# Carb & Insulin overload



## imtrying (Jan 10, 2012)

Hi all,

I'm back on strictly following DAFNE guidelines so I can try and work out my levels with exercise.

Today I ate for lunch wholemeal pitta bread and humous. The pitta bread was 50+g per slice, and I had 3. So 150g carbs = 15CP.

My carb:insulin ratio is 1:1.5

so had 22u.

I was 5.9 before eating. 2 hrs later, levels were 3.4. treated, and they went down to 3.2. Now up to 3.7.

The reason for the post is I have been coming to the conclusion that if I eat lots of carbs in one meal, I don't actually need to inject at the same ratio. Is this common to anyone else?


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## Pumper_Sue (Jan 10, 2012)

imtrying said:


> Hi all,
> 
> I'm back on strictly following DAFNE guidelines so I can try and work out my levels with exercise.
> 
> ...



Hi Katie,
that seems a very high carb count for pitta bread  Did you misread the label by any chance?

As a general rule though the more carbs consummed in one sitting means a lot more insulin per 10 carbs than what you would normally have.

Many people also find though pitta bread doesn't effect blood sugars as badly as proper bread


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## Northerner (Jan 10, 2012)

I was also going to say that the carbs per slice seem high to me, so first thing to check. I would normally only get through 150g carbs in a whole day, so I'm probably not the best person to ask about ratios changing - I'm also very much a creature of habit so tend to have similar carb counts for most meals of the day, each day. 

Hope your levels settle soon


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## trophywench (Jan 10, 2012)

A 60g weight wholemeal pitta should be approx 27g carbs.  Sure 55g wasn't the weight?


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## mum2westiesGill (Jan 10, 2012)

In the carbs and cals visual guide

Pitta bread - weight = 69g = 38g carbs
----------- weight = 35g = 19g carbs
(not wholemeal pitta though) 


_Gill_


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## imtrying (Jan 10, 2012)

thanks guys, but I have checked the packaging several times!! lol 

definitely says, 'each pitta (typically 85g) contains 51.5g carbs'!

I had stopped eating them because they are so high in carbs, but I miss the pitta bread and humous too much! and the 'of which sugars is only 3.2g. 

I did eat 3 of them though lol because I hadn't eaten any breakfast and being starving hungry. 

maybe I'm just weird!!


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## randomange (Jan 10, 2012)

I use Tesco large wholewheat pitta bread to make pizzas, and they're 85g in weight and ~50 g carbs per pitta 

I find if I go above 100g carbs in one sitting I have to change my ratio - I typically use about a third again as much insulin.  However, I also find that I need to spread out the insulin - on a pump I do 50% up front and the other 50% over three hours and that tends to work well for me.  On MDI I used to split the injection.  I find if I take all the insulin up front, I hypo and then rise - I figure the big meal slows absorption of the carbs and the insulin kicks in first.

Hope this helps!


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## Pumper_Sue (Jan 10, 2012)

Hi Katie,
if you like pitta bread have a look around for other makes and brands, hopefully you will find some with less carbs in them 

Just popped out to the freezer in garage... wholemeal Pitta bread from morrisons is 47.1 carbs per 100gms


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## sofaraway (Jan 10, 2012)

As I am on a pump if I ate that amount of carbohydrate I would extend the bolus due the the digestion of the food being slightly slowed down. Possibly there is a case for splitting a dose on MDI in this situation. 

Maybe you don't need as much as the dose increases, it's known that insulin is dose dependent in terms of duration of action. ie. 3 units of novorapid isn't going to last as long as 30 units. Maybe for you you get more 'stength' out of higher doses? Something to monitor and another factor to throw into the mix!


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## imtrying (Jan 11, 2012)

thanks for all your replies guys 

I am having the same lunch today (to finish off the packet of pittas and humous) so will test with maybe splitting the dose. 

I was wondering if all that insulin peaks within an hour, but wholemeal pitta coupled with chick peas in the humous maybe doesn't get into my blood for longer???????

Ideally I wouldn't be eating these large pittas....just when i stopped off at my little local tescos on Monday, this was all they had for wholemeal pitta bread!


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## everydayupsanddowns (Jan 11, 2012)

As a rule of thumb on MDI *any* meal much over 90-100g CHO seemed to need a split dose (and as Sue suggested slightly more insuolin than normal). More food does seem to take longer to digest for me. You'd need to find your own split by experimentation, but 60:40 before and 1.5 - 2 hrs after eating seemed to work OK for me much of the time.


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## Natalie123 (Jan 11, 2012)

Hi Katie, this happens to me too, if I eat lots my carb ratio doesn't apply so I take off a couple of units. I think it is bcause the carbs take longer to be broken down than my insulin is used so I go low quickly after the meal and then find I am high later on. Good luck with splitting your dose. Now that I have a pump, hopefully I will be able to see if that works for me too


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## imtrying (Jan 11, 2012)

thanks so much for replying guys. 

I've just eaten exactly the same again. Was 7.4 before eating, so will see what happens with a split dose, but think given the hypo yesterday, I will stick with Natalie and try taking less insulin, rather than more, and see what happens. 

Will calc units and then take a couple off. Then split 60:40 as you suggested Mike 

Will let you know how it goes!


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## Northerner (Jan 11, 2012)

imtrying said:


> Will let you know how it goes!



Can we all wait to find out this instead of trying to find out what my 'special surprise' is please? Please? 

Hope things work out Katie


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## imtrying (Jan 11, 2012)

Northerner said:


> Can we all wait to find out this instead of trying to find out what my 'special surprise' is please? Please?
> 
> Hope things work out Katie



haha no chance Alan!!!

An update though... 

150g carbs consumed = 15CP
15 x 1.5 (ratio) = 22.5 units of insulin. 
Said I'd knock abit off as went hypo, so took it down to 20units
Split 60:40 and took 12u with lunch, planning to inject the other 8 1.5/2hrs later.
Just tested (bit later than I wanted) 2hrs later - 5.7!!!!!!!!! 

I don't even have a theory now!


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## Northerner (Jan 11, 2012)

what a puzzle!  Good job you didn't take the full 20! What are you doing about the other 8 units?


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## everydayupsanddowns (Jan 11, 2012)

Sounds about right to me... Perhaps watch what happens this time, but in the future (if you rise a lot later on 4-8 hours after eating) it might suggest it's taking a while to digest.

On the other hand... I think Pattidevans (who posts here sometimes) recently had an experience where she started *massively* reducing doses that she knew worked due to the suggestions of one of those fancy bolus-wizard type meters. BGs behaved perfectly.

Apparently if you regularly take too much insulin what can happen is that your liver and pancreas cooperate to fire out extra glucose to balance the excess insulin. Or something!


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## trophywench (Jan 11, 2012)

Not something Mike - exactly that.  If it's any help, she's currently using the Insulinx meter, but would like an Accu-Chek Expert.


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## imtrying (Jan 17, 2012)

Northerner said:


> what a puzzle!  Good job you didn't take the full 20! What are you doing about the other 8 units?



Sorry Alan, didn't see I hadn't replied to this!

I didn't take the other 8 in the end...I was too scared! I haven't had pitta bread since lol I've moved back to sandwiches!


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