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Carb counting - what did I do wrong?

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This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
Sprogladite

Sprogladite

Well-Known Member
Relationship to Diabetes
Type 1
Tonight I attempted carb counting for the first time ever. And I'm now so frustrated and upset I'm literally sitting here crying.

I've been T1 for nearly 23 years and have never received proper advice for the implications of eating carbs. It was a minor miracle I discovered this on my own, mostly because I am sick of my sugars being out of control and don't know where else to turn other than the Internet.

Today I read a link kindly provided by someone here on the forum. It all made sense, I understand the theory behind it all, so I figured I'd give it a try and see what happened.

Before eating, my sugar level was 13.1. So, aiming for a sugar level of 7, I did 2 units as a correction dose, combined with 8 units for my main meal (spag bol). I had 200g of cooked pasta - 6 units. Didn't count the meat, with 2 units for a glass of Ribena, which I used "squash" values from the carbs and cals app for.

So my dose was:

2 units - correction
6 units - spaghetti
2 units - ribena

2 hours after eating my sugar level is 18.9!!! What am I doing wrong? I feel so upset it just seems no matter how hard I try nothing works!!
 
I think what may be happening is that the carbs you ate may have arrived as glucose in your bloodstream before the insulin had got there to mop them up. That was quite a high amount of the sort of carb that gets broken down into glucose really quickly. See where you are after four hours. You've still probably got half your insulin dose on board still working at the moment. Next time, if you're going to have the same meal (and you've come down to the levels you're looking for in a couple of hours time ) try giving your insulin dose a bit earlier, so the insulin has time to get working.
Don't expect to get it all right immediately! I know it's frustrating, but it's just something that needs practice.
 
Thanks for your reply @Robin. You are right, I know it's unrealistic to expect instant results but I think it being so high just shocked me. I will keep at it and see how adjusting injection times works for me. I think I've just got to the end of my rope with it all, I really feel like I'm fighting a losing battle at the moment :(
 
Sprogladite said:
Thanks for your reply @Robin. You are right, I know it's unrealistic to expect instant results but I think it being so high just shocked me. I will keep at it and see how adjusting injection times works for me. I think I've just got to the end of my rope with it all, I really feel like I'm fighting a losing battle at the moment :(
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If you find you're consistently high after four hours, then adjusting your insulin ratio may be necessary. Keep at it!
 
My novorapid ratio is higher than 1/10, think its 1.5/10 and my accu-check meter is set at that when I put my carbs in. Sorry you feel so upset, it took me a while to get used to it. You will get there.
 
Hi Sprogladite

What ratio are you using for your carbs. These are different for different people so as Robin has suggested you may need to gradually tweak these until you find what suits you. It takes time to get it right so don't be disheartened if it does not work at the start.

Also if you start with higher levels the insulin can find it hard to do it's job. So once you have got your BG levels lower you may find that you need to adjust your ratios again. It really is worth the effort and eventually becomes a lot easier to deal with, so stick at it.
 
Thanks @Lucy Honeychurch - how did you figure out your ratio was more than 1/10?
 
SB2015 said:
Hi Sprogladite

What ratio are you using for your carbs. These are different for different people so as Robin has suggested you may need to gradually tweak these until you find what suits you. It takes time to get it right so don't be disheartened if it does not work at the start.

Also if you start with higher levels the insulin can find it hard to do it's job. So once you have got your BG levels lower you may find that you need to adjust your ratios again. It really is worth the effort and eventually becomes a lot easier to deal with, so stick at it.
Click to expand...

I used the standard 1/10 ratio as I figured I'd go from there. I honestly wouldn't be surprised if mine was higher than that, I seem to have an uncanny ability to absorb a ton of insulin with minimal effect when I'm high. It's just got to the point where I've got the beginning stages of retinopathy and have developed neuropathy pain in my feet and I am scared. It feels like I'm standing in a room full of medical professionals shouting "HELP ME" and nobody is listening. It would be fine if I knew what I was doing...but I don't. The fiddling I've done over the years has meant I've developed a system where I just swing from one end of the scale to the other, high to low back to high again. It's getting me nowhere!
 
Hi Sprog - have to say - for 100g carb I'd need 10u of Novorapid (1u per 10g carb) so I'd have needed 20u just for the spag bol, without adding Ribena. But I simply couldn't eat that amount of carb at one meal, or even in a whole day. It's been observed by various people that when they need much more than 7u in one go, it doesn't absorb so well so they reckon they're better off splitting that jab into at least 2 if not 3 separate jabs, one after the other in different places. (To me that's another reason - for me I mean! - just not to eat that much carb at one go, then.)

Are you absolutely certain your carb ratio is as high as 1u to every 33g ? Or for eg a sandwich made with 2 slices of medium sliced, you only need 1u of insulin?
 
My dietician and DSN set my meter as my levels were too high. I have an accu check meter which I test on, I put my carbs in then it suggests a bolus: ie; 40g carbs = 6 units of novorapid.
 
trophywench said:
Hi Sprog - have to say - for 100g carb I'd need 10u of Novorapid (1u per 10g carb) so I'd have needed 20u just for the spag bol, without adding Ribena. But I simply couldn't eat that amount of carb at one meal, or even in a whole day. It's been observed by various people that when they need much more than 7u in one go, it doesn't absorb so well so they reckon they're better off splitting that jab into at least 2 if not 3 separate jabs, one after the other in different places. (To me that's another reason - for me I mean! - just not to eat that much carb at one go, then.)

Are you absolutely certain your carb ratio is as high as 1u to every 33g ? Or for eg a sandwich made with 2 slices of medium sliced, you only need 1u of insulin?
Click to expand...

Lol I'm not certain of anything at this point, that's why I don't know if I've done something wrong!

I used the table on the Bertie online website - which says 100g of cooked pasta has a CHO of 30g; I had 200g so that's 60g, equating to 6 units?
 
You mentioned spagbol and counting the pasta, but you didn't mention the sauce. (If this is because you just had the meat with no sauce, ignore me!) Most store bought sauces are packed with sugar and even home made ones have a fair bit because of the tomatoes, so if its there it needs to be counted. Stick with it - it can take a while to get your ratios right, but it'll be well worth the effort when you do.
 
I should probably also confess my maths is absolutely shocking so if I've been an idiot please feel free to point that out lol
 
Ginny03 said:
You mentioned spagbol and counting the pasta, but you didn't mention the sauce. (If this is because you just had the meat with no sauce, ignore me!) Most store bought sauces are packed with sugar and even home made ones have a fair bit because of the tomatoes, so if its there it needs to be counted. Stick with it - it can take a while to get your ratios right, but it'll be well worth the effort when you do.
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There was a sauce, but it was home made. So how would I work out how much insulin I need just for the sauce? By how much pasatta is used? :/
 
If pasatta is the tomatoes, then yes - you'd need to roughly work out how many carbs were in the amount you used - I kept a calculator in the kitchen!
 
Just thought - was it 80g weight of spag before you cooked it? Raw spag is 73g carb for 100g weight so 80g raw weight = 60g carb.

To establish your carb ratio, wait till there's no fast acting hanging round (so at least 4 hours, preferably longer 4.5 or 5ish hours, after your last jab of it) and your BG is as near 'normal' (over 4 and under 8 - above 8 and you can't do this because you'd need a correction as well which could skew the result) as poss, then eat an exact amount of carbs, and try a dose of 1u to each 10g. By 4 hours later has your BG come back to the same as your pre-meal figure? If it's higher than pre meal you need more insulin, if it's lower, you need less. Repeat as many times as you need to till it's near enough right. That then gives you your carb ratio for that time of day.

If your whole yo-yo problem is only caused by incorrect carb ratio(s) then your problem's solved.

However - a lot of the time people's basal insulin doses need looking at - and to my mind I'd rather get the basal right first - after all, it's the BASIS - and with a firm base, you can build a decent building, can't you? So have a read of this, and spend the next week or so having a go at this first, I should. http://www.diabetes-support.org.uk/info/?page_id=120
 
trophywench said:
Just thought - was it 80g weight of spag before you cooked it? Raw spag is 73g carb for 100g weight so 80g raw weight = 60g carb.

To establish your carb ratio, wait till there's no fast acting hanging round (so at least 4 hours, preferably longer 4.5 or 5ish hours, after your last jab of it) and your BG is as near 'normal' (over 4 and under 8 - above 8 and you can't do this because you'd need a correction as well which could skew the result) as poss, then eat an exact amount of carbs, and try a dose of 1u to each 10g. By 4 hours later has your BG come back to the same as your pre-meal figure? If it's higher than pre meal you need more insulin, if it's lower, you need less. Repeat as many times as you need to till it's near enough right. That then gives you your carb ratio for that time of day.

If your whole yo-yo problem is only caused by incorrect carb ratio(s) then your problem's solved.

However - a lot of the time people's basal insulin doses need looking at - and to my mind I'd rather get the basal right first - after all, it's the BASIS - and with a firm base, you can build a decent building, can't you? So have a read of this, and spend the next week or so having a go at this first, I should. http://www.diabetes-support.org.uk/info/?page_id=120
Click to expand...

Honestly I don't know what the weight of it was before it was cooked - was cooking for the family so it wasn't just my portion in there.

Thank you that is really helpful. My basal dose probably does need looking at, the issue I am having with my care team has been ongoing and it's been well over 2 years now that I haven't see an actual endocrinologist. Can you believe at the last appointment I had the doctor left early because he "forgot" I was there (I had the last appointment of the day)...I mean, really? Complained til I went blue in the face and now have given up! Starting carb counting seems like a good time to start fighting this again. At the very least for a referral to a carb counting course so I'm not just fishing in the dark and bugging you guys! Lol
 
I just walked in my kitchen, got the packet of spag out of the cupboard and read what it said on the back - must admit I'd never dream of using the interwebnet, when the packet's already in my hand - and anyway - they hadn't invented the internet yet when I first started cooking pasta for our dinner! LOL There are a few things I remember from the leaflet I was given in 1972 like 7 chips = 10g and one egg-sized spud = 10g - but sadly pasta wasn't one of Kidderminster General's staples at the time. Neither did they define the size of the spud the chips were cut from, nor who laid the egg - a quail or an ostrich? LOL Consequently - I've learned to always just take my carb info from wherever I can get it easiest.
 
I've just retested sugar and I'm down to 16.7. Should I start thinking about doing a corrective dose?
 
Well I'm cooking for husband and I - so I start off with approx. 150g ish dry weight and when it's cooked I have about a third and he has two thirds - never bothered weighing it cooked ever!
 
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