# Am i like the only person who doesn't carb count?



## Estellaa (Aug 24, 2012)

I have noticed with majority of posts you all carb count?
However i don't, does this make me strange aha?


----------



## Northerner (Aug 24, 2012)

Well, I know the principles, but don't really carb count. My diet is pretty boring and consistent so I know pretty much how much insulin I'll need for a particular meal, and taking into account my pre-meal number plus whether I've been exercising etc. The only time I attempt carb counting is if I try something new - even then I tend to base my dose on a similar sized/type of meal. 

So no, I don't think you are strange - if you are, then so am I!


----------



## Phil65 (Aug 24, 2012)

Estellaa said:


> I have noticed with majority of posts you all carb count?
> However i don't, does this make me strange aha?



....I wouldn't be able to maintain good control if I didn't, hence why for 12 years I guessed, sometimes I got it right...often I got it wrong! After 4 years of carb counting and just as importantly knowing my insulin/carb ratio (wildly different for me depending on time of day) my control is so much better and my A1c is much,much better. Everyone is different..... but I will always carb count from now on.


----------



## Caroline (Aug 24, 2012)

I don't either, it took my doctor 6 years to send me to meet DESMOND and I get mixed messages about carb counting from the surgery


----------



## jalapino (Aug 24, 2012)

Northerner said:


> My diet is pretty boring
> 
> Awwwww....i meen that to...i can almost hear the boring tone in your typing  go on be norty just once


----------



## Northerner (Aug 24, 2012)

jalapino said:


> Awwwww....i meen that to...i can almost hear the boring tone in your typing  go on be norty just once



It's OK, what I meant was that other people would probably find my diet boring - I don't!


----------



## DeusXM (Aug 24, 2012)

You certainly won't be the only one, but I think it's impossible to get good control on MDI without doing some carb counting.

The entire principle behind MDI is that you inject an appropriate amount of insulin at mealtimes to cover the carbs you are eating. If you don't know how many carbs you're eating, you can't possibly know how much insulin to inject. Granted, if you've enough experience you can suitably eyeball food and judge it, but without carb counting, it's a bit like walking across your living room with your eyes closed. You might roughly know where everything is, but unless you look, you are probably going to end up with a bruised shin and a broken TV.


----------



## Phil65 (Aug 24, 2012)

DeusXM said:


> You certainly won't be the only one, but I think it's impossible to get good control on MDI without doing some carb counting.
> 
> The entire principle behind MDI is that you inject an appropriate amount of insulin at mealtimes to cover the carbs you are eating. If you don't know how many carbs you're eating, you can't possibly know how much insulin to inject. Granted, if you've enough experience you can suitably eyeball food and judge it, but without carb counting, it's a bit like walking across your living room with your eyes closed. You might roughly know where everything is, but unless you look, you are probably going to end up with a bruised shin and a broken TV.



.....couldn't have put that better!! .....however you don't realise until you get used to carb counting.....it's like saying you don't need reading glasses.... although you are still holding the newspaper at arms length!


----------



## Austin Mini (Aug 24, 2012)

I just look at what I am about to eat, take a guess and do a jab.


----------



## grufflybear (Aug 24, 2012)

I don't really count carbs but I have learned the habit of simply being aware of them and I eat a slightly restricted quantity - seems to work but I am aware that I eat less carbs than is "normal".   I know a loaf of bread has to last nearly a week and I have small portions if I have rice or potato.


----------



## MaryPlain (Aug 24, 2012)

Austin Mini said:


> I just look at what I am about to eat, take a guess and do a jab.



How often do you guess correctly? I'm just wondering whether this kind of instinctive approach could save a lot of bother!


----------



## Austin Mini (Aug 24, 2012)

MaryPlain said:


> How often do you guess correctly? I'm just wondering whether this kind of instinctive approach could save a lot of bother!



I guess about 90% of the time.


----------



## MaryPlain (Aug 24, 2012)

Austin Mini said:


> I guess about 90% of the time.



That's pretty good. I estimate that with my carb counting I generally get it wrong a much higher percentage of the time.  Makes you wonder, doesn't it!


----------



## Austin Mini (Aug 24, 2012)

In 2001 I went on the NovoPen and was told I could now eat as normal people. I went through the carb counting when first diagnosed in 1987 when I injected twice a day (breakfast and dinner) with a mix of Actrapid and Monotard. In those days you *had* to carb count otherwise you would be too 'high' or too 'low' if you didnt. These days with a NovoPen things are much better. Although I eat healthy food I will eat cake, ice cream etc. These 'treats' are thanks to the NovoPen.


----------



## Northerner (Aug 24, 2012)

Austin Mini said:


> In 2001 I went on the NovoPen and was told I could now eat as normal people. I went through the carb counting when first diagnosed in 1987 when I injected twice a day (breakfast and dinner) with a mix of Actrapid and Monotard. In those days you *had* to carb count otherwise you would be too 'high' or too 'low' if you didnt. These days with a NovoPen things are much better. Although I eat healthy food I will eat cake, ice cream etc. These 'treats' are thanks to the NovoPen.



Are we talking about two different reasons to count carbs though? On fixed insulin doses you had to make sure you had the right carbs to match the insulin doses (and at the right times too), whereas now you count the carbs you want to eat in order to decide how much insulin you need to cover it.


----------



## everydayupsanddowns (Aug 24, 2012)

Sounds like great guestimation Austin!

Having a few years experience under your belt can help make it easier. I have to say I am far less precise than many seem to be (especially in the evenings, where generally the whole family meal is counted/measured but portions are judged by eye) - but then again I make far more errors at that time of day!


----------



## Austin Mini (Aug 25, 2012)

Having a few years experience under your belt can help make it easier.

Thats exactly so, over time comes confidence.


----------



## Copepod (Aug 25, 2012)

I must admit that I tend to guestimate, too, based on occasional bench mark meals at home, when I can weigh food. Fortunately, most of the produce we get from our garden (eggs from ducks, various veg and berries) is vey low carbohydrate. We make our own bread, so that's pretty constant - the only variable being how thick I cut my slices. 

I will be volunteering on a week long trail run in Wales in September - food (breakfast, packed lunches for the hill / midday check point, snacks & soup on arrival at overnight camp, evening meal, drinks whenever camp kitchen is open) will be provided for all racers & marshals, all vegetarian, and portion size will be basically what you want to eat. As participants provide their own plates / bowls / mugs, I might check what my normal portions look like in the crockery I'm taking, but otherwise, will take a chance. There's no way I could bother with carrying a set of scales, and that would cause interuptions to meal queues. 

I reckon that using techniques to improve guestimates of carbohydrate content of food is the key to a happy life - there are so many other variables, including exercise / stress / sleep hours / meal times / weather etc, that there's no point being ultra accurate in one factor, when it's impossible to have the same level of accuracy for other inputs.


----------



## Northerner (Aug 25, 2012)

Copepod said:


> ...I reckon that using techniques to improve guestimates of carbohydrate content of food is the key to a happy life - there are so many other variables, including exercise / stress / sleep hours / meal times / weather etc, that there's no point being ultra accurate in one factor, when it's impossible to have the same level of accuracy for other inputs.



Pretty much my approach. Whilst I may know approximately the carb content of my meals, nearly all of which I prepare myself, I will make a guess on how to adjust based on the other main variables you outline. Most of the time I seem to get it right, as witnessed by my HbA1c in the 5s practically since diagnosis. I accept, however, that I'm pretty lucky in that I may be getting a helping hand from my partially-functioning pancreas. I also have a good general routine which helps, keep carbs in meals fairly constant and around 140-180 per day (having much more than this throws my guessing out!), and regular exercise helps hugely. For me, because my carbs are fairly constant, it's my level of exercise which can throw things out the most. If I stop exercising for a few days I find it difficult to work out how much extra insulin I need so I get a few higher than normal levels, and if I return to exercise then the problem is reversed giving me a few hypos as I try and work out what reduction is required.


----------



## Otenba (Aug 25, 2012)

Estellaa said:


> I have noticed with majority of posts you all carb count?
> However i don't, does this make me strange aha?



I think it's more common than the impression you're getting. I wasn't carb counting for most of my diabetic life (at least 19 years) before I did the DAFNE course which teaches carb counting as part of the course. It does make a hell of a difference and I wish I had been doing it sooner but hey, that's life. Docs didn't think it was important enough to tell me about it before. *rolls eyes*


----------



## FM001 (Aug 25, 2012)

Estellaa said:


> I have noticed with majority of posts you all carb count?
> However i don't, does this make me strange aha?





How do you get your insulin dose right if you don't count the carbs


----------



## pgcity (Aug 25, 2012)

I went on a carb counting course just after diagnosis with a few long term type ones who didn't carb count in the way I do by weighing my food. They were all brilliant at estimating the carb counts of what we we're given. 

One lady was taught the exchange system (what approx 10g of carbs is) when she was diagnosed and by trial and error worked the effect on blood glucose using this method. She equates everything she ate to digestive biscuits.


----------



## Estellaa (Aug 25, 2012)

i just base my insulin dose on my levels and how much i have eaten and whether i have had extra sugary things.
one of the reasons i don't carb count as i don't cook my own food majority of the time, my mum has 3 other people to cook for and she refused to carb count, we tried it and it was ridiculous the amount of time it took, i don't have time for such things and the fact the majority of lunch times i am out and about anyway.


----------



## mcdonagh47 (Aug 25, 2012)

Estellaa said:


> i just base my insulin dose on my levels and how much i have eaten and whether i have had extra sugary things.
> one of the reasons i don't carb count as i don't cook my own food majority of the time, my mum has 3 other people to cook for and she refused to carb count, we tried it and it was ridiculous the amount of time it took, i don't have time for such things and the fact the majority of lunch times i am out and about anyway.



you are supposed to "eyeball" your grub and learn to guesstimate how many carbs in a serving/portion.


----------



## Northerner (Aug 25, 2012)

Estellaa said:


> i just base my insulin dose on my levels and how much i have eaten and whether i have had extra sugary things.
> one of the reasons i don't carb count as i don't cook my own food majority of the time, my mum has 3 other people to cook for and she refused to carb count, we tried it and it was ridiculous the amount of time it took, i don't have time for such things and the fact the majority of lunch times i am out and about anyway.



What are your levels like, generally?


----------



## redrevis (Aug 25, 2012)

Just to clarify, carb counting doesn't mean you have to weigh every single thing you eat and work out every last carb you will be eating. I carb count and have done since diagnosis, but I weigh things only occasionally. I have learnt to count the carbs in food by seeing portions on a plate, with the help of carbs and cals. So if there is nutritional info on a packet I will use that, if not, for fresh things, I'll see the portion on the plate and work it out as best I can. Yes I don't get it 100% right all of the time, but it does make a big difference than just having a guess and hoping I don't go high or low. Without carb counting I know for a fact my HbA1cs wouldn't be as consistent as they are.


----------



## Tina63 (Aug 25, 2012)

I'll stir things up here!  When my son had good control (HbA1c of 6.1) I was weighing all his rice/pasta/potatoes etc and when making the main part of the meal I did weigh and look at packets and jars and calculate the whole meal and divide by 4 if we were all eating it, and it really did seem to work 100%.  I know from years doing slimming clubs on and off it's so easy to pour a bowl of breakfast cereal and _think_  you have 30g when in fact you have 60g+.  Rice in particular, I would never be able to estimate accurately, or potatoes come to that.  I found it no hassle though, and just used digital scales that I could put his plate on top of and have an idea in my head of how many grams to aim for for ease of calculation and go for it.  It really was no bother.  It actually opened my eyes to the size of portions I was feeding my whole family :O

Obviously going out he always had to guess and did so, there was no choice really.  Even lunch boxes, he knew the values of a slice of bread/an apple/pack of crisps/cereal bar etc so would calculate for how much he was eating at that time and inject for it.  It really did work well for him.


----------



## MaryPlain (Aug 25, 2012)

Copepod said:


> I must admit that I tend to guestimate, too, based on occasional bench mark meals at home, when I can weigh food.
> I reckon that using techniques to improve guestimates of carbohydrate content of food is the key to a happy life - there are so many other variables, including exercise / stress / sleep hours / meal times / weather etc, that there's no point being ultra accurate in one factor, when it's impossible to have the same level of accuracy for other inputs.



I completely concur!


----------



## Estellaa (Aug 25, 2012)

my levels are typically from 4-13 ish all depends what i have done during the day and all that.


----------



## DeusXM (Aug 25, 2012)

That's an extremely wide variation - if you're frequently getting readings over 7, that's not good news. Good control means it shouldn't really matter what you do in the day, you adjust your insulin intake accordingly and keep your readings in the 4-7 range. 

Otherwise, at the risk of sounding critical, you are going to store up problems for the future and they will catch up with you far quicker than you think. Again, don't want to be the prophet of doom here but there are people out there with variations in line with yours who are getting retinopathy after just 5 years. They might be unlucky but that should serve as a real wake-up call to get your diabetes under control.

I'm with Austin - you don't need to weigh out every single thing but I think it's really helpful to do this at first so you get a good feel for how much x g of carbs looks like on a plate. 

I tend to eyeball all my food and then every six months or so (or whenever my control seems to slip) do a couple of weeks of religiously weighing stuff out and calculating to ensure I don't get off track. Some people also find carb counting strangely liberating too. While I'm the first to say that life's too short to agonise over exactly how much weighs what on your plate, it can be very reassuring to weigh out the food, say to yourself "ah, now I need exactly 8u to cover this" and get it down.


----------



## Estellaa (Aug 25, 2012)

thats all very well, but i have been discharged from hospital cause i have such good control, never had problems? so i must be doing something right?


----------



## Northerner (Aug 25, 2012)

Estellaa said:


> thats all very well, but i have been discharged from hospital cause i have such good control, never had problems? so i must be doing something right?



Are you just with your GP now Estella, or do you have reviews with a consultant and DSN?


----------



## Estellaa (Aug 25, 2012)

i see a dsn thats it


----------



## Northerner (Aug 25, 2012)

Estellaa said:


> i see a dsn thats it



Has she ever suggested that you go on a carb counting course, like DAFNE? Were you discharged from the hospital because you have just turned 18? Sorry for being so nosy, I just find it interesting how nowhere seems to have the same procedures for looking after people, in spite of NICE guidelines!


----------



## DeusXM (Aug 25, 2012)

Estellaa said:


> thats all very well, but i have been discharged from hospital cause i have such good control, never had problems? so i must be doing something right?



No, you are discharged from hospital when you show you could theoretically get good control. You may not have had any problems yet but you've only had diabetes for 2 years - the damage from having BGs over 7 takes a few years to manifest itself. You are only hospitalised for poor control when it represents an acute medical emergency. An A1C of say, 8%, doesn't constitute this, but it certainly isn't a safe A1C for a good long-term prognosis. Happily any threat of damage can be reversed and eliminated through getting better A1Cs.

I am sure that generally your diabetes control is ok but if you are routinely seeing your BG swing between 4 and 13 then it definitely needs refining. The blood vessels in your retinas are particularly sensitive to blood sugar swings and these are blood vessels you really don't want to get damaged.

What was you last A1C like? The NHS defines 'good' control as 7.5% or lower, in conflict with most other authorities which define it as 6.5% or lower.


----------



## Doghouse (Aug 25, 2012)

I always count carbs if I can, and try to be accurate to 5g each way. 
If I eat out then I have to guess, but I?ve never been worse than 9mmol/l after 3 hours. If there is any doubt, then I aim on the hypo side, because eating is always more pleasurable  than injecting. However if I am driving, then I err on the hyper side because getting there is always better than crashing.


----------



## Estellaa (Aug 25, 2012)

i've had diabetes for 11years now, i joined the forum two years ago.
when i moved here my hb1ac was high, so i was sent to the hospital clinic, i got it down considerably within 3 months so i was discharged to just seeing the diabetic nurse at the clinic, i have been assigned there since last july i'd say and i've only ever seen her for diabetes related issues.


----------



## DeusXM (Aug 26, 2012)

Sorry, my misunderstanding about the length of time you've been diagnosed. But if anything, that underlines the point I'm making about control even more so.

The situation you describe about your care arrangements is pretty much the standard, regardless of control. Many people see just a DSN at their GPs for their diabetes. Personally I always fight to make sure I see a proper endocrinologist at the hospital. I've always found DSNs at GPs to be very sub par, they seem to think an A1C of 7.5% is acceptable whereas the endos at the hospital are much more with it and have far more prescription power too. However, I've had bad luck with GPs in that most of them just don't know what they're doing with diabetes - I'm sure this isn't the case for all GP surgeries.

It was thanks to an endo that I was taught the 1000s rule - a very unscientific way of predicting complications but extremely good at showing how improvements to A1Cs work.

You take your A1C and subtract by 5. You then multiply the answer by 12. Then you divide 1000 by the answer, and the answer you get from that is the number of years away from your diagnosis date (roughly) that you'll develop serious complications.

So say you've got an A1C of 6.5. You subtract by 5 to get 1.5. Multiply that by 12 to get 18. 1000 divided by 18 is 55.5 - so say you're dxed at the age of 14, you probably won't get serious complications until you're about 69 or 70.

As I said, it's not scientific, but it's a great way for anyone to really consider the impact their control has on their long-term health.


----------



## Northerner (Aug 26, 2012)

DeusXM said:


> ...You take your A1C and subtract by 5. You then multiply the answer by 12. Then you divide 1000 by the answer, and the answer you get from that is the number of years away from your diagnosis date (roughly) that you'll develop serious complications.
> 
> So say you've got an A1C of 6.5. You subtract by 5 to get 1.5. Multiply that by 12 to get 18. 1000 divided by 18 is 55.5 - so say you're dxed at the age of 14, you probably won't get serious complications until you're about 69 or 70.
> 
> As I said, it's not scientific, but it's a great way for anyone to really consider the impact their control has on their long-term health.



Hurrah! I'll be 216!


----------



## Estellaa (Aug 26, 2012)

Aha it doesn't bother me about who i see, i see no point in raising the topic of seeing an endo as i am moving in jan and will be with new care and it will probably end up me going to a hospital clinic cause of the area. i find my diabetes is under control i have no problems and of course i know the consequences of not keeping it under control so thats why i try my hardest in the 11years i've had it i've always done it my way and no one has questioned it or told me different.


----------



## redrevis (Aug 26, 2012)

Just showing off now Alan 

I'll be 97, yey!


----------



## MaryPlain (Aug 26, 2012)

Estellaa said:


> Aha it doesn't bother me about who i see, i see no point in raising the topic of seeing an endo as i am moving in jan and will be with new care and it will probably end up me going to a hospital clinic cause of the area. i find my diabetes is under control i have no problems and of course i know the consequences of not keeping it under control so thats why i try my hardest in the 11years i've had it i've always done it my way and no one has questioned it or told me different.



Until  now, eh?


----------



## Estellaa (Aug 26, 2012)

Aha I spose so :


----------



## Mark T (Aug 26, 2012)

DeusXM said:


> ...I've always found DSNs at GPs to be very sub par, they seem to think an A1C of 7.5% is acceptable...


I suspect this is because of the advice that is given them.

The nurse at my GP "accidentally" let me see the information screen on the computer that the GP's are presented when looking up the HbA1c results.  This showed that the target HbA1c was 6.5% to 7.5%


----------



## Estellaa (Aug 27, 2012)

in all honesty i don't think my dsn has actually told me a hba1c to aim for.


----------



## Northerner (Aug 27, 2012)

Estellaa said:


> in all honesty i don't think my dsn has actually told me a hba1c to aim for.



You've always struck me as someone with a very mature and positive attitude towards your diabetes Estella, long may it continue  I must admit, if it was me I would want to know what I was aiming for so that I knew where I stood - it helps me to feel more in control of things and ready to do something about it if things seem to drift. Do you know what your current HbA1c is?


----------



## Estellaa (Aug 27, 2012)

no im due for it was gonna make an appoinment today but me being a div forgot it wass bank holiday lol, i shall be phoning tomorrow. and thanks northy


----------



## lauraw1983 (Aug 27, 2012)

Was your last hba1c good? I'm sure people do get good at estimating how much insulin they need over time, especially those who have had diabetes for years. 

I'm still a crazy label reader - I prefer checking for different foods and doing a quick sum to try to get the dose more accurate for me. Of course I still make mistakes but more related to exercise than anything else! 

Doing Dafne next month though so be interesting to see how accurate I am and how much I can tighten it up!


----------



## Estellaa (Aug 27, 2012)

i moved here what two years ago, my hba1c was at 9.9 worst it has ever been but i had let myself slip as at the time i was moving, doing gcses and my mum was pregnant it was all abit hectic but i think my last one was at 8.9 so i got it down but that was ages ago and i could be wrong i could have another one after that and i may just not have remembered aha.


----------



## itsallgood (Aug 27, 2012)

My doctor printed out all the blood results and wrote at the top 'Hba1c < 6.5'. It was 9.6 at the time with a fasting BG of 13.2 which was a bit of a shock as I only went to see him because my knee hurt.

It still hurts now but at least my sugars are down


----------



## novorapidboi26 (Aug 27, 2012)

You definitely are not the only one who doesn't cab count, there are many diabetics who are still on twice daily injections and don't, and many like you, who are on MDI and don't....

For me personally, I was introduced to MDI alongside carb counting, so the two go hand in hand for me, but they do actually work well together, one is designed for another, and its worthwhile learning.....

I have been doing it now for 3 years and so I dont actually look at the back of packaging anymore, its all a well educated  guess, bag of crisps 15g, slice of bread 20g, 300g of fried rice 70g. Its all assimilated over time and it becomes really easy....

your living arrangements will change in time and you may feel you need to start carb counting, or that it will become easier if your on your own/with partner.

At the moment, it seems you are not having any problems with your diabetes which is good, as long as you know you may need to start tightening things up as the years go bye and the diabetes has had time to do damage.

I need to keep things as tight as I can, I don't, but I do a good enough job for the moment, minor retinopathy/maculopathy and elevated BP is all I am battling at the moment, but no doubt these will deteriorate in time. 

When the time is right, take the next step........


----------



## DeusXM (Aug 27, 2012)

> The nurse at my GP "accidentally" let me see the information screen on the computer that the GP's are presented when looking up the HbA1c results. This showed that the target HbA1c was 6.5% to 7.5%



Yeah - if you do a rummage on the NICE website you'll find the guidance notes to the same effect.

The important thing to remember is that the NHS is the ONLY organisation in the world that believes an A1C of 7.5% represents good diabetes treatment. Diabetes UK calls for a maximum of 7% and most of the American organisations call for 6.5% or lower (or define an A1C of >6.5% as 'untreated diabetes).

Part of this is suspect is because doctors understandably need to cover their arses. There is a perception that A1Cs below 7 mean the patient must be having lots of hypos. Therefore the goal is to artificially elevate BGs to prevent hypos - because hypos kill quickly and could be traced back to a doctor, whereas high blood sugar takes a while to cause problems, by which time the doctor will have enough paperwork and diffused responsibility to ensure they can still play golf in the Bahamas while their patient loses a leg.

Also, most doctors come from an understandable position that patients are either too lazy or too incompetent to manage their diabetes properly, so the advice we get is always the lowest common denominator. The best doctors are the ones who realise this and genuinely get excited when they find a patient who wants better treatment. I had a fantastic DSN once who would basically throw anything she could at me and actually listened. To date, she is the only DSN who's ever bothered to acknowledge a relationship between Lantus and depression, and also was happy to support me in trialling a low-carb diet - she's Suzie  at the Royal Devon and Exeter, if anyone's interested. Best diabetes person I've ever had.



> i think my last one was at 8.9 so i got it down but that was ages ago and i could be wrong i could have another one after that and i may just not have remembered aha.



Ok, don't forget that your A1C is the single most important number relating to your diabetes. What's done is now done but it's really important you get another one done soon so you can see how on track you are. Your most recent A1C does look quite high so I would tactfully suggest your control could improve quite a bit - some basic carb counting could knock a good 1-2% off and put you down almost into the non-D range, the best place to be if you want to avoid complications. Best thing about carb counting? It doesn't mean having to completely upset your lifestyle to get good control.


----------



## Estellaa (Aug 29, 2012)

i've booked in for my blood test and ecg next tuesday so i guess we'll find out how i'm doing.


----------



## Phil65 (Aug 29, 2012)

Estellaa said:


> i moved here what two years ago, my hba1c was at 9.9 worst it has ever been but i had let myself slip as at the time i was moving, doing gcses and my mum was pregnant it was all abit hectic but i think my last one was at 8.9 so i got it down but that was ages ago and i could be wrong i could have another one after that and i may just not have remembered aha.



....I have been reading this thread with interest and from someone that didn't carb count for 12 years but now have done so for the past 4 years......I can GUARANTEE that if you did carb count your control will improve dramatically with fewer highs and fewer lows!  .....and your A1c will improve......I will ALWAYS carb count, it has been the best 'tool' for my diabetes that I have ever used and I now think back and laugh at myself and wonder how I got my control right before!!


----------



## In My Stride (Aug 29, 2012)

I don't carb count either! Glad you asked the question cause i was beginning to feel like the only one. I gave it a go but i'm 18 and it really didnt fit in with my lifestyle, plus it involves maths.. nightmare haha


----------



## Estellaa (Aug 29, 2012)

yeah thats another thing im awful at maths, i don't cook my own food and i'm often not here for food, i just don't have the time i know how to do it i just don't want to i spose.


----------



## DeusXM (Aug 29, 2012)

The maths is the easy part - if your insulin ratio is 1:10, then a sandwich with 50g of carbs is 5u. The hard part is knowing how many carbs there are in the first place!

The trick is balancing things out. There are people who meticulously weigh everything and freak out whenever someone cooks them a meal or they go to a restaurant. A better option if you want to minimise the effect on your lifestyle is to get really good at eyeballing the amount of carbs in food, but this does take practice. It is the best and most valuable skill you can pick up when you have diabetes and you'll be amazed at how much more freedom it gives you. No more feeling crap because of high or low blood sugar and no more worrying over whether you've taken the right amount of insulin. If it wasn't for carb-counting (or more precisely, guestimating carbs), I'd never have been able to climb to the top of a mountain in Thailand and get smashed on whiskey and fried rice with a bunch of tribal people and some French and German tourists. Ok, that's not everyone's idea of a good time but the point is when you get good at this stuff, you can do whatever you like without worrying or compromising.


----------



## Estellaa (Aug 29, 2012)

i don't understand ratios at all so thats where im stuck. the amount of people who have tried to explain it to me.
i rarely drink as i don't like it, so i no need to worry about that. i eat what i like without having out of control levels.


----------



## everydayupsanddowns (Aug 29, 2012)

Estellaa - You might really like an Expert meter or Insulinx

You get ti set up with the help of your DSN with your ratios, then at any meal you just guestimate the carbs, tell the meter and it suggests a dose for you.

Based on whether or not that is working you can then adjust the ratios with the help of your HCP. Takes pretty much all the maths out of it!

That and 'Carbs and Cals' (photos of portions of most foods with carb counts, available for smartphones) and you'd be most of the way there!


----------



## Phil65 (Aug 31, 2012)

Estellaa said:


> i don't understand ratios at all so thats where im stuck. the amount of people who have tried to explain it to me.
> i rarely drink as i don't like it, so i no need to worry about that. i eat what i like without having out of control levels.



Estella,

Everyone is different but for me I have very different insulin to carb ratios depending on the time of day, for example 3 slices of toast (50g carb) at breakfast would mean 13.5 units (ratio 2.7 units per 10g carb) the same 3 slices of toast at lunchtime would mean 10 units (ratio 2 units per 10g carb) and the same in the evening would mean 12.5 units (ratio 2.5 units per 10g carb)....sounds complicated but it isn't really. Incidently, I don't measure and weigh out food, I do read labels for carb counts and I use 'carbs and cals' when I need to. Inevitably I sometimes have to guess a carb count.  Soon, you get to know certain meal carb counts automatically. I don't mean to criticise you, but you say you eat what you like without having out of control levels....I wouldn't be happy with your A1c and I would consider that to be outside of 'good control'......mine used to be in the 8s and once 9, since carb counting I have never been in the 8s or 9s.


----------



## novorapidboi26 (Aug 31, 2012)

Try for DAFNE, 5 days of your time and you will leave with all the tools you need, it fits around your lifestyle........I rarely cook, the wife does it, and she has the carbs value ready for me when I get in from work, she is crap at maths but picked it up easily.........tell your parents they need to do it, for your health, guilt trip 'know.........

Do you have a lot of carbs in your diet? I have carb free dinner 2/3 times a week, fish, vegetables, salad..........so no insulin, eating this stuff could make the move over to carb counting easier.....


----------



## Urbansoulpie (Aug 31, 2012)

Wow, I'm surprised that so many don't carb count!
Maybe people are doing it but not realising? 

I can't talk for type 2's but for type 1's I can't see how to get good control without carb counting. 

Carb counting is a must for people using a pump and my consultant won't give anyone a pump without being sure they are on track with carb counting.

Even simple carb counting such as reading labels can greatly improve control, there are many food items that carbs very so much in, e.g yoghurts (pots of the same weight) and cereal bars.

I would reccommend any type 1 that doesn't carb cout to give it a go, once you've got going, it really is quite easy and the effort is well worth the rewards in better control.

Good luck all!


----------



## Estellaa (Aug 31, 2012)

i think the way i deal with my diabetes is because it was how i was brought up and i find it easiest for example today my levels have been below 7 all day? and this is for most days.


----------



## Phil65 (Aug 31, 2012)

Estellaa said:


> i think the way i deal with my diabetes is because it was how i was brought up and i find it easiest for example today my levels have been below 7 all day? and this is for most days.



mmmm.....so why isn't your HbA1c then?


----------



## scotty (Aug 31, 2012)

I have just started to carb count myself, the question I ask is what is everyone's ratio and how do you find out what ratio suits you I am going on 1 unit per 10 grams is this about right ?...


----------



## MaryPlain (Aug 31, 2012)

scotty said:


> I have just started to carb count myself, the question I ask is what is everyone's ratio and how do you find out what ratio suits you I am going on 1 unit per 10 grams is this about right ?...



This is a fairly typical starting point but you may find it will vary at different times of day. The way to check it that I was taught on DAFNE is (having first made sure your basal levels are right - there's a sticky post somewhere about this on the forum).  Then write down in a table each day what your pre-meal blood sugar reading is, how much carb you ate, and what insulin you gave yourself. This allows you to begin to see patterns and decide whether you need to adjust your ratios. 

For example, if you regularly find that your pre-lunch reading is higher by more than about 1 than your pre-breakfast, this tells you that your breakfast ratio is too low, so you might try 1 unit to 8g, say. If the pre-lunch was regularly lower than the pre-breakfast, then you could try 1:12.

The key things to remember (others will say if I've forgotten anything):

- don't make big changes - go slowly and re-test to check the effects
- only change one thing at once so you can clearly see the effect
- don't be too hard on yourself - there are many variables that affect blood sugar and it isn't always easy to get things right straight away. Some of the things that can throw out the results are stress, hormones, exercise and illness so it's easiest to try and isolate these effects if you can.

Good luck and ask if you have any questions as I'm sure others will chip in with good advice!


----------



## Clarkey (Aug 31, 2012)

I always carb count now. i don't really cook myself, but when I buy things from the shops I look at the carb content before I eat it so i know how much insulin to take.

My readings for the past few days:

Lunch - 6.2
Dinner - 6.3
Bed - 4.2
Breakfast - 6.3
Lunch - 5.3
Dinner - 10.6
Bed - 5.4
Breakfast - 6.2
Lunch - 6.5
Dinner - 7.2

Besides the odd drop and spike I have kept my levels really well and that's all down to knowing what carbs are in my food. This is before i've even been on DAFNE.

I couldn't imagine having levels like that without carb counting unless I ate the same thing each day. I see carb counting the same as testing your BG's. You need to test your BG's to know if you require any insulin correction. Both of them, in my mind, are essential to good control.


----------



## Estellaa (Aug 31, 2012)

i dunno what my hba1c is lately i'll find out on tues.


----------



## Estellaa (Sep 12, 2012)

so had my hba1c results they are 8.8! which is brilliant considering about 3 months ago they were in the high nines apparently!


----------



## DeusXM (Sep 12, 2012)

It's a move in the right direction, definitely, so well done. 

But it is still pretty high - the NHS maximum recommended is 7.5%, and that recommendation is far too high anyway. I don't want to sound like a depressing monster of doom, but if you go by my rough-and-ready A1c complication calculation, an A1C of 8.8% means you could expect to see serious complications in just 22 years following your initial diagnosis. If you've had diabetes for 11 years already, that is not a lot of time left.

The great news is all of that can be completely avoided with a bit more work. I think you would benefit massively from doing some formal carb counting. I think you could easily get your A1c into the 6s in just three months. It really won't be that hard (literally just an extra 10 seconds though before each meal) but it will add years onto your life and transform the quality of your life too.


----------



## astbury1 (Sep 12, 2012)

Glad you said this as about to do the carb counting and going to Thailand in April so was slightly concerned! lol









DeusXM said:


> The maths is the easy part - if your insulin ratio is 1:10, then a sandwich with 50g of carbs is 5u. The hard part is knowing how many carbs there are in the first place!
> 
> The trick is balancing things out. There are people who meticulously weigh everything and freak out whenever someone cooks them a meal or they go to a restaurant. A better option if you want to minimise the effect on your lifestyle is to get really good at eyeballing the amount of carbs in food, but this does take practice. It is the best and most valuable skill you can pick up when you have diabetes and you'll be amazed at how much more freedom it gives you. No more feeling crap because of high or low blood sugar and no more worrying over whether you've taken the right amount of insulin. If it wasn't for carb-counting (or more precisely, guestimating carbs), I'd never have been able to climb to the top of a mountain in Thailand and get smashed on whiskey and fried rice with a bunch of tribal people and some French and German tourists. Ok, that's not everyone's idea of a good time but the point is when you get good at this stuff, you can do whatever you like without worrying or compromising.


----------



## everydayupsanddowns (Sep 12, 2012)

Estellaa said:


> so had my hba1c results they are 8.8! which is brilliant considering about 3 months ago they were in the high nines apparently!



Well done on your drop from 9's to 8.8 Estellaa. Onward and downward


----------



## DeusXM (Sep 12, 2012)

> Glad you said this as about to do the carb counting and going to Thailand in April so was slightly concerned!



I'm off there again in 8 weeks so drop me a line if you've any burning questions before you go. The hardest part actually is adjusting your basal jab time so you're not having to take it at some insane hour of the day, but once you know the secret, it's actually pretty easy as long as you think carefully about the time difference.


----------



## astbury1 (Sep 12, 2012)

Thanks! Yes I can see me having to take it 3:30am ha ha! I think judging the rice and noddles will be the difficult one!














DeusXM said:


> I'm off there again in 8 weeks so drop me a line if you've any burning questions before you go. The hardest part actually is adjusting your basal jab time so you're not having to take it at some insane hour of the day, but once you know the secret, it's actually pretty easy as long as you think carefully about the time difference.


----------



## redrevis (Sep 12, 2012)

Congrats on getting down from high 9s to high 8s. Now just have to keep going down. Using the HbA1c to Blood Sugar Level Converter your average BG level is 13.1mmol.  I agree with DeusXM. If you carb counted I'm sure you could get that down a lot further and the extra bit of effort carb counting takes will be definitely be worth it in the long run. I hope you consider giving carb counting another try.

p.s. astbury1 - You need a bit more blank space adding to your posts


----------

