# Daily Diabetical Carbcount conundrum



## rossi_mac (Nov 9, 2010)

Hello people,

I thought it might be an idea to have a thread where you can quickly note what insulin (or other meds) you have taken for a meal or snack and how you worked it out.

We could go on and discuss the other factors and see what your levels are like an hour or two or later to see how well we are carb counting!

Together we can share some insight to how we all work the carbs out and how other factors affect us in working out the carb count! Maybe one day I'll stop guessing!

Hopefully it will help share our knowledge and maybe if we're on mdi or a pump we can tighten up our understanding even work out our ratios and dual waves! (Sorry not really sure about pumps, but notice the phrase dual wave mentioned a fair bit)

I'll start with first post below...

Cheers

Rossi 
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Morning,

Last night I was a good 5.8 before tea (not that great I had corrected after lunch as was in teens!), had a bowl of pasta I would guess 70gramms of pasta when dry and alsoa small portion of cabbage and corgette with it, and a little pot of yoghurt, I inject 6 units of novorapid, I think I had guessed it would be a 80 grams of carb meal? I was shaking like a leave whilst shifting a washing machine around about an hour or so later! I really am struggling with evening meals the most at the moment!

Does that carb count seem right to any of you?

Cheers

Rossi


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## Ellie Jones (Nov 9, 2010)

Hi Rossi

I've got a snotters with a cough  So I've got my the TBR of 150% seem's to be holding my BG's at the 6mmol/l mark..  So a lot of my figure for next day or so are going to be hit and miss

Pasta meals, not surprised that you felt a bit shakey when moving a washing machine after, as the pasta is only really starting to asorb into the system, one to watch is pasta, pastry is another one...  When I was on MDI meals like pasta I used to split my dose, inject some before my meal then the rest about an hour after..

The Pump bolus brillient things you get three types (different manufacturers have slightly different names for their bolus)

Basic/Standered delivers insulin all in one go..
Square wave/Extended wave the insulin is delivered evenly over a chosen period of time

Multi Wave/Dual Wave, combination of Standard and square wave,  Insulin is split, first part of dose is delivered in one go, the 2nd part of dose is delieverd evenly over a chosen period of time..


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## MeanMom (Nov 9, 2010)

rossi_mac said:


> Last night I was a good 5.8 before tea (not that great I had corrected after lunch as was in teens!), had a bowl of pasta I would guess 70gramms of pasta when dry and alsoa small portion of cabbage and corgette with it, and a little pot of yoghurt, I inject 6 units of novorapid, I think I had guessed it would be a 80 grams of carb meal?



I'm new to this too, but I would weigh the pasta once you've cooked it (and also dont over cook) 70g dry weight would I think make about 150g cooked so just under 30g of carbs. The 'little pot of yogurt' is a bit vague I'm afraid, my Collins Gem says a 125g fruit yogurt is 17g carbs, a plain yogurt about 10g, but Mullerlight fruit yogurts are about 10g carbs. My rough guess would therefore be between 40g and 50g of carbs - so you have overestimated. Plus did you have some protein and/or something high fat with it (like cheese)? As Ellie says Pasta can be quite slowly digested and if you have protein with it even more so, so you might want to split the dose or just inject after the meal (as my daughter does)

As for the 6 units of Novarapid, cant tell if this is correct for 80g carbs as dont know your ratio - but for 80g of carbs K would have injected 16 units as she is on 1 unit for every 5g of carbs 

Good idea for a thread by the way


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## everydayupsanddowns (Nov 9, 2010)

rossi_mac said:


> Last night I was a good 5.8 before tea... had a bowl of pasta I would guess 70gramms of pasta when dry and also a small portion of cabbage and corgette with it, and a little pot of yoghurt, I inject 6 units of novorapid, I think I had guessed it would be a 80 grams of carb meal? I was shaking like a leaf whilst shifting a washing machine around about an hour or so later!



Hi Rossi

I also suspect you might have over estimated the count. We always weigh pasta dry like you (that way the water absorbed during cooking, which can vary a lot, doesn't matter). 

Our ready reckoner is 100g pasta = 60g cho (though wholewheat is a little less)
Yoghurt often 15-20g per pot (for the no added sugar varieties)
I wouldn't count for cabbage/courgette, or even for the proportion of tin of toms if that was involved since we split between 4.

My guess would be more 55g - 60g for the meal. 

Not sure when your correction dose was administered, but you may have had some active insulin on board. Plus over estimation of carbs. Plus effort expended in washing machine shifting. 

Since you started on 5.8 before tea hardly surprising that you went low I guess! 

If you are anything like me you need less insulin in the evenings anyway.

Tch! Diabetes... never easy is it


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## Phil65 (Nov 9, 2010)

Hi Rossi,

My ratio is 1 unit of Humalog to 5g of carb, so for 80g of carb I would take 16 units, obviously dependant on activity etc,etc if I was going to do something strenuous I would take a couple of units less.  There is no need to guess carb count by the way, it is really easy when you get used to it, I thought it would be much more of a pain!! Information if not on food labels can be got from internet or a brilliant book that I always use is Carbs and Cals......there is even an iphone app now for it!!


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## novorapidboi26 (Nov 9, 2010)

For lunch yesterday I had the following:

Numbers in grams;

Homemade salad (lettuce, tomatoe, cucumber, coleslaw, sliced pepperoni) = 0

Muller Corner = 20

Bannana (ripe) = 30 (usually 20, but ripe)

Apple = 10

Plum = 10

Snickers = 30

Total = 100, if 1 CP (Carbohydrate portion) is 10 grams = 10 CPs

Lunchtime ratio is 2 units of Novo: 1 CP = FINAL DOSE = 20 units

BGs

12:00pm - 6.6 mmol/l - pre lunch

2:20pm - 5.9 mmol/l

3:20pm - 3.9 mmol/l

I think that my decision to add on and extra carb portion for my bannana was the reason for this low, it has worked in the past but it obviously was not as ripe as anticipted......

Pre dinner reading after 6 jelly babies

5:10pm - 5.8 mmol/l


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## MeanMom (Nov 9, 2010)

everydayupsanddowns said:


> We always weigh pasta dry like you (that way the water absorbed during cooking, which can vary a lot, doesn't matter).



Understand this point but can never work out how you do that if cooking for more than one person? (Same with rice)


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## novorapidboi26 (Nov 9, 2010)

carolynsurry said:


> Understand this point but can never work out how you do that if cooking for more than one person? (Same with rice)



I agree, if cooking for a mob, weighing after it has been cooked is the the most accurate way, I seldomy cook, I come home to my dinner and a CP amount too...........gotta love the misses......


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## Ellie Jones (Nov 9, 2010)

I'm not so lucky I am the cook (and chief bottle washer)  

What I do is sit my plate on the kitchen scales, as I dish up I wiegh as I go, electronic scales are easiest as you can zero them, piece of paper + pen by time it's dished I've got my carbs...

Mind you I tend to weigh my Pasta cooked, just find it easier that way...


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## MeanMom (Nov 9, 2010)

Ellie Jones said:


> I'm not so lucky I am the cook (and chief bottle washer)
> 
> What I do is sit my plate on the kitchen scales, as I dish up I wiegh as I go, electronic scales are easiest as you can zero them, piece of paper + pen by time it's dished I've got my carbs...
> 
> Mind you I tend to weigh my Pasta cooked, just find it easier that way...


 
same here Ellie 'cept not the bottle washer bit - we have a dishwasher  (wedding pressie so OMG its 17 years old - no it cant be????)


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## rossi_mac (Nov 9, 2010)

Wow cheers guys, no worries about going off topic, it's what I'm good at!!

Yeah okay I guess I over estimated, my pot was little and I would have said 15gramms, the pasta was with bacon as a carbonara type dish.
I think my ratio is 1 unit of Insulin for 10 grams, but as I thought I still had some in and as I had been a bit active and about to fight a washing machine I dropped it to 6 units! 

So maybe my method and ratio was correct (slight positive) but my counting sucks! I guess it was not a lot of veg really, and the 70 grams of pasta was a guess as wifey puts a cup full in the pan which is either 100 or 115 grams can't remember, and I have the bigger half, so thats why I thought 70 grams!

I really agree I shouldn't guess, and I have the internet and collins gems books, and hope this thread will steer me to being a bit better!

I kind of understand that fat makes things release slower but didn't think pasta would itself, then again we're also on brown pasta! Maybe I'll split does next time.

What I would like to do is weigh the finished meal I'd happily do that, but how do you work out the carbs of it all mixed up??

Thanks peeps you're great!

Novo, wicked numbers and wifey you got there pal!

Yes another washing up ma(n)chine here one of my few skills!

For those interested I won the battle with the washing machine and the drip has stopped so yay!

Cheers again

Rossi


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## rossi_mac (Nov 9, 2010)

Lunch today 

pre lunch 6.8, yes my breakfast I think I have sorted, when I have the same thing. I have 2 shredded wheats and semi skimmed millk, and take generally 3 units, ifI'm low or high or am going to be on my feet etc I adjust my 1 or 1.5 units.

So lunch I have treated my self as feeling a bit low about not much work on the books. I went to Greggs..

Tomatoe soup (guess at 10gramms)
Chicken Bake (40 gramms I think)
Pepperoni pizza slice (40 gramms I think)
Cheese and ham wholemeal bloomer (60 gramms I think)

Quite a lot of carbs don't normally have this much total 150!! So 15 carb units, I have already injected 10 units as I like the idea of injecting 15 mins before, and am unsure weather to inject 5 more or more! I think when I have finished eating it all I will inject 6 more then all is covered (aftenoon biscuit!) assuming I'm on a 1 unit to 10 grams of carbs.

over & oot,

Rossi.


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## novorapidboi26 (Nov 9, 2010)

All you have to weigh is the pasta, everything else has labels or tiny to no carbs in it, veggies and meat.

Good luck for next time............


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## Phil65 (Nov 9, 2010)

12.29 - BG 5.3, Lunch - Jacket Potatoe (55g Carb) and Chilli con Carne (30g Carb) and an activia yoghurt (15g Carb) 100g Carb took 15 units of Humalog.

14.45 - BG 6.2


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## novorapidboi26 (Nov 9, 2010)

Today wasnt as succesful as yesterday.....

Salad - 0
Bannana - 2
Satsuma - 1
Cocolate - 1 (dont laugh - chocolate santa lollipop, where for my son from gran)
Muller Corner - 2
Mattesons Rippa Dipps Sausage and Tomatoe Dip - 1

Was 7.4 mmol/l before lunch, even though everything was exactly as it was yesterday, exactly....

Took 14 units - 7CP(70gram)x 2 as 2 units:10grams

2:00pm - 11.4mmol/l

3:00pm - 8.7mmol/l

No dount I will be on target at tea but its still annoying when everything is the same, more or less..........


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## rossi_mac (Nov 9, 2010)

Gonna have jacket potatoe tonight do most of you split the dose here? as when I did Bev's big night in I went a bit low!
Just weighed the spud and it is 245grams pre cooking (cheating and cooking in microwave!)

weighing is winning!!


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## MeanMom (Nov 9, 2010)

would probably weigh after cooking and if K would split the dose would try that (she wont split so injects all after meals) Carb count of jacket depends on if you eat the skin or not - almost double if you dont. Would guess that one was about 70g carbs if you ate the skin. Hope it was yummy


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## novorapidboi26 (Nov 9, 2010)

Everyone is different but if my meal is over 15 units I do a 75-25 split before and after meal


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## MeanMom (Nov 10, 2010)

novorapidboi26 said:


> Everyone is different but if my meal is over 15 units I do a 75-25 split before and after meal



Most meals over 15 units at the moment Novo ('cept Brekkie) but unfortunately K will not split the dose. I can't make her - it's her diabetes not mine


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## novorapidboi26 (Nov 10, 2010)

carolynsurry said:


> Most meals over 15 units at the moment Novo ('cept Brekkie) but unfortunately K will not split the dose. I can't make her - it's her diabetes not mine



As I say its just a rule I have implemented to try and birng down my spike a bit, sometimes it send me a bit to low, as I am assuming that the variety and amount of carbs will delay the release of glucose, but it doenst always work out like that...


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## rossi_mac (Nov 10, 2010)

novorapidboi26 said:


> Everyone is different but if my meal is over 15 units I do a 75-25 split before and after meal



Sounds like a good idea Boi! 

I ate the jacket last night and injected after I ate, and injected 4 units basing it on a 60gram meal as when cooked it weighed 200 grams and I didnn't count for the mayonnaise ni the tune or the salad even though I had about a dozen little tomatoes.

Couldn't have been that bad as before bed I was 6.3 and 6.7  this morning!

Just had a chicken and bacon salad 40 grams of crabs so inject 6 units as a wee bit high and will have a choc biscuit in a bit.

So it looks like I have 3 different ratios and they might even work! Breaky 12 grams, lunch 10 grams, dinner 15 grams!

Cheers

Rossi


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## novorapidboi26 (Nov 10, 2010)

rossi_mac said:


> Sounds like a good idea Boi!
> 
> I ate the jacket last night and injected after I ate, and injected 4 units basing it on a 60gram meal as when cooked it weighed 200 grams and I didnn't count for the mayonnaise ni the tune or the salad even though I had about a dozen little tomatoes.
> 
> ...




Looks like your getting to grips with it mate.........I think with the jacket pot, on its own, is that its a steady release of glucose, even if its not straight away which is why splitting it probably wouldnt of done much, I only really split if its a mixture of different foods with different GIs that will all be released at different rates as my digestive system sifts through it....

Where does the 40g come from in your salad..........?


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## rossi_mac (Nov 10, 2010)

it said so on the back of the packet didn't question it lots of sauces, twas a layered one from m&s (half price) although shaking like a leaf right now, so maybe it is questionable!


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## novorapidboi26 (Nov 10, 2010)

rossi_mac said:


> it said so on the back of the packet didn't question it lots of sauces, twas a layered one from m&s (half price) although shaking like a leaf right now, so maybe it is questionable!



lol...........get some jelly babies in you.............if thats what the packet says its probably right, I didnt think of any dressing sauces as I, or the misses, makes mine at lunch......

Might of been one of those per 100g carry ons...............


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## mimms2 (Nov 10, 2010)

Right , when  i first got diagnosed i got the usual leaflets and pep talks , nothing mentioned about carb counting and ive never been offered courses . I ve had the usual struggles with getting my readings down and the juggling of insulin ,, but im human and still love the odd packet crisps or cake etc ,
I really dont think ive been educated about what to eat etc ,, im goign make appointment for docs and ask about this DAFFRE  course ,, Im also goign ask about weight referal , i need to lose weight ,, I didnt know these things excisted until I came on this support forum ,
I been reading all this with utter confusion ,, you are all wonderful ,, i really need to understand all this !


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## rossi_mac (Nov 11, 2010)

Hey mimms

Sorry you feel you haven't been educated about what to do, but glad you've found this gaff, crackin ain't it!
Not sure how long you have been diagnosed, but I assume you're on Insulin so I would guess you should get to know about carb counting etc.
However when I was first diagnosed I wasn't told about carb counting, I had a couple of months just eating normally (?), and injecting a set amount prior to each meal and before bed. Then they told me about adjusting my dose. I think for me this was a good way around it, there is a hell of a lot to take in and they can't tell you everything straight away.
If you have any specific questions, please do ask on here or another thread or start your own thread.

Take care,

Rossi


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## Phil65 (Nov 11, 2010)

Tried a different approach last night.  I had spaghetti carbonara, bit of side salad, and some garlic bread, total carbs were 145.  I split my dose of humalog, I took 20 units before eating (my pre meal BG was 5.1) and another 10 units 40 minutes later, my BG at 11.10 pm was 5.0  took 38 units of lantus.  This morning at 7.30 my BG was 6.8  Really pleased!!, pasta often a problem for me, but splitting the dose (as read on this forum) has definitely worked for me and I will continue to use this method!!


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## rossi_mac (Nov 11, 2010)

nice work there phil, I think I would consider splitting if I had a large bowl of pasta.

Had chip van fish & chips and weighed my portion of chips and fish and consulted my gem book and used the ratio of 15gramms injected all at begining, and all good, even with a glass of red to wash it down!

On same lunch as yesterday and hope not to hypo so have taken less 2.5 instead of 4!

Cheers


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## everydayupsanddowns (Nov 11, 2010)

Loving this thread Rossi. Brilliant to see carb counting working so well for everyone. Some cracking results being posted even with tricky meals. 

Mimms - if you haven't come across the idea before but are curious there's an online course you can do here http://www.bdec-e-learning.com/

I sent a letter to DUK about the dreadful lack of education given to some people on insulin here: Not counting - the cost


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## Phil65 (Nov 11, 2010)

everydayupsanddowns said:


> Loving this thread Rossi. Brilliant to see carb counting working so well for everyone. Some cracking results being posted even with tricky meals.
> 
> Mimms - if you haven't come across the idea before but are curious there's an online course you can do here http://www.bdec-e-learning.com/
> 
> I sent a letter to DUK about the dreadful lack of education given to some people on insulin here: Not counting - the cost



Great article Mike........I wonder if DUK will publish?!!


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## mimms2 (Nov 11, 2010)

Thank you for making me aware of the importance of carb counting , 
Im reading through all the posts and going to try the online course , 
Mike,  your letter to DUK made perfect sense , im so overwhelmed at the lack of information ive had with my medical team , thank you all x


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## everydayupsanddowns (Nov 11, 2010)

carolynsurry said:


> Understand this point but can never work out how you do that if cooking for more than one person? (Same with rice)



Hi Carolyn

Sorry I missed your reply... took my eye off this thread for a few days!

Perhaps our approach is a bit more crude than others, perhaps we've just got used to it after so many years, but we find measuring out dry ingredients works well enough for me. By contrast some people's approach seems like laser-precision! We only ever really count in numbers of 5g or 10g rounding up or down. There are so many other variables (number of times I've walked up and down stairs, size of piece of fruit, ripeness, actual makeup/number of raisins in that particular bowl of muesli, ambient temperature, stress level... blah blah blah) that gram-perfect counting hasn't ever really seemed worth the bother.

For simplicity I often aim for the same amount of CHO in an evening meal (60g). Not a huge plateful for pasta, but we bulk up with lots of yummy roasted veg or whatever that counts for little. Pretty decent helping of rice (though not a takeaway-style blowout by any means). Before we had kids it was easy... measure 200g of pasta and dish up equally between 2 plates. When the kids were small we did three portions and dished up 1 1 .5 and .5 

These days, now that the girls are bigger, we do 4 lots of same sized portions and sort of split it evenly. I'm also pretty used to what a helping of around 60g CHO in rice or pasta looks like on our plates (though we still measure the cooked quantity to begin with). 

With that ready-reckoner in my head, guestimating monster takeaway portions and meals out has become a bit more art than science. But then I think a lot of diabetes management is like that.

Like most things in my life it's a sort of combination between careful measurement and stab-in-the-dark guesswork. 

Seem to be getting away with it quite a lot of the time though


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## MeanMom (Nov 11, 2010)

Thanks MIke - yes I think with more practise (and confidence) the 'guestimate' is the way forward. I accidently did it last night (sort of)  because K and I had pasta and my lentil bolognase (sp?) and Id weighed hers but then couldnt remember which was hers and which was mine (she eats about the same amout as me) So just guessed which was hers (Her BS all over the place anyway so no idea what the result was)
In the 'early days' my hubby made mash potato (always his job) and said 'o thats about 200g of mash' which I decided was too much for her so took about half off. Weighed what she had left and it was still 150g! (We have measuring spoons for it now

What about this one this morning?
Woke up BS 8 (ish)
Slice of 'Best of both' toast - 20 carbs
Jam -20 carbs 
200ml Milk - 10
Cream cracker - 6
I know, I know , too much jam - my husband does her breakfast
So total carbs 56 divided by 5 (her new 1:5 b'fast ratio) = 11 units Novorapid BEFORE b'fast
School , inclu PE, also including a 15g snack (either rice cakes or malted milk biscuits - she had both with her)
Pre Lunch reading 13 (ish) - so that didnt work - did it


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## everydayupsanddowns (Nov 11, 2010)

Hmmmm tricky one that!

My first thought given the jam and best of both (which would both hit me quite quick, no idea about K) is that if I spike way up after a meal I need more insulin to bring me back to proper levels.

I'm sure I read some clever explanation somewhere (here?) about how much more insulin is needed to reduce by x mmol/L at 12.x as opposed to 6.x or whatever.

But with a set up like that (breakfast... exercise... level of activity... post PE snack...) it's almost impossible to know what caused what without a bunch of tests in between breakfast and lunch. Hardly practical for her at school 

I suppose if this is a regular school day you could take today's result as a basis for further experimentation the next time that day comes round on the timetable? Try without the snack? Miss the cream cracker at breakfast?


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## MeanMom (Nov 11, 2010)

everydayupsanddowns said:


> Hmmmm tricky one that!
> 
> I suppose if this is a regular school day you could take today's result as a basis for further experimentation the next time that day comes round on the timetable? Try without the snack? Miss the cream cracker at breakfast?



Welcome to our life 

That wasnt her usual breakfast and yes any bread I'm beginning to think is dodgy for her (she usually has wholemeal, but thats nearly as bad) Usual breakfast is scrambled eggs and toast or cheese on toast though so it was only the jam that was 'new' 

Like you say the only way to know for sure is to test more - not going to happen at school I'm afraid and at home levels are a whole different calculation so wouldnt help much with school day levels.  Ho Hum


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## everydayupsanddowns (Nov 12, 2010)

carolynsurry said:


> That wasnt her usual breakfast and yes any bread I'm beginning to think is dodgy for her (she usually has wholemeal, but thats nearly as bad) Usual breakfast is scrambled eggs and toast or cheese on toast though so it was only the jam that was 'new'




HI Carolyn 

Thanks for your 'battered sausage'/'throws calculator out of window' thread. Made me laugh 

Regarding bread... you may well know this already, but I did a little bit of looking around earlier this year (I'd always thought anything wholemeal would be fine, but like you found there was little difference in release time between that and white). The best bread (in average GI terms) for many diabetics seems to be Burgen soya/linseed which has a GI in the 'low' category. It's quite a seedy one (whole seed and grains far harder for the gut to break down so slower release). If K is anything like my girls she may have an aversion to seedy breads. Both my daughters did, though one now loves Burgen and will choose it over regular wholemeal! Stoneground wholemeal seems to be slower release than regular wholemeal (the grains are not so effectively mashed in the coarser stoneground flour so there's more work to be done breaking them down).

Of course for a slower release the cheese in cheese-on-toast will work wonders 

Hth
M


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## rossi_mac (Nov 18, 2010)

Morning campers 

How about this one...

So I've worked out some ratios, no doubt I'll be tweaking them a bit over the next wee while.

Do your ratios work for all food types?

I got a low for lunch t'other day and carb counted right as had it written on the side. I realise some foods have different GI values so sometimes splitting a dose is done to match the profile of the insulin with the profile of the food..

Any thoughts etc always welcome.

Cheers

Rossi


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## Phil65 (Nov 18, 2010)

rossi_mac said:


> Morning campers
> 
> How about this one...
> 
> ...





I always now split my dose if I'm having pasta or pizza.  2/3rds before I eat and a 1/3 after I eat.  Last week I had a big bowl of spaghetti carbonara, carb counted, I am 2 units of humalog to 10g of carb, took 20 units before I ate, 10g an hour after eating, I was 5.1 pre meal at 8.20pm, at 11.10pm I was 5.0and at 7.34am I was 6.8!! Happy days.  I had always ran high with pasta with a single dose pre-meal.


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## rossi_mac (Nov 18, 2010)

Phil65 said:


> I always now split my dose if I'm having pasta or pizza.  2/3rds before I eat and a 1/3 after I eat.  Last week I had a big bowl of spaghetti carbonara, carb counted, I am 2 units of humalog to 10g of carb, took 20 units before I ate, 10g an hour after eating, I was 5.1 pre meal at 8.20pm, at 11.10pm I was 5.0and at 7.34am I was 6.8!! Happy days.  I had always ran high with pasta with a single dose pre-meal.



Cracking result there Phil, 

Can I ask what "10g an hour after eating" means? So you took 20 units before meal then every hour you took 2 units until you had taken your lot?

Sorry if I'm being (extra) dim

Rossi


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## Phil65 (Nov 18, 2010)

rossi_mac said:


> Cracking result there Phil,
> 
> Can I ask what "10g an hour after eating" means? So you took 20 units before meal then every hour you took 2 units until you had taken your lot?
> 
> ...



Doh!! Sorry Rossi.......I meant 10 units not 10g!!!!!


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## everydayupsanddowns (Nov 18, 2010)

My rule of thumb tends to involve the total dose as much as the meal type.

I'm lucky not to have too much of a problem with pasta or even half a regular supermarket pizza, but once my dose goes over a certain limit I know I'll have to split it (fish and chips, takeaways etc).

The time of day also has a significant effect on how 'early' I need to inject. 30-60 minutes at breakfast, 15-30 minutes at lunch, just before at dinner.

Well that's the case if I'm in range anyway. Additional time-to-get-going is usually required if I'm a little high before a meal. Which might mean waiting 2 hours  after injecting before I can eat any breakfast! I've tested this on more than one occasion testing BG every 20-30 minutes so I know that it's not a case of me dropping low and then bouncing back up. After an hour it's likely I'll have only dropped 1mmom/l from a high fasting BG. Once it gets going it seems to behave more by the book.


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## novorapidboi26 (Nov 18, 2010)

everydayupsanddowns said:


> My rule of thumb tends to involve the total dose as much as the meal type.
> 
> I'm lucky not to have too much of a problem with pasta or even half a regular supermarket pizza, but once my dose goes over a certain limit I know I'll have to split it (fish and chips, takeaways etc).
> 
> ...



I have never considered experimenting with injecting times to this extreme, I will need to try this........


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## everydayupsanddowns (Nov 18, 2010)

Actually looking back over recent weeks 30 minutes seems more like it for breakfast.

From 27th October though:
07.54 10.2 (FBG) 7u Humalog and 15u Lantus
08.57 9.7 (No carbs yet, just coffee)
09.47 8.9 20g Carbs (about half normal)

Looking back at this I suspect a little Liver tomfoolery. Additionally, of course, I'm taking my Lantus in the morning so I am up and about (and wanting to eat) during its onset period. This probably goes a long way to explaining the increased requirement for giving Humalog a bit of a head start.

30th October though:
08.38 7.5 (FBG) 8u Humalog and 15u Lantus 
09.40 7.9 Again, just coffee, but a minimal rise!) 50g carbs
11.42 10.4 (a little on the high side)
13.30 4.7 (Lunch time)

Today:
07.06 4.6 (FBG) 6u Humalog 14u Lantus (slightly reduced basal)
07.47 ?.? 35g carbs
08.48 5.9
10.45 3.7 (oops!)
13.01 4.9

It's taken a bit of trial-and-error guesswork to get the delays roughly right and it's not 100% there by any means but it seems to be more or less working. Well until everything changes again that is!

M


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## Phil65 (Nov 18, 2010)

everydayupsanddowns said:


> Actually looking back over recent weeks 30 minutes seems more like it for breakfast.
> 
> From 27th October though:
> 07.54 10.2 (FBG) 7u Humalog and 15u Lantus
> ...



Hi Mike,

Do you take lantus before bed time, as well as morning? I am thinking of taking some lantus in the morning instead of 38 units before bed. As I often go a little low/very minor hypo late afternoon.


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## everydayupsanddowns (Nov 18, 2010)

Hi Phil

I experimented with splitting my lantus dose morning and evening, but that didn't work out for me (though I know it does for many). Possibly because my dose is quite small, so splitting it meant two small doses which don't seem to last as long.

The problem I was working around was waking up low in the mornings (several times a week at one point). By shifting Lantus dose to breakfast time it seems that when I need less overnight now coincides with my Lantus dose petering out. It did play havoc with post-breakfast levels for a while, but a little experimentation seems (at the moment at least) to have provided a half-decent workaround.

M


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## everydayupsanddowns (Nov 18, 2010)

Phil65 said:


> I am thinking of taking some lantus in the morning instead of 38 units before bed. As I often go a little low/very minor hypo late afternoon.



That seems slightly counter-intuitive to me (though may work despite that!).

It would seem to me that by late afternoon the activity of your evening dose would be beginning to fade away (suggested activity is 22 hours +/- 4 hours)

Have you basal tested* at that point to see what happens if you have no rapid-acting on board?

M

* Choose a not-especially active day. Eat no lunch, drink only water and test every hour or so over the course of the afternoon. With no rapid-acting on board Lantus *should* hold BGs steady +/- 1.7 mmol/L


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## Phil65 (Nov 19, 2010)

everydayupsanddowns said:


> That seems slightly counter-intuitive to me (though may work despite that!).
> 
> It would seem to me that by late afternoon the activity of your evening dose would be beginning to fade away (suggested activity is 22 hours +/- 4 hours)
> 
> ...



Tried this yesterday:

ate my evening meal at 5.26pm (probably 3 hours earlier than normal) BG 4.7 65g Carb took 14 units humalog, then fasted uniti 08.30 this morning.  I was really impressed with the results, I am going to fast at other times of the day to give me more of an indication that my basal dose is right.

9.50pm BG 3.0 (ate a cookie 14g carb.....I know, I know!! This is not fasting!)
10.14pm BG 4.7
11.19pm BG 6.0 (took 38 units Lantus)
00.02am BG 7.2
03.04am BG 4.4
04.04am BG 4.6
06.31am BG 4.4
07.36am BG 6.3
08.39am BG 8.5 

ate Breakfast at 08.45.

Very surprised with these findings (had a few glasses of red as well!!)although a little scared at readings of 4.4 during the night!! Very rarely tested at night, unless hypo.


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## everydayupsanddowns (Nov 19, 2010)

Phil65 said:


> 9.50pm BG 3.0 (ate a cookie 14g carb.....I know, I know!! This is not fasting!)
> 10.14pm BG 4.7
> 11.19pm BG 6.0 (took 38 units Lantus)
> 00.02am BG 7.2
> ...



Looks great! You are your own CGM 

Hardcore basal-testing veterans will say that results don't really count (or at least need to be viewed with some caution) if you have had a hypo before you start. Nevertheless as you say, it's a pretty good set of figures.

Really you'd need a few more samples to check for consistency in changes and/or to spot any emerging patterns but here's what that list looks like to me:


I would expect the cookie to have been pretty much done and dusted in an hour, so the rise to 6.0 is more than likely that alone. Possibly with a little bit of Lantus-fade added in.
Over the next hour the 1mmol/L rise is a great result, especially since you are likely to be between the activity of the old Lantus and during the onset of the new dose.
Lantus has a mini-peak (typically around the 4-5 hour mark) which might explain the drop to 4's at that point
From 6.30 onwards there's a fairly significant rise which might be indicative of some Dawn Phenomenon going on, though you'd need a few more tests to be sure...
So if we kinda ignore the post hypo wobble it was 6.0 - 8.5 which is not too shabby at all. 10 gold stars to you 

M


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## bigpurpleduck (Nov 19, 2010)

everydayupsanddowns said:


> Hardcore basal-testing veterans will say that results don't really count (or at least need to be viewed with some caution) if you have had a hypo before you start. Nevertheless as you say, it's a pretty good set of figures.



And if nothing else proves your 14g cookie is the perfect hypo treatment for you!



everydayupsanddowns said:


> Lantus has a mini-peak (typically around the 4-5 hour mark) which might explain the drop to 4's at that point



I didn't know about this peak. I often wonder if I could have managed better control on MDI had I actually known *anything* about how it worked! Do you get any of your info from DSN/consultant, or is it all your own research?


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## everydayupsanddowns (Nov 19, 2010)

bigpurpleduck said:


> I didn't know about this peak. I often wonder if I could have managed better control on MDI had I actually known *anything* about how it worked! Do you get any of your info from DSN/consultant, or is it all your own research?



All stuff I've found out this year. After realising that Lantus was causing a few problems I've done some looking around and a fair bit of trial-and-lots-of-error testing. When I asked my DSN about changing the timing of my Lantus (which was suggested in a comment on our blog and has been spectacularly successful) she just said that in her experience it simply 'moved the problem'.

Here's a graph from http://www.sanofi-aventis.co.uk/products/Lantus_OptiClik_SPC.pdf







That shows a minor peak followed by a bit of levelling off and though it doesn't show much of a fade at the end, I'm pretty sure that's what happens for me. This graph, being one of those 'averaged' ones won't necessarily be 100% accurate for anyone. I suspect every individual is likely to have something a bit different. Tch! typical!


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## Phil65 (Nov 19, 2010)

everydayupsanddowns said:


> All stuff I've found out this year. After realising that Lantus was causing a few problems I've done some looking around and a fair bit of trial-and-lots-of-error testing. When I asked my DSN about changing the timing of my Lantus (which was suggested in a comment on our blog and has been spectacularly successful) she just said that in her experience it simply 'moved the problem'.
> 
> Here's a graph from http://www.sanofi-aventis.co.uk/products/Lantus_OptiClik_SPC.pdf
> 
> ...



I tend to agree, I am sure my lantus has a mini-peak but also I reckon starts to wear off after 20 hours or so, so significantly better than Humilin I, but I am doing more fasting sessions at different times in a 24 hour period......watch this space, if you are interested.  I am pretty happy with my humalog and carb ratio with the odd hiccup obviously!!


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## Phil65 (Nov 19, 2010)

bigpurpleduck said:


> And if nothing else proves your 14g cookie is the perfect hypo treatment for you!
> 
> 
> 
> I didn't know about this peak. I often wonder if I could have managed better control on MDI had I actually known *anything* about how it worked! Do you get any of your info from DSN/consultant, or is it all your own research?



For me identifying a 15g Carb treatment for a hypo has been perfect, chocolate not a good idea as slow release (took me a long time to realise that!) glass of orange juice also 15g and a good treatment, I always test 15 mins later to confirm, I used to stuff anything down my neck, inevitably it was always too much and my BG then went too high!!


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## Catwoman76 (Nov 19, 2010)

rossi_mac said:


> Hello people,
> 
> I thought it might be an idea to have a thread where you can quickly note what insulin (or other meds) you have taken for a meal or snack and how you worked it out.
> 
> ...



Hi Rossi I went on a carb counting course in September at my local hospital and I had the most problems with my evening meal. My ratio is I unit for 10 carbs but in the evening my blood sugars were crashing so I was put on 1/2 unit for every 10 carbs but that went high and then high readings in the morning, After a while I changed it to 3/4, so if the total was 12 units of insulin I will take 8 or 9 and that is working much better for me.  So I take more for my lunch than I do for my dinner! I don't know if this might help you, you could give it a try and see how it affects you, I didn't think carb counting would work for me, but after a lot of tweeking I got there in the end. Sheena


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## rossi_mac (Nov 25, 2010)

Evening D's

So had a good few days even though last night I sinned and had sausage fish & chips, hey I was hungry!

Anyway a thought I had, when I once mentioned I had veg with pasta and some said don't count for that veg, well tonight I had mince with kidney beans not too many and some veg, I had it all with pitta bread in an easy tea meh-hi-co stylie, so I only counted for the pita as the veg wan't much and the beans weren't huge in quantity, but thinking back would you have counted for the chilli beans too?

I guess I'll find out soon enough!

Sheena, thanks I think I am getting there with the help of y'all! 

eduad - wow cracking info there cheers! 

Cheers

Rossi


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## Northerner (Nov 25, 2010)

I was told not to count pulses like kidney beans


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## rossi_mac (Nov 25, 2010)

Northerner said:


> I was told not to count pulses like kidney beans



Cheers big guy, I'm finding a lot of useful stuff oot!

I'm celebrating this new knowledge with a pint of thatchers gold, I think I'll need to correct after that!


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## Northerner (Nov 25, 2010)

rossi_mac said:


> Cheers big guy, I'm finding a lot of useful stuff oot!
> 
> I'm celebrating this new knowledge with a pint of thatchers gold, I think I'll need to correct after that!



OoH! Enjoy!


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## rossi_mac (Dec 6, 2010)

Hi folk

All going allreet at the mo give or take.

Twas thinking, my breakfast ratio is pretty solid, mainly varies when I vary my work activites in the morning. Lunch I'm not so hot on but not bad really, generally go high in the afternoon when I end up munching! Dinner is my worst success at carb counting and working out my carb to insulin ratio. So I thought would it be worth having a few nights of say microwave meals which accurately (are they?) quote the carb contents? Then I could see what I do need (work out a ratio), then fine tune my carb counting skills!??

Hope you allreet too

Rossi


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