# Carb Counting



## lesley1978 (Jul 22, 2009)

Hi there,

I have never officially been taught how to carb count but I have learnt to estimate how much insulin I need dependant on what I am eating ie. salad versus jacket spud and bean etc.  

I am looking into getting a pump and have my first appointment on the 10 Aug to go and see the consultant (think this will just be the diabetic consultant and not the actual pumper).  I meet the criteria for hypos etc but as I have not been taught to carb count I was wondering if anyone could give me any info or point me in the best directing to get a bit more clued up on it before I attend my appointment?

I know that they send you on a DAFNE course and I have been looking on their website but I really want to give myself every chance of getting a pump and I want to be as prepared as I possibly can!

Thanks

Lesley


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## katie (Jul 22, 2009)

Hi Lesley.  This site is really good for teaching yourself how to carb count: http://www.bdec-e-learning.com/

This is good too: http://www.leedsth.nhs.uk/sites/diabetes/food/CarbohydrateCountingRef.php

Goodluck


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## Caroline (Jul 22, 2009)

Ask your consultant or your GP to put you on a DAFNE course. You probably do it all already. Good luck


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## aymes (Jul 22, 2009)

http://www.bdec-e-learning.com/ This may be useful as a starting point, but absolutely do take the chance to go on dafne if it's offered.

Good luck with the appointment.


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## Freddie99 (Jul 22, 2009)

Perhaps a SADIE or a DAFNE course would be a good thing to get onto. I myself am on a SADIE course and I start tomorrow. Best of luck getting a course.

Tom H


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## Northerner (Jul 22, 2009)

Tom Hreben said:


> Perhaps a SADIE or a DAFNE course would be a good thing to get onto. I myself am on a SADIE course and I start tomorrow. Best of luck getting a course.
> 
> Tom H



Hey Tom, hope the course goes well - what does SADIE stand for? Sandwiches And Desserts In Equilibrium?


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## Freddie99 (Jul 22, 2009)

Northerner said:


> Hey Tom, hope the course goes well - what does SADIE stand for? Sandwiches And Desserts In Equilibrium?



Sandwiches and Deserts In Eastbourne more like ! I can't recall what it actually stands for. Probably something where half the words would do!


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## rossi_mac (Jul 23, 2009)

Tom, 

Let us all know how it goes, with SADIE.

Are you quite confident with carb counting before you're going on this course?? Just trying to work out if I should go on one or not??


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## aymes (Jul 23, 2009)

rossi_mac said:


> Tom,
> 
> Let us all know how it goes, with SADIE.
> 
> Are you quite confident with carb counting before you're going on this course?? Just trying to work out if I should go on one or not??



I'd say if there's any doubt about if you should or not then go for it! I don't know about SADIE but certainly on DAFNE (what is with these names?!?!) there is a lot more to it than just carb counting so I'd have thought most people would get something out of it.


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## rossi_mac (Jul 23, 2009)

aymes said:


> I'd say if there's any doubt about if you should or not then go for it! I don't know about SADIE but certainly on DAFNE (what is with these names?!?!) there is a lot more to it than just carb counting so I'd have thought most people would get something out of it.



I think you're right, whats going on about these names!?

But seriously I agree probably is best to go on one. I'm moving (I hope!!) in the next couple of months, so will have to change everything, guaranteed to be a headache! But once I'm settled, I think I'll look into it! Hmm I hope I don't get a poor service area, still what will be will be, at least I've got you guys/gals!!!


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## lesley1978 (Jul 23, 2009)

The online BDEC course is sooooo good.

I hate to say it but after 13 years of being a type 1 I have learnt so much more from an online course than I have ever been taught by my professionals!  I have never been taught to carb count and have just worked things out myself through having the same sort of meals!!  I now feel clued up about my condition and feel armed with the right information to try to manage things correctly.  

i really can't believe it!!  what is going on with our health service?  For the first time in 13 years I actually feel like I know what I am doing!

Lesley x


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## sasha1 (Jul 23, 2009)

Hi Lesley

Good luck with your appointment regarding a pump....Hope all goes well..Please keep us all posted how this goes

Re: Carb counting...I cannot say anything that has'nt already been said by others...Glad though that you have found the information that you needed...

As you may be aware Nathan does'nt carb count either.

Heidi
x


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## Becca (Jul 23, 2009)

Hi 

Don't know if these will help?

http://www.insulin-pumpers.org.uk/pdfs/recipe.pdf

http://www.diabetes-scotland.org/yorkhill/documents/pdf files/Food for Life Best Ideas Final.pdf


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## lesley1978 (Jul 23, 2009)

not sure who nathan is???

Ignore this.  I have just realised that this is relating to the post that I ranted about.  Have you tried looking at the bdec website and going down that route?

x


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## sasha1 (Jul 23, 2009)

lesley1978 said:


> not sure who nathan is???
> 
> Ignore this.  I have just realised that this is relating to the post that I ranted about.  Have you tried looking at the bdec website and going down that route?
> 
> x




Hi Lesley....

Hahahahaha...Nathan aka "Kevin the Teenager" is my 14 year old son....

I have'nt actually  had a look at the web site...but I am going to tomorrow..hopefully it may give me some pointers etc...

Heidi
x


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## rossi_mac (Jul 24, 2009)

katie said:


> Hi Lesley.  This site is really good for teaching yourself how to carb count: http://www.bdec-e-learning.com/
> 
> This is good too: http://www.leedsth.nhs.uk/sites/diabetes/food/CarbohydrateCountingRef.php
> 
> Goodluck



Hmm is this right, I can do a carb counting style course by registering with the sunny bournemoth e learning website link above posted by Katie? I never looked at it before as it was for bournmouth peeps! This is tempting? How long does it take, do I need days off work, like you do for dafne?? Sorry if questions are stupid, I just never expected an online course thing!


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## Adrienne (Jul 24, 2009)

rossi_mac said:


> Hmm is this right, I can do a carb counting style course by registering with the sunny bournemoth e learning website link above posted by Katie? I never looked at it before as it was for bournmouth peeps! This is tempting? How long does it take, do I need days off work, like you do for dafne?? Sorry if questions are stupid, I just never expected an online course thing!



It looks great, go for it.


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## katie (Jul 24, 2009)

rossi_mac said:


> Hmm is this right, I can do a carb counting style course by registering with the sunny bournemoth e learning website link above posted by Katie? I never looked at it before as it was for bournmouth peeps! This is tempting? How long does it take, do I need days off work, like you do for dafne?? Sorry if questions are stupid, I just never expected an online course thing!



Hi Rossi,

You can start the online course whenever you want, stop part way through and resume when you are next online or whenever.  The guy who made it was on my course at uni  Think it was his dissertation.  It isn't just for Bournemouth people, anyone can try it.  Give it a go


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## rossi_mac (Jul 24, 2009)

coolio!

I'm just registering now,and it told me I already have registered!!??
Maybe one drunken night I read a thread of yours and did it without realising!!

Oh well cheers Katie and all.


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## rossi_mac (Jul 24, 2009)

thats one hell of a dissertation!

I'm a doer apparently!!


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## katie (Jul 24, 2009)

rossi_mac said:


> coolio!
> 
> I'm just registering now,and it told me I already have registered!!??
> Maybe one drunken night I read a thread of yours and did it without realising!!
> ...



haha you're welcome.



rossi_mac said:


> thats one hell of a dissertation!
> 
> I'm a doer apparently!!



yeah, wish i'd thought of it, it would actually interest me grr.


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## runner (Jul 25, 2009)

rossi_mac said:


> Hmm is this right, I can do a carb counting style course by registering with the sunny bournemoth e learning website link above posted by Katie? I never looked at it before as it was for bournmouth peeps! This is tempting? How long does it take, do I need days off work, like you do for dafne?? Sorry if questions are stupid, I just never expected an online course thing!



Thanks for the Leed link Rossi - been looking for a more comprehensive carb table!


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## lesley1978 (Jul 26, 2009)

I had a really good day yesterday carb counting and when I got up this morning I was 4.0.  I thought it was too good to be true....and it obviously was.  Have been doing it today and 2 hours after my breakfast I was 16.7 and just before my tea now I am 17.4.  GOD I HATE HAVING DIABETES!


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## lesley1978 (Jul 26, 2009)

I haven't done anything different than what I did yesterday!  oh well, back down to lesley reality with a big band then!


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## sasha1 (Jul 26, 2009)

lesley1978 said:


> I had a really good day yesterday carb counting and when I got up this morning I was 4.0.  I thought it was too good to be true....and it obviously was.  Have been doing it today and 2 hours after my breakfast I was 16.7 and just before my tea now I am 17.4.  GOD I HATE HAVING DIABETES!




Hi Lesley...

Please don't be to hard on yourself........you are working very hard....
Although I dont carb count for Nathan....Looking at your 2 readings at breakfast and the tea...they have stayed quite level...to me if this were Nathan it would suggest may be his bolus needed a bit of tweaking.
What was your lunch time reading?

Heidi
x


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## Northerner (Jul 26, 2009)

sasha1 said:


> ...to me if this were Nathan it would suggest may be his bolus needed a bit of tweaking......



Do you mean 'Basal' there Heidi? I'm not sure actually, if Lesley woke to 4.0 then any increase in basal (if you did mean that) would have resulted in a hypo. 

What did you have for breakfast Lesley? 2 hours after is probably a spike/peak. What was your level before lunch, and did you have any lunch?

What insulin are you on and when do you inject your basal (slow-acting)? Could be it's not lasting. Sorry for all the questions!

Stick at it, you'll get there! It can take some time and there are always anomalous days, so don't lose hope!


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## sasha1 (Jul 26, 2009)

Northerner said:


> Do you mean 'Basal' there Heidi? I'm not sure actually, if Lesley woke to 4.0 then any increase in basal (if you did mean that) would have resulted in a hypo.
> 
> Hi Northerner...
> 
> ...


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## Northerner (Jul 26, 2009)

Apologies Heidi - of course what you say makes sense.


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## sasha1 (Jul 26, 2009)

Northerner said:


> Apologies Heidi - of course what you say makes sense.





Hehehehehehe....You had me there Northerner...totally confused with the two B's.....lol

Heidi
x


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## Northerner (Jul 26, 2009)

sasha1 said:


> Hehehehehehe....You had me there Northerner...totally confused with the two B's.....lol
> 
> Heidi
> x



Yes they should give them totally different names - like Stan and Hilda or something...


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## Freddie99 (Jul 26, 2009)

Hello all,

Just to say that I started carb counting on Thursday. The first few days were really quite crappy. I seem to be getting the hang of this now...sort of. With the carb counting today's bloods have been better. It's still quite a novelty for me to have to weigh everything that I eat though, a bit of a pain in the arse to if I'm honest.

Tom


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## Becca (Jul 26, 2009)

It is a complete pain but the results do make it worth it   I'm sure you will become used to it and you will hopefully be able to 'eye' ball portions sizes or regular foods.  I have to stop myself weighing mine or my son's food (which i do do :$) in the morning as it's just second nature now....Doh!

We used these for R (not sure if mentioned before) : http://www.littlewoods.com/rf/p.do/...tary-computer-scales?A=5656000514973566279002

We can add in recipes or certain foods, and it has a long list of foods with carb values.  They are expensive, i know if you go to vouchercodes you can get money off them as well, also if you sign up to a littlewoods account that used to give you money off as well - not sure if that still goes.....


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## lesley1978 (Jul 27, 2009)

Northerner said:


> Do you mean 'Basal' there Heidi? I'm not sure actually, if Lesley woke to 4.0 then any increase in basal (if you did mean that) would have resulted in a hypo.
> 
> What did you have for breakfast Lesley? 2 hours after is probably a spike/peak. What was your level before lunch, and did you have any lunch?
> 
> ...




Hi,

For my breakfast I had 2 slices of toast (white) and 2 rashers of bacon and I had 4 units .  I worked out that each slice was 1.5 cp so that was 3 cp's and I have been using 1.5u to 1cp.  As my pen doesn't do .5's I rounded to 4 units
as my sugar was only 4.  then 2 hours later I was 16.3!!  so I did just 1 unit to start bringing down and then before dinner I was 14.3 and I had a very small wholemeal bun with some chicken on so this was probably no more than 3 cp (I roughly guessed) so even though this would have worked out to 4.5 units I gave myself 6 units to bring it down.  2 hours later I was back up to 17.1!!!!
I don't understand what is going on.  I had a chicken salad with jacket spud for tea last night and had 8 units (more that I needed but still needed to get results down.  was 12.1 before bed then woke up at 2.am this morning feeling not quite right (no major hyp signs though) went downstairs and tested and I was 1.6!!!!!  Needless to say, I am shattered today!


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## Becca (Jul 27, 2009)

Good grief!!  No wonder you are shattered   Do you know what your correction factor is and if it's different at certain times of the day?

Hope today is better for you


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## aymes (Jul 27, 2009)

lesley1978 said:


> Hi,
> 
> For my breakfast I had 2 slices of toast (white) and 2 rashers of bacon and I had 4 units .  I worked out that each slice was 1.5 cp so that was 3 cp's and I have been using 1.5u to 1cp.  As my pen doesn't do .5's I rounded to 4 units
> as my sugar was only 4.  then 2 hours later I was 16.3!!  so I did just 1 unit to start bringing down and then before dinner I was 14.3 and I had a very small wholemeal bun with some chicken on so this was probably no more than 3 cp (I roughly guessed) so even though this would have worked out to 4.5 units I gave myself 6 units to bring it down.  2 hours later I was back up to 17.1!!!!
> I don't understand what is going on.  I had a chicken salad with jacket spud for tea last night and had 8 units (more that I needed but still needed to get results down.  was 12.1 before bed then woke up at 2.am this morning feeling not quite right (no major hyp signs though) went downstairs and tested and I was 1.6!!!!!  Needless to say, I am shattered today!



Did you do any readings nearer the 4 hour after eating mark? At 2 hours you may still be getting a peak from the food so a later reading, when most of the insulin has gone, may be useful to help you assess whether your ratio is right or not, it may be that it needs tweaking, and it may be you need different ratios at different times of day.

You mention CPs which I know primarily as a dafne term (although I'm sure other use it too!) have you had the chance to do a dafne course or similar?


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## sasha1 (Jul 27, 2009)

Hi Lesley,

I hope you are feeling a little better now..I'm not surprised you shattered....sending (((hugs)))

I cant really offer any advice other than what has been said by others.

Heidi
xx


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## sofaraway (Jul 27, 2009)

I wonder if you need some help working out out your insulin to carb ratio? I haven't been on the bournemouth website for a long time so can't remember if it works one out for you.

Also maybe you need to try and be more accurate in your carb counting, if bread comes in a packets then it'll be easy to know how many carbs and start weighing other foods. Once you get to know how much is in things then it'll get easier to start eyeballing amounts, but to begin with it can be amazing how far off you can be. 

Something about your basal doesn't seem right to me, it seems too much and not enough at the same time. From your day time readings (misbolusing aside) it seems not enough but hypoing in the night and waking up to 4 seems like it's too much. Not sure that i have any suggestions, but getting the basal set is so important. And you really can't get a good hold on your bolus ratios until your basal is there or thereabouts. 
Are you on a flat basal insulin? 

As Becca said I hope today is better for you


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## lesley1978 (Jul 27, 2009)

aymes said:


> Did you do any readings nearer the 4 hour after eating mark? At 2 hours you may still be getting a peak from the food so a later reading, when most of the insulin has gone, may be useful to help you assess whether your ratio is right or not, it may be that it needs tweaking, and it may be you need different ratios at different times of day.
> 
> You mention CPs which I know primarily as a dafne term (although I'm sure other use it too!) have you had the chance to do a dafne course or similar?



I didn't do any readings around 4 hr after but to be honest, my reading pre meals were still high so I don't think it would have been much different.  i haven't actually done a dafne course, I have been reading online and did the bdec learning course so I have basically taught myself.  I have an appointment 2 weeks today to see the diabetic consultant as I want to go on a pump so hopefully they will refer me for the couse and hopefully (fingers tightly crossed) I might get accepted for the pump sometime soon.


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## lesley1978 (Jul 27, 2009)

I am on a flat basal amount of 18 units which I have a 9pm every night.  I was having 16 units but waking up too high (around the 10's) so was told to up it to 18 units.  To be honest, my sugars have never really been well controlled, not through lack of trying though!  Don't know whether anyone has the same sort of thing but they seem to do what they like regardless of what I eat or do!


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## Becca (Jul 27, 2009)

This is one of the things i hated about MDI for R.  Her morning BM would be say about 5 mmol/L, then 2 hours later she would be in mid 20s up to 30   Then by lunchtime she would be back to 5 mmol/L !!  We tried everything to get rid of that spike but the only thing that worked is the pump.  She now goes up to 3-4mmol/L from her breakfast BM.  I think you would be a good candidate for a pump, being able to adjust basals that fit your body's natural rythmn (sory can't spell) is invaluable.

We were also taught that by testing 2 hours after eating you should be 2-3mmol/L from your BM done before.  If too high or too low after 2-3 days then something is wrong with your bolus.  Trouble was, for R was that she still needed a snack when she was in the 20s as she would hypo by lunchtime.  Not nice


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## Becca (Jul 27, 2009)

Have you tried splitting your long acting?  Maye one in morning, one at night?


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## lesley1978 (Jul 27, 2009)

I haven't tried this but presumably this is something that the consultant might mention when I go in a couple of weeks.  I will enquire about it anyway.


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## sasha1 (Jul 27, 2009)

Hi Lesley..

Can I ask which long acting insulin you use... Nathan was on Levemir initially, at first it was given in one dose..Then in split doses..apparently this is the best approach when using Levemir..After his BG were still not level and very erratic he was changed on to Lantus.

Heidi
x


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## lesley1978 (Jul 27, 2009)

I am already on Lantus.  I use Humalog for my short acting.


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## Adrienne (Jul 27, 2009)

Hi  

We used to use Lantus as well.    I am presuming that you do your one injection in the evening  and it may well be running out by lunch time ish.    I would imagine the post breakfast high is the 'normal' post breakfast spike which lots of people get.   Your basal may not sort this out, this could be something that you quick acting should sort out.   Maybe you need more.  What ratios are you on for each meal?

Before you think about spliting the Lantus and some people do need to do this even with Lantus I personally would think about having the injection in the morning instead of night time and see what happens then.  With my daughter we found that it worked better in the first 12 hours than in the second 12 hours so we wanted it working in the day time more than the night time as she was prone to hypos overnight.

Its worth a try but obviously speak to your team first.   Don't let them palm you off with anything other than help.

Good luck


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