Can anyone please explain Bolus and carb counting

Hi @Millie_

Your 'fried' brain may be the result of high blood glucose levels rather than cancer treatment but that's another issue.

Do you still have issues with cancer or are you in remission, cured ? On any related medication? I ask because this could also be a contributing factor to high glucose levels.

I will respond to your main question from the point of view of a Type 1 diabetic. The basic premise is simple, the more carbs I eat, the more insulin I require.

Firstly, I estimate all the carbs in my meal, this used to involve weighing portions but now I can pretty much wing it. Then I use a carb to insulin ratio - let's say 10grams of carbohydrate for every unit of insulin so a meal with 40g of carbohydrate requires 4 units of rapid acting insulin. 1 to 10 is a common starting point for T1 diabetics but most of us eventually settle for a ratio that suits our personal requirements and it may be a different ratio for breakfast than the evening meal.

Your lamb stew sounds like a low carb meal unless you had potato or dumplings in it? So I'm not sure why you'd go high overnight unless it has something to do with the factors in 2nd paragraph above.

Millie_ said:

Hi, I've been put on Novorapid, the endicrinologist said to start on 6 units and increase it a couple if that doesn't work, ok, so 20 minutes before i eat i've been taking this jab and 2 days ago I took 10 units but the only carbs i had was in a lamb stew with carrots, brussels and broad beans and i had the most dreadful night, i went up to 19 and woke up on 18 and felt light headed, it's actually the worst i've ever felt since being diabetic. Now, i went through the internet and found a chart and advice saying the lower my carbs the higher the dose and vice versa.. what's all that? as far as the endi's concerned, just up the dose if it doesn't bring my sugars down, i'm currently also on 80 units of Toujeo per day, i was on Canagliflozin until recently but it started giving me boils so hence why i'm now on this Novorapid, any advise would be welcome, i'm trying to understand this chart but ever since i had cancer treatment my brain is fried and i find things ever so confusing.

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Can you give a link to the chart you mention?

The goal of your insulin treatment is for you to get even blood sugars in the background via your toujeo.
If you are being treated still this could be making insulin resistance worse and perhaps you will need additional background.
The novorapid is a meal time bolus to cope with spikes caused by carbs in the meal.
If your blood sugar was very high before your meal because the background bit isn't being controlled the bolus will be hard to get right even if your meal was healthy and had very high quality carbs in it (beans).
Typically type 1s don't have insulin resistance so our carbs to insulin ratio s are going to be different to yours. When starting most of us are advised to match 1 unit of insulin for 10 g carbs but this is definitely an art more than a science!
I'd agree that high blood sugars lead to feeling pretty fuzzy and unwell so it is important to get these down but that should be achieved with the Toujeo and the help of a nurse or doctor checking your blood sugars to adjust the dose appropriately. I hope you have access to some support with that.
Personally I would be sticking to the kind of meal you described because it is low in carbs and slowly absorbed. If you were to eat those kinds of foods (meat, fish, eggs with green veg) you may find your sugars reduce as do your medication needs meaning less jabs and fiddling with boluses).
Best of luck

Millie_ said:

Hi all, Thank you for your replies , @urbanracer I'm in remission but had radiotherapy to my head and since then have had dreadful brain fog, this was just before i was diagnosed with diabetes though i've never been right since. I am type II supposedly. Today for example i took 8 units of Novorapid and had 31g of carbs with breakfast and i'm on 16.5 and feeling like i want to pass out, this is typical for me after any breakfast, what is odd that if i use the low carb bread : under 3grams of carbs per slice i'll still spike to the same levels!! (nearly £5 a small loaf fgs)

No, no dumplings- i wish and no potatoes either, if i do ever have them they're the sweet veriety anyhow but not very often at all, i may have 8 sweet potato fries baked in the oven, i really don't tend to eat over 100 grams of carbs in an entire day, maybe 50 because they just make me feel so ill. @NicoleC1971 Yes, i was high when i got up this morning before i had anything to eat so you're right, my 80 units of Toujeo doesn't seem to be doing much at all, maybe i should ask for a change. I do try and eat healthy as possible, if i could get back down under 8mmol i'd be very happy. I've enclosed a link to that chart i looked at...

https://www.nhstaysidecdn.scot.nhs....atestReleased&noSaveAs=1&dDocName=prod_347963

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The chart works well for dosing boluses but unless you are 'in range' at the start of eating I think you will always be chasing your tail. Do you know your ratio of insulin to carbs?
The trouble with 'healthy' is that it may still be high carb and I don't consider that healthy for someone who is very insulin resistant. For example I'd steer clear of the low carb breads as they tend to achieve their low carb status by making the slices small (the Poundland trick).
Not familiar with Toujeo and there may be a better basal for you or a different dose but the bottom line is to reduce your insulin needs you're likely to need to be filling up ono protein and fat rather than the 'healthy wholegrains'.
I hope the current pattern is a blip and gets resolved though as it is tiring and bad for you to be high like this.

You need to get the basal insulin right - the idea is if you eat nothing your blood glucose levels would be stable and in range. You probably need help from your medical team to get this right.

The chart looks to have grams of carbohydrate each unit of insulin treats across the top.

All I can say a food which makes you feel this bad isn't adding much to your quality of life!! In truth there is no such thing as an essential carb no matter its hue. There's a load of great stuff you can eat without spiking so enjoy finding out if that advice helps but do check bgs before you eat then 2 and 4 hours. iF you were to eat less bread etc. you'd probably end up needing less insulin so do be careful for hypos too.
Good luck and we have plenty of links here for low carb eating tips if you need them.