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Carb Counting (need advice)

J

joelcam

Well-Known Member
Messages
167
Hi all,

I had my latest HBA1C result last week and it was a disappointing 6.7%. I know this isn't a catastrophe but compared to 5.7% and 5.8% on my first 2 this is still disappointing. It was not a surprise though as I did stop my weight training and did have the odd 'bad' thing to eat in the months before I gave blood samples. I also was only checking my levels once or twice
a day - sometimes not at all. (Stupid I know but I am back to checking regularly). I am now training again and eating clean as well as checking my levels more frequently and things appear back on track. I do however need some help with something as I am still getting the odd slightly I high (8-11mmol) where I misjudge my insulin requirements. I also have the odd hypo for the same reason.

When I was diagnosed I was told to just use trial and error, so I recorded everything I ate and how much insulin I used for 3 months...This led to me quickly being able to create a checklist of what to inject and coupled with checking before and after eating it worked like a dream. It was a hell of a lot of work though and not only did it get in the way of work it also got in the way of my family life to some extent. These days I literally just 'look' at my food and go "mmm that looks like 8 units worth of carbs to me". It feels like I need a more scientific way that just looking at something. Sometimes I may be eating out and eating something new so have no clue what to take but I still just guess and although I'm not normally far out I'd rather not do it that way.

I have heard of carb-countin - can anyone advise of the best way of learning this method please?

Thanks

JC
 
If you know what you ratios are...I just "do what is says on the tin". I either look at the packet and see what teh carbs are...and weigh if necessary eg 10g CHO/100grams...so 50 g we 5g CHO. I am lucky, my ratio is 1 to 10. I test vefore the meal...if I am above say 8, I will have a correction dose and teh insulin for the meal...if I am below 4.5, I will have teh insulin for the meal, minus a smidge to avoid hypos...simple as that.

I would love to know if there was a easier way! I am not sure what eating clean means...but I suspect you will weighing lots of stuff out for a while...but then you get to know that30g CHO of say, rice comes up to that blue stripe on the bowl or something.

It is great that you are taking such an active path with this...but I just wanted to add thatyou may be nearing the end of your "honeymoon period" which might affect you HbA1C a little...and 6.7 is still great!
 
The best way would be to go on a DAFNE course if they are available near you. Ask your DSN.

We were lucky in that the hospital dietician trained us before we left hospital with my son.

But 6.7 is still good. I would be delighted if my wee boy's HbA1c came in at that and we carb count religiously!
 
Sugar2 - Thanks for the advice, makes sense I just don't know what my ratios are but I guess that's pretty easy to find out. How do you know I have blue lines on my food bowls though? Are you spying on me?

Annette - thanks. I really feel for you having a little on with T1. One of the things that keeps me going when it gets hard is that at least I am a grown man. I think about my kids becoming T1 every single day and I hope they are lucky enough not to be. I hope all goes well with your boy he must be very brave bless him!
 
Joelcam

I now see a consultant who has been practising for many years and is a pioneer for insulin pump therapy. Your present hba1c is flippin brilliant. My consultant would want you to increase the a1c up a bit more towards 6.9 before she would happy.

Most people can have a very good life being diabetic using insulin with an a1c somewhere between 6.8 to 7.1. There is no need at all for you to try and get your bg levels much lower. By doing so, you will slowly develop variable hypo awareness if it hasn't already happened.
 
joelcam said:
Hi all,
I have heard of carb-countin - can anyone advise of the best way of learning this method please?

Thanks

JC
Click to expand...

As stated earlier best way would be a DAFNE Course if available to you. If not then here is the online version, just register and learn at your own pace......

http://www.bdec-e-learning.com/
 
if Dylans hba1c came in at that i would be delighted we have never had one under 10 and have everything crossed the next one will be after a couple of months on the pump but im sure it wont be anywhere near ur level. plenty of diabetics would love ur hba1c result

anna marie
 
Joel,

To my knowledge the DAFNE course is the best carb counting course available to type 1's, you'll struggle to find anyone who has been on one that says they didn't learn anything or failed to improve their diabetes control.

Nigel
 
I agree with everything that's been said and just wanted to add my voice to those saying 'your HbA1c is brilliant' :
- whenever you see people talking about 'good control' preventing complications in Type 1, they are almost certainly referring to the huge DCCT trial which showed that their 'intensive therapy' group significantly reduced their long term risks by improving their HbA1c.... the intensive therapy group's average HbA1c was 7.3. (Diabetes Control and Complications Trial Research Group, The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin dependent diabetes mellitus. New England Journal of Medicine, 1993. 329: p. 977-985.)
- the majority of Type 1s don't even get to the NICE recommended HbA1c of 7.5. Only a third of Type 1s reach this target. (National Health Service, National Diabetes Audit 2008-2009, 2010, NHS Information Centre: Leeds.)

So, your blood sugar is doing good. Even if it gets a bit worse it's still doing good!
 
I was trained in carb counting when I was diagnosed, 30 years ago this September.
Diabetes UK (when it was still the British Diabetic Association) did a publication called Carbohydrate Countdown which gave all of the carbohydrate figures for ready-made products. I don't know if they still do it.
A DAFNE course would be your best bet these days, but if you can't get on one then your best guide would be to speak to your local DSN (diabetes specialist nurse) and try to get some advice from them.
Most peoples' ratio is about 0.75 to 1 unit of insulin to 10g carbohydrate I think. It could be that you start at the lower end, test and test and test and see whether this gives accurate control. This will also depend on what your background insulin is and how many units of that you take of course.
Many ready-made foods, ready meals, ingredients etc have carbs figures on them in the info on the back. It's worth checking.
Steve
 
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