz something in this might help
http://www.diabetesinscotland.org.uk/Publications/9224 Overview of Carbohydrate Counting.pdf

http://www.diabetesinscotland.org.uk/Publications/9225 Carbohydrate Counting.pdf
http://www.diabetesinscotland.org.uk/Publications/9226 Carbohydrate Counting the Next Steps.pdf

http://www.diabetesinscotland.org.uk/Publications/9227 Carbohydrate Tables A6.pdf
http://www.diabetesinscotland.org.uk/Publications/9228 Free Diary Portrait A4.pdf
usa numbers
http://www.bd.com/us/diabetes/download/insulin_adjustment_workbook_complete.pdf