Is a carb just a carb?

@SugarBuzz hopefully you will get some answers from someone more knowledgeable than me, but RE the food packets, you want the total carbs, so in your example it would be the 23g you are looking at.

If you are having a lot of hypos, are you sure your ratios are correct? A basal test would probably be a good place to start.

In theory, a carb is just a carb, but you may find with meals that are particularly fatty, or low in carb and high in protein, it is more of an art than a science, but the first thing to do is to get your ratios sorted and your basal correct. When your basal is sorted, you can look at your ratios, which ideally your DSN should be helping you with.

Hope some of that helps.

Can you tell us a little bit more about when the hypos are happening?

You just look at total carbs, the 23g part (although if 17g of which is sugar, that's probably a fast acting carb).

If carb counting is causing a lot of hypos maybe your ratio needs adjusting?

You say you've not started training yet, the Bertie online course is a good guide to carb counting and working out your ratio - https://www.bertieonline.org.uk

I always use the GI index (glycemic index) it tells you the effect of food on blood sugar and the rise in it after 2 hours

If you search in Wikipedia on glycemic index it gives a good overview what is is

As everyone recommends, figure out your ratios. If you need to adjust them, adjust them slowly and err on the side of running a bit too high. It's easier to correct a food induced high than to deal with hypos all the time. The training should help with that!

I personally find that the timing of the insulin is important on whether a carb is just a carb. If I want something sweet, I know that it will spike my bloodsugar in under an hour (peaking starts at 30-45 minutes and lasts up until an hour or two). Rapid acting insulin peaks at about an hour to 90 minutes, so I try to inject at least 20-30 minutes before a sweet treat. This means the insulin is already working in my system before the sugar gets there, so it evens out the curve. It doesn't matter whether it's a sugar-free white bread or a straight up sugar laden cookie, they act the same. 'Complex carbs' only become 'complex' when paired with other foods that are fatty, fiber or protein rich.

If I'm eating fatty foods (like the odd serving of fries) I have to split bolus because the fat will delay when the carbs kick in. For me that's usually around 4-6 hours. If I have dinner at 6pm then I usually take 40% of my insulin for those carbs right as I begin eating (I don't spike very fast with fatty foods so that's totally okay). Then after 4-5 hours I test to see where I'm at. I might still be around 6 and low 7 and that's fine. I do test again an hour later, but whenever I'm hittinghigh 7 or 8 (or higher) I take the remaining 60% of my insulin for those carbs because that's when the rest kicks in.

Fibers are the only thing I deduct from my carb counting, unless the packaging says they already deducted them. I know there are differences per country so the training will probably tell you what to do with that.

So in summary, the key points in carbs:
- Your ratios should be determined first, the rest doesn't work until you have this info.
- Plain carbs without fat, fibers or protein will spike you within an hour or so, regardless of whether they're simple or complex.
- Timing of the insulin injection differs per kind of food. This is individual, so you'll have to test, but can affect your levels for the better if done right.
- Err on the side of caution. Better to be slightly high and correct with small injections than have a big hypo to deal with out of nowhere.

maria030660 said:

I always use the GI index (glycemic index) it tells you the effect of food on blood sugar and the rise in it after 2 hours

If you search in Wikipedia on glycemic index it gives a good overview what is is

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That can be super useful, I agree! I do recommend taking the GI with a small grain of salt - some foods that are low GI still spike a lot of people, so it's best used as a guideline until you've found what works for you individually.

Yes pizza for instance is not worth the hassle for me

I find that a carb is not just a carb all the time.
Although I do not use insulin I have known for a long time that the carbs from some foods affect me more than the same number from other foods - I checked when I got a meter and the foods which stopped me losing weight are the same ones that cause high BG levels at 2 hours after eating.
If it is any help, I eat the foods allowed on Atkins Induction plus the first few rungs in the Carbohydrate ladder up to No 4, berries, which I try to eat in moderation.
I can get 11.4 on the meter by eating grapes and strawberries on the same day, even if I do not eat the salad and veges which would be equal to the same number of carbs.
It could be that you have removed the denser carbs from your diet trying to get control - those on the higher rungs, you now need to alter the amount of insulin per carb for the lesser types you are eating, and/or adjust the timing, as I imagine things with sugar are swifter to affect BG - having avoided most things with sugar since diagnosis I have no evidence of how they affect me on my meter.

maria030660 said:

I always use the GI index (glycemic index) it tells you the effect of food on blood sugar and the rise in it after 2 hours

If you search in Wikipedia on glycemic index it gives a good overview what is is

Click to expand...

That's what I do too. Glycemic Index. For instance fruits: strawberries (in fact most berries) low, pineapple higher, dates high too. Sweet potatoes lower the white (go figure!). Whole wheat pasta lower than white. I don't take as much insulin per grams of carb eating lower glycemic foods, which is most of the time. Thin crust pizza I can get away with, the thick crust gets me every time, so I avoid it.

Glycemic load not index is actually more useful when measuring the effect that it'll have on your blood glucose.

As for types of carbs:

TheBigNewt said:

I don't take as much insulin per grams of carb eating lower glycemic foods, which is most of the time.

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That's interesting, so you use different ratios depending on the GI of the carb?

I seem to find that the overall carb content will have the same impact on my BG whether it is high, medium or low GI. The only difference for me, is the rate at which my BG would increase after eating the carbohydrates.

SugarBuzz said:

In relation to insulin is a carb just a carb no matter what?

Getting to grips with carb counting - it's more difficult than it initially seemed. Lot's of guesswork and hypos involved (which I hardly ever had before making a conscious effort to try and get my blood sugars down to a 'healthier level')

I know there are slow release and fast release carbs and I generally don't eat too much of the fast stuff unless treating a hypo.

Another big question - when it says on a food packet for example 23g or carbs OF WHICH SUGARS 17g should I just take the 23g figure into consideration? Does the 'sugar' part matter?

Help. I've been having hypos every day and often more than once in the last few weeks - and I haven't even started 'sports' training again properly yet. This used to be rare when my bs were constantly running at around 10.5 mmol average.

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For me, 20g of carbs are 20g of carbs regardless; and will almost always require the same amount of insulin. There is a difference however, with the speed of which certain carbs are turned to glucose, and this is where the GI scale can come in handy.

The addition of significant amounts of fat to carbohydrates can cause some very, very strange things to happen with your BG - and in this instance, you may need to split and/or increase your bolus dose.

In the UK we use the total carbohydrate value (the higher number) for carb counting. The "of which sugars" part is with reference to how much of the total carbohydrate value is made from simple carbohydrates.

The tighter your control, the smaller the error margin and therefore the more likely you are to experience hypos. It may be that your basal dose needs tweaking and/or your I:C ratios need reducing to stop frequent hypos. Your DSN should be able to assist you with adjusting your ratios.

There's also some great advice in this book regarding everything diabetes related, including tweaking ratios, insulin doses and advice on carb counting:

https://www.amazon.co.uk/gp/aw/d/B06XCDTPP1/ref=tmm_kin_title_0?ie=UTF8&qid=&sr=

According to my Carbs & Cals book, sweet potato has slightly more carb content than ordinary potato and exactly the same amount of fibre.

Bluetit1802 said:

According to my Carbs & Cals book, sweet potato has slightly more carb content than ordinary potato and exactly the same amount of fibre.

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I wasn't referring to grams of carb/grams of food. I was referring to the GI of sweet potato vs white potatoes. I had 1/2 of a white potato last evening for the first time in a couple months. My weakness is French fries!