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Guessing insulin doses techniques

Brownie1993

Well-Known Member
Hi all,

I'm particularly directing this to the people that don't carb count - those that look at a meal and completely guess their insulin doses!

I'm a carb counter and that works for me. However I haven't been carb counting the past week cos I've been travelling in Iceland so have been eating out and eating foods I've never had before/foods whose carbs I have no idea! And my BG levels have been consistently high. Usually my daily average is 4-7mmol but over the past week they've been 8-12mmol. I just simply cannot correctly guess my insulin doses. Unless I count my carbs to the gram, apply my ratios accordingly, my BG levels are never where I want them. I just cannot do it and it's really frustrating me.

So, those that don't carb count, I'm wondering if you have any tips for me? How do you guess the carbs in a meal by simply looking at a plate? I try to use carbs and cals but that doesn't work when eating out cos I don't know how much my food weights. Back in the uk I usually ring up the restaurant and find out the carbs, or look on their website. Unfortunately this isn't possible in Iceland! And next week I'm going to Israel , and I really don't want the same as I've experienced the past week. I just want normal blood sugars!!!
 
For savory stuff I tend to guestimate based on the size of a thick bit of bread.
On average a thick slice of bread is around 20g CHO and I have found that if you stack say some rice, chips, mash etc on a plate to have a similar footprint this seems to give a reasonable approximation I have found.

Pasta etc can sometimes work in a similar way but it can be dependent on the sauce.

Sweets / Deserts. Well all bets are off any it kind of comes down to all out guess work really, though if I go back to the same place again I will look at what my guesses did for me the last time and then adjust up/down depending on how close I was the last time.

It is a hard thing and I probably get it right about half the time if I am lucky.
 
Hi Brownie,
I might be one of those guilty ones, just guessing away as you describe it.
Think though there is more to it than that, as it takes some experience to get it right, as suppose that is what you want to achieve. But do not despair, you will get better and better in this. The first 10 years of my diabetes history as very young boy could potentially be called Hell by some, but that was the life back then even with a very poorly controlled diabetes (compared to the bg standards today). All meals, and I mean all, were weighted on a scale. Each food component was weighted by itself, one by one. I come from a technical family, so all was done in rather scientific fashion. Today recognizing the value and lessons learned back then. All food components were analysed, and sugar contents looked up in books etc. So as to understand the amazing thing that you actually were even 'allowed to' exchange your 120g of boiled white potatoes with 87g of rice (depending on type...). Revolution!
At that time I just got like 1 daily shot of slow-acting, and your day was set in stone. With the exact same diet day in day out. You had to eat to meet your insulin's requirements for sugar. But those years taught you well with regards to how much does different food really weigh and how big/small do they look like when put on your plate. You also learned over the years the approx. contents of carbohydrates in all kind of foods. That together makes it possible for me to 'guess' (an informed guess) about how many carbs are in the meal in front of me today, and I then adjust my insulin shot of fast acting to match that precisely. 18g carbs = 1 unit of Novorapid for me pt. So somewhat bit misleading your description above, as actually not just guessing away. You observe the plate/meal, then approximating the total carb content, considering the components GI and then converting to what insulin dose is required and when to counter that. Btw I always check my bg just before eating/injecting insulin for all main meals. So know if I start from lo/med/high bg level. That helps both to determine optimal injection time (before, start at or after meal?) and the total dose required to keep my bg in good range also after.
 
Google mobile.fatsecret.co.uk
and search Iceland, there you will find calorie and nutrition informations of most Iceland foods. It might help you at least get an idea of how much calories and carbs in their food per serving. Even Israeli foods/recipes has their calorie information in some website.
 
As you said @Celsus, I think it's all down to experience! I've only been diagnosed for a year and it's not been many times at all where I've had to guess (informed guess ) insulin doses. I do eat out sometimes but usually at restaurants where I can google the carbs, and at restaurants I'm used to. Just need to have more practice at it I guess!! (No pun intended!)
 
Hi Brownie1993
in my humble opinion it is a lot about experience -- I have been diabetic for nearly 43 years ( Type 1)
and i ate weighed amounts of food long before the insulins matched the rigid amounts of carbs per day and did it for many years.

these days I am so used to looking at a plate of food i am normally pretty spot on

had fish and chips last night in a restaurant along with a partial portion of curry at about 6:30pm
bolused 32 units for it -- went to bed at 6.3 at 11pm and got up at 6:30am to a 5.5
 
Wow, good stuff @himtoo, it's always a good feeling waking up to a perfect result such as 5.5 following a big meal the night before!
Also, what do you guys do, or what would you do (if you weren't experienced in looking at a plate and 'guessing' insulin dose) when you go to people's houses for dinner with a large number of people. If my parents cook for me, I don't mind, but usually I feel awkward/embarrassed to ask the person for all the ingredients in the meal/to weigh out my portions. I don't want to make it seem like it's a big deal... I know it's vitally important that I get my carbs right but I don't feel comfortable asking my host to do that all the time, especially if I don't know them well...
 
I tend not to ask when I'm out to dinner, I just use the WAG method of carb counting (wild ***** guess). Just compare the food size and volume on the plate to food you know ie bread, rice, pasta, potato. Then try to get a couple of bgl tests in for corrections.
 
Agreed. What's important to get right are all the components on your plate containing the majority of starch/sugar. Typically its only one maybe two components in total. So quickly you will learn how to point them out and also 'sizing them' to quantify their carb content. The list above from Zjed points out the usual suspects.
 

Haha WAG method! Love it!!
 
WAG method! Rofl! Better than mine - the *** method and fix it later if badly wrong.
 
Hi I decided to just guess last night and forgot to take my BS before dinner and my BS was 7.4 before bed so happy with that, but I usually go by the book. But going to try, now and then, to guestamate more, but i do this when out for dinner and try to get it right
 
We oldies who have had Diabetes from a very young age still count carbs, it was drummed into us. I had a pack of cards which showed you the carbs in food, free foods, protein. It is instilled in you how many carbs per meal and to eat protein and veg with your main meal. Free foods will help fill you up to waive off hunger.
 
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