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

[redrevis]

Just showing off now Alan 😛

I'll be 97, yey!

 

[MaryPlain]

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]

Aha I spose so :

 

[Mark T]

...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]

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

 

[Northerner]

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]

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]

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]

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]

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]

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]

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]

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

 

[Phil65]

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]

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]

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]

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 c**p 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]

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]

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]

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.