Carb counting struggles

[diabeticmegxo]

My diabetes has been out of control for ages and I've only recently just got it sorted out I'm back on carbohydrate counting but I'm really struggling to get the bolus right does anyone know what it could be?



-megan

 

[kaylz91]

What seems to be the problem? Could you be more specific? is it that your going low? high 4 hours later etc xx

 

[deborabaratto]

Hey! How are you?
Are you having difficulties in find out the proportion of carbs to match the bolus? Or knowing how much will it raise our BS?

Sent from my XT1033 using Diabetes.co.uk Forum mobile app

 

[azure]

My diabetes has been out of control for ages and I've only recently just got it sorted out I'm back on carbohydrate counting but I'm really struggling to get the bolus right does anyone know what it could be?



-megan

Can you give a little more detail?

There are two aspects here. First, you need to count the carbs right, but second you need to get your insulin to carb ratio right.

There's also a third thing - the timing of your bolus.

 

[diabeticmegxo]

What seems to be the problem? Could you be more specific? is it that your going low? high 4 hours later etc xx

Sometimes I go high but sometimes I go low if I have 36 g of carbs etc I'll do 5 units and still be high xx

 

[diabeticmegxo]

Hey! How are you?
Are you having difficulties in find out the proportion of carbs to match the bolus? Or knowing how much will it raise our BS?

Sent from my XT1033 using Diabetes.co.uk Forum mobile app

It's the carbs matching the bolus and the blood sugars sometimes they go high but I don't know why

 

[diabeticmegxo]

Can you give a little more detail?

There are two aspects here. First, you need to count the carbs right, but second you need to get your insulin to carb ratio right.

There's also a third thing - the timing of your bolus.

I usually get confused with counting carbs because if I have 20 g etc my ratio is 1-8 and my pen doesn't have half a unit so I round it up

 

[kaylz91]

Hmm it sounds like your ratios may not be quite right at times, do your ratios change throughout the day? mines certainly does and lots of others do too, so it might be that, also I would suggest you ask your team for a half unit pen too, it has really helped me, I was given mines by the DSN as we established 1 unit correction was too much for me so its well worth asking about x

 

[Peppergirl]

hi @diabeticmegxo i know it can be tedious but a good start is to record everything - time, BG level, carbs, insulin doses...

 

[diabeticmegxo]

Hmm it sounds like your ratios may not be quite right at times, do your ratios change throughout the day? mines certainly does and lots of others do too, so it might be that, also I would suggest you ask your team for a half unit pen too, it has really helped me, I was given mines by the DSN as we established 1 unit correction was too much for me so its well worth asking about x

My ratio is 1-8 and I am going to ask them about it when I go there next. Thank you x

 

[deborabaratto]

Usually 10g of carbs for me rise 45-50 mg/DL but it depends on the time of day - in the morning I get more sensitive to carbs then in the late afternoon (8g x 12g or something like that).
You can try out some foods because there's also the difference between the body's absorption to the kind of food your eating - for example, one large spoon of white rice gets absorbed a lot faster then and one of sweet potatoes.
For me, the best thing I thought to fix this problem was going low carb so usually I don't have to take any insulin for meals, or max 1 unit of fast acting insulin.

But you can try to eat one slice of bread, with a normal pre meal BG, and not taking any insulin - then, you can check the BG the next 30'/1h and 2h to see what happens. Then the next day, at approximately the same time, eat the same slice of bread (let's say it has 15g of carbs) and take 1u of fast acting insulin and do the same thing as before (measure it 30'/1h/2h later) and check if the dosage you used was enough to lower the post meal BG to the same level as it was before.

Just a suggestion, but I hope it helps! )

Sent from my XT1033 using Diabetes.co.uk Forum mobile app

 

[catapillar]

Have you had a look at the Bertie online course to teach yourself a bit more about carb counting - https://www.bertieonline.org.uk

That should help you assess your own insulin to carb ratio and whether they are different at different times of day, or because of changes in activity. Really, if your looking to analyse whether your I:C ratio is working correctly for you you need to eat meals with not too much fat in (because high fat slows down carb digestion) and a certain carb content (so you need to be confident you know the exact carb content of what you are eating) you need to bolus using your I:C ratio and test to see what your blood sugar is doing 2 hours after eating.

 

[azure]

I usually get confused with counting carbs because if I have 20 g etc my ratio is 1-8 and my pen doesn't have half a unit so I round it up

Get a half unit pen. It makes things so much easier

While you're waiting for that, the other thing you can do is add a small amount of carbs to get your amount up to a multiple of 8 Eg a digestive biscuit is 10g so you can break that in half or whatever to easily add a few carb grams.

My ratios are different for each meal of the day.

 

[diabeticmegxo]

hi @diabeticmegxo i know it can be tedious but a good start is to record everything - time, BG level, carbs, insulin doses...

That sounds like a good idea thank you

 

[diabeticmegxo]

Usually 10g of carbs for me rise 45-50 mg/DL but it depends on the time of day - in the morning I get more sensitive to carbs then in the late afternoon (8g x 12g or something like that).
You can try out some foods because there's also the difference between the body's absorption to the kind of food your eating - for example, one large spoon of white rice gets absorbed a lot faster then and one of sweet potatoes.
For me, the best thing I thought to fix this problem was going low carb so usually I don't have to take any insulin for meals, or max 1 unit of fast acting insulin.

But you can try to eat one slice of bread, with a normal pre meal BG, and not taking any insulin - then, you can check the BG the next 30'/1h and 2h to see what happens. Then the next day, at approximately the same time, eat the same slice of bread (let's say it has 15g of carbs) and take 1u of fast acting insulin and do the same thing as before (measure it 30'/1h/2h later) and check if the dosage you used was enough to lower the post meal BG to the same level as it was before.

Just a suggestion, but I hope it helps! )

Sent from my XT1033 using Diabetes.co.uk Forum mobile app

Okay thank you

 

[diabeticmegxo]

Get a half unit pen. It makes things so much easier

While you're waiting for that, the other thing you can do is add a small amount of carbs to get your amount up to a multiple of 8 Eg a digestive biscuit is 10g so you can break that in half or whatever to easily add a few carb grams.

My ratios are different for each meal of the day.

Okay thank you. I'm hoping to get the pump in October so hopefully things are better before then

 

[diabeticmegxo]

Have you had a look at the Bertie online course to teach yourself a bit more about carb counting - https://www.bertieonline.org.uk

That should help you assess your own insulin to carb ratio and whether they are different at different times of day, or because of changes in activity. Really, if your looking to analyse whether your I:C ratio is working correctly for you you need to eat meals with not too much fat in (because high fat slows down carb digestion) and a certain carb content (so you need to be confident you know the exact carb content of what you are eating) you need to bolus using your I:C ratio and test to see what your blood sugar is doing 2 hours after eating.

I've never heard of it but I will have a look
Thank you