I would do some testing to start with, peoples insulin carb/ratios vary considerably. Many type 2s on insulin do carb count and learn to adjust their insulin. Typically, they take larger doses than people with type 1. Your present starting doses are quite low and blood glucose targets quite high, I'm sure that this is deliberate to make sure that you take things slowly and safely.
this is my take on a way to start carb counting but it would be a good idea to discuss things with your nurse/doctor.
How to carb count.
For your sandwiches if you checked the label on the bread, you would find that there was about 18g of carb per slice. There would be no carbs in the turkey. A turkey sandwich would therefore have about 36 g of carbs.
For mixed meals you need to take account of carbs in starches( bread,pasta, rice, pots etc), jams, cakes, biscuits, fruits and fruit juice, milk, and yoghurt, some processed meats like sausages, sauces , and vegetables. The biggest amount will normally be in the starches , bakery products and fruits, to start with you should at least weigh these. You may be able to estimate the carbs in the other items.
From the label or from a carb counting book you will find how many gms of carb there are in 100gs of the food.
If there are 33g carbs per hundred grams, thats 33%
Weigh the portion you want to eat then multiply the percentage of carbs by the weight.
eg. If the food has 33% carb and your portion is 160g you find 33% of 160.
(0.33x 160g= 52.8g)
(take care particularly with things like rice and pasta that you are using the right figure: cooked and uncooked carb counts are very different)
Total your carbs for the meal.
A calculator in the kitchen is a big help.
Just carb counting your meal won't do anything, you need to record it and then use the information .
1)your bg levels before and 2 hours after the meal.
2)the number of carbs in the meal,
3)the insulin dose
4)(and its helpful to record the food as well)
5) Any exercise you have done in the period before the meal. (or if you have been ill etc). Exercise may mean that your insulin is more effective, an illness may mean that you have more insulin reisitance.
6) take notice of the rise from before to 2 hours afterwards, at this point your bolus insulin will still be working and glucose levels should decrease further still before the next meal ( novorapid has an onset of 10-20 minutes, Maximum effect: 1-3 hours and Duration: 3-5 hours)
When you have done this for a while you will begin to get an idea of how many carbs each unit of insulin 'covers.' in your body.
A couple of tips that might be of help.
1)At the start your records won't be of much use if your meals vary a lot in carb content from day to day. If you find your normal breakfast has say about 35 carbs, try to stick with this amount for
other breakfasts , similarly for lunch and dinner.Regularly timed meals helps too.
The amount of carbs you eat is individual and should be dependent upon your age, weight, activity etc . If you eat very large amounts of carbs, you will normally need larger amounts of insulin. This is where you should have individual advice.
2) At the moment your insulin doesn't seem to be reducing your levels to your target levels. You are starting the meal outside the target. This may be cumulative through the day.
It maybe that (with the guidance of your health care team) you will need to adjust the bolus dose even before you've worked out approximate ratios. Do it gradually (unit by unit, don't change too much before you understand its potential effect.
Again this is much easier if you eat to a regular pattern.
3) As pizza is a mixture of fat and cheese it's very awkward to dose for, quite frequently people are much lower at the 2 hour level but blood glucose rises, somtimes many hours, afterwards. This is quite probably what happened with your pizza meal. I'd avoid very fatty meals at the moment.
A last point the purpose of your basal insulin is not to reduce glucose levels but to keep them stable overnight and beween meals, but thats another chapter!
I assume that you have been told what to do if your glucose levels go too low ie a hypo.
