insulin for vegetables

[joanna2468]

my diabetes dietician told me not to take insulin for the carbs in vegetables except for starchy stuff like potatoes; i get that spinach has like 1g of carbs per cup which is negligible but a yellow bell pepper has 12g of carbs which is a lot. I eat mostly vegetables for all my meals and it can really add up. He said the fibre offset the carbs but why not just subtract the fibre from the total carb count?

I feel really paranoid about taking insulin now, like if i have pasta with tomato sauce, do i not count the tomato sauce? if i buy a sandwich from a shop, how am i supposed to figure out how many carbs are in the slices of tomato and onion to subtract from the total carb value on the box? if i have a bowl of bean chilli or a big bowl of salad, not taking any insulin at all is going to make my blood sugars high.

if i take the normal amount of insulin for like a salad, i do notice my blood sugar going down a bit but if i don’t take any at all, i’ll go high. sometimes i think that i’ve figured it out but then i’ll have a salad and my blood sugar will spike to 17.

I need a formula or something to make sense of this, help!

 

[Rokaab]

He said the fibre offset the carbs but why not just subtract the fibre from the total carb count?

Just out of curiosity where are you?
In the UK fibre is already subtracted from the carbs value on nutritional info on packaging.
In the US it is not, so in the US you do need to subtract the fibre from the carb values

 

[Deleted Account]

Welcome to the Type 1 club!
Yes there are carbs in the food you mention but the usual strategy is to focus on the big hitters like pasta, rice, bread. This is because all carb counting is an approximation and, if you inject your insulin, you have to round your numbers up or down to get the whole insulin unit dose.
I eat a lot of veggies so, when injecting (I pump now ... which is different), was to always round up if I had a high veggie meal such as a big salad.

Another thing worth considering (which supports this approach) is your basal insulin.
When working out the dose of long acting insulin, we make the assumption we need the same amount 24 hours a day. In reality, we probably need less when we are moving around during the day but we typically calculate how much to ensure we have a flattish line overnight. This means we have "spare basal insulin" during the day which can mop up some of the carbs from the veggies we eat.

My recommendation is to try to follow the approach your dietician advised. If you have some meals which result in higher BG afterwards, you can adjust your dose up a little bit next time you eat them.

 

[EllieM]

but if you have any sort of dressing on it, odd on that will have either carbs or sugar in it so spike you.

Shop bought maybe, but if you're brought up to make your own dressing (the simplest is 3 parts oil to one part vinegar) no.
Homemade mayonaise (oil plus lemon juice plus egg yolk) no.

None of the home made dressings I make or use have any carbs, though I admit to using some lemon juice at 1g per tablespoon....

 

[Robinredbreast]

my diabetes dietician told me not to take insulin for the carbs in vegetables except for starchy stuff like potatoes; i get that spinach has like 1g of carbs per cup which is negligible but a yellow bell pepper has 12g of carbs which is a lot. I eat mostly vegetables for all my meals and it can really add up. He said the fibre offset the carbs but why not just subtract the fibre from the total carb count?

I feel really paranoid about taking insulin now, like if i have pasta with tomato sauce, do i not count the tomato sauce? if i buy a sandwich from a shop, how am i supposed to figure out how many carbs are in the slices of tomato and onion to subtract from the total carb value on the box? if i have a bowl of bean chilli or a big bowl of salad, not taking any insulin at all is going to make my blood sugars high.

if i take the normal amount of insulin for like a salad, i do notice my blood sugar going down a bit but if i don’t take any at all, i’ll go high. sometimes i think that i’ve figured it out but then i’ll have a salad and my blood sugar will spike to 17.

I need a formula or something to make sense of this, help!

I must admit I am a lover of veg, both cooked and raw. Love home made veggie curry, if I put root vegs in, those grown underground, I do add a little Insulin, if I put a small amount of potatoes in it, then more Insulin.
I know my DSN says we don't need to bolus for veg, but things like fried onions I definitely have to as they release sugars when fried. Just to add I have a 1/2 unit pen which helps a lot, but what works for me, may not be the same for someone else. ps I personally wouldn't worry about veg/salad in a sandwich, as it is so small, it would be the bread that took prevalence.

 

[kitedoc]

Hi @joanna2468,
As others have said vegetable sauces can have added carbs, and below ground grown veggies are starchy plus please look at dietary tables regarding beans, as in baked beans, chickpeas etc, they can vary in carb content between different varieties and some diet programmes count them in and orhers not.
The only sure way is to try a particular food and see how it affects your bsls, usually at the 2 hours mark, although that may depend on
the food - beans except broad beans tend to be associated with longer than usual bsl risees,
amount of fat in the meal - some find more fat slows absortion of carbs,
size of the meal, a meal that fills you up to near bursting seems to up bsls

There are a number of diet options for TIDs, such as exemplified on the Home page of this site under Type 1 Diabetes, and Living with Diabetes. You need to find what works best for you, weight-wise, BSL-wise, general health-wise and a dietitian should know all these options and not be pushing one to the exclusion of others without a good reason.

 

[WuTwo]

I absolutely love veg! I chomp my way through an average 10 portions per day, some raw, some cooked. Some salad, most not.

I bolus for the carb content of any and all veg and it does work for me. It's amazing how it tots up in a meal if you're having lots of different veggies - say carrot, cauli, broccoli, courgette and babycorn - all at the same time. And casseroles are loaded with veg! Carrots are quite sweet, babycorn is a bit carby.

I would always bolus for sauces, whether home-made or shop bought. For home made I tot up the carbs as I make it - so many per ingredient - and since I know how many I'm serving I can work out the carbs per serving of a sauce - usually it's low but I micromanage my diabetes . There tends not to be that much fat in my own sauces, but there is in shop bought and then it's a value judgement of fat to carb.

All beans and legumes are carby as far as a diabetic is concerned. I eat quite a few of them because they are a good source of protein but again, I bolus.

 

[JAT1]

I'm another veggie-lover. I weigh the vegetables and carb count to bolus correctly because even above-ground adds up at the rate I eat them. I don't eat any factory-made dressings. I google the veggies for the carbs and fiber as in Canada we have to subtract the fiber from the carbs for net carbs to insulin for. I inject just before eating as they enter my blood pretty quick. If I'm eating them with fat-laden meat, and the veggies are green, I won't need to inject at all. It's trial, error and learn.

 

[LooperCat]

It’s is a bit trial and error - for example I don’t dose for raw cauliflower but I do when I roast it. I don’t tend to for leaves. It’s all down to experimenting, I’m afraid.

 

[Deleted Account]

Whilst those of us who are experienced with diabetes over ten or more years weigh and count carbs from veggies, as the OP is a Newbie, I believe there is value in simplicity when there is so much to get used to.
Therefore, I have no problem with the advice from the dietician.

And bear in mind, how much estimating and rounding there is in carb counting which is exaggerated when you have no pump so your basal dose is fixed throughout the day and your smallest bolus dose is a whole unit (or half a unit if you are very lucky to have a kids pen). I certainly felt the difference when I reverted back to pens when my pump broke.
Then you remember all the other things (stress, exercise, illness, ...) that can impact BG, missing the carbs from a carrot is not a huge deal.

If someone told me, when I was first diagnosed, to weigh and carb count everything that has more than 5% carbs and to weight and protein count everything, I would just give up and decide this was all too difficult.
Over the years I have refined my weighing and carb counting and insulin dosing but it is not perfect.

<<I will now duck as I see butternut squash, tomatoes, broccoli and onions being thrown in my direction>>

 

[Japes]

I was given the "Don't count vegetables as carbs" when I was started on insulin 16 months ago and certainly at that time it was very sensible, especially when trying to work out what my ratios should be, whilst bringing my blood sugars down from the stratosphere they'd got used to. Even if I did argue with both the DSN and dietician I was used to counting every carb when I was trying to control by diet and meds as a misdiagnosed T2 and they were busy being horrified by my low carb diet, I'm glad now I didn't try to account for veg carbs then.

Now I'm used to how my body reacts to the unholy trinity of insulin, diet and exercise, I do a rough add up of the veg carb count if it's not greens or mushrooms and add on another unit or two if I'm definitely not going to be active after my veg-laden meal, but don't bother to account for it otherwise. But that's just what works for me.

 

[cz_dave]

my diabetes dietician told me not to take insulin for the carbs in vegetables except for starchy stuff like potatoes; i get that spinach has like 1g of carbs per cup which is negligible but a yellow bell pepper has 12g of carbs which is a lot. I eat mostly vegetables for all my meals and it can really add up. He said the fibre offset the carbs but why not just subtract the fibre from the total carb count?

I feel really paranoid about taking insulin now, like if i have pasta with tomato sauce, do i not count the tomato sauce? if i buy a sandwich from a shop, how am i supposed to figure out how many carbs are in the slices of tomato and onion to subtract from the total carb value on the box? if i have a bowl of bean chilli or a big bowl of salad, not taking any insulin at all is going to make my blood sugars high.

if i take the normal amount of insulin for like a salad, i do notice my blood sugar going down a bit but if i don’t take any at all, i’ll go high. sometimes i think that i’ve figured it out but then i’ll have a salad and my blood sugar will spike to 17.

I need a formula or something to make sense of this, help!

Basically, I would say that there are 2 scenarios:

1) If you eat a high carb meal, such as pasta with tomato sauce, you probably don't have to worry too much about the tomatoes in the sauce as the carbs in them will be more or less negligible compared to the pasta.

2) If you eat a low carb meal - let's say a lot of leafy vegetables, a tomato and some nuts, you should still bolus. Personally, I would bolus between 1.5 and 2.5 units, depending on how much and what kinds of vegetables I eat.

 

[mentat]

Carbs are not the only thing that raise your blood sugar. They're just the primary factor if you are eating high-carb meals. Protein and fat can contribute too. This effect tends to be more noticeable in low-carb meals. And, simply, different foods have particular effects on your blood sugar because of how they interact with your body.

I learned from Bernstein's book that when you are eating a low-carb meal, part of the equation is literally how much your stomach is stretched. So in other words how much food you eat. This influences how much glucose is released by the liver at the time. When I have a big low-carb meal I base my dosage mostly on its volume (bearing in mind that a salad, once chewed up, takes a lot less volume than vegetables).

Except for prepacked food or things you cook yourself, carb counting is no better than an educated guess. I wouldn't analyse all the ingredients of a sandwich, just say "the filling is probably 5g of carbs". Or 15. Depends on sauce/mayonnaise/whatever. And because there are other things that affect your blood sugar, I don't believe it makes sense to get carb counts perfect. But learn from experience with particular foods, particular restaurants, and so on.

 

[Marie 2]

I am a vegan and I do generally count the carbs in my veggies. I eat a lot of them! I don't get technical about the exact amount though. Just use a rule of thumb for my normal amounts.