Carb counting help please! / with steel cut oats porridge ( Help with ‘splitting dosages’

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Upset Racoon

Upset Racoon

Active Member
Relationship to Diabetes
Type 1
Hi ,



Many months ago I posted on this forum and although I didn’t reply, I had incredibly helpful and informative answers so thank you



However I still feel I’m at a loss to the whole carb counting .. I guess …and that doesn’t feel good enough and very reckless



I would love to be able to manage to eat porridge for example .. today, I had a 60g portion of steel cut oats 33.66g carb worth and ( with 7g worth or milk) so it totalled 46.86 of carb, oh and the strawberries, again , only adding 6g carbs to the total
I eat my first meal quite late in the day, just like I did today ( around 12pm)
and according to my libre my blood was around 8.9 /9 ish but unfortunately it spiked to around twelve but about an hour later managed to work into a healthy range but ( unfortunately!) was gradually reducing .. I had to have a biscuit then dosed 4 for 42g of popcorn.
it went to about 8 but then fell into a hypo ( was on its way anyway ) after me dosing 5 for a 52g banana protein pot thing
Does porridge unfortunately look like it’s not suitable for me ? I counted it as being 46.86 in total and I I used the 1:7 ratio. From my understanding I seem to need that little bit xtra insulin as my first meal of the day . But why did this happen ? Wrong ratio ? Wrong to eat anything anyway as it was already high ? porridge not suitable ? I done hula hooping yesterday .. yes I could have done the 1:8 ratio .. surely would have been a bigger spike though

Here is the libre .. proof ! I manually tested it aswell to make sure it was correct .. and close enough …
 
and I had two jelly babies once finished my banana pot ( didn’t have access to sweets when I would have liked to ‘catch’ the hypo before it happened . but WHY was that hypo happening in the first place ? Was it due to the porridge dosaging
Really dislike this
 
We used to find porridge a real pain to dose for, because it’s quite slow to digest so we’d end up with the insulin working faster than the porridge and she would always go low after eating it. She’s on a pump so in the end we had to tell the pump to deliver 30% immediately and the rest over about 90 minutes to avoid the drop. If you are on injections you could try splitting the dose and have some up front and the rest an hour or so later. How much up front and how long to wait is a matter of trial and error.
The other thing to consider is, are you sure you didn’t make a mistake counting the carbs? I never used to bother counting the milk as there isn’t much carb in it and it didn’t seem to make any difference.
 
Going from 9 to 12 isn’t much of a spike. If you only rose 3mmol, you’d have ‘spiked’ to 9 if you’d started at 6mmol. The problem was you dropping later. I’d try splitting your porridge bolus so that all the insulin doesn’t hit at once. You might also need to look at your ratio. It’s a case of experimenting, keeping notes, and working out what works best for you. I wouldn’t have counted the carbs in that small amount of strawberries, so perhaps you just had a bit too much bolus. Certainly nothing you’ve said suggests you need to avoid porridge. It just needs some tweaks to get your insulin dose and timings right.
 
Thank you for both your helpful answers 🙂 however…..I feel I need even more help .. I have great difficulty ‘spilting the dose ‘ for example something that was worth 50g of carbs but say, was fatty …I usually start by dosing 5 units ,, then maybe about 4 about an hour later ..
yet I hear others do ‘the first 60% followed by the remaining 40% say couple of hours later . Well i’m reluctant to try that as .. ( I can’t even work out 40 percent of 50, sorry ) not good at maths . It would go really high surely as in the example above I’m already putting ‘100%’ of the dose before putting extra in , It’s a huge amount of guess work and I clearly don’t know what I’m doing :(
HELP , I DONT UNDERSTAND FOOD RATIOS, splitting dosages / working out percentages : S

I just keep putting random amounts on top of more random amounts.
 
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Easy way to work out the percentages (to me anyway)

If your total calculated dose is 5 units 10% is a tenth of that = 0.5 units so 60% is 6 tenths i.e. 0.5 x 6 = 3

You are allowed to use a calculator as well so 60% of anything is your total figure x 0.6

Works for me. May or may not for you.
 
@Upset Racoon You can split the bolus by splitting it into halves or a third then the remains two-thirds or vice versa. In your case, if it was me, I’d ignore the ‘spike’ for now because it wasn’t really a spike (only rose 3mmols). I’d ignore the strawberry carbs and call your porridge and milk a round 40g carbs (presuming you’ve got the right carb counts for the oats and milk). I’d then knock a bit off your ratio, eg try 1:8g or 1:9g and try that. To my mind, your biggest issue was the drop. You might even need 1:10g.

That’s an easy first thing to try before you consider splitting the bolus.
 
I've been using insulin now for a little over 3 months and starting to get the hang of it a bit with some good results.
My nurse is pleased with my grasp of it and the results I'm getting.
she has more or less left me to my own devices from day one with the learning process and making my own ajustments.
One of the things i have noticed is that if i eat a carbohydrate meat for example total 60g i need 12 units of novo rapid with my insulin resistance of about 4.9g to 1. if i inject before the meal my levels can drop from say 5.5% to 4.0% even 3.6% very quickly.before they start to rise as my body needs time to absorb the carbs i am eating. i therefor find i need to inject either directly after my meal or halfway through it to stop this from happening even though i have be told to inject before each meal. getting the timing right is hard, to stabilise and maintain a level within range i difficult because of the differences in absorption rates for different foods..is anyone else experiencing this or is this just the way my body is using Novo rapid ?

using a CGM Libra2
Derek
 
Sorry to hear you are finding the ratios and splits hard to get your head around @Upset Racoon

While I do use ratios now, I didn’t so much for many years. Instead I had a set of fairly predictable scenarios to choose from by keeping to a fairly consistent set of meals, and working out the doses that ‘worked‘ (more or less) for them.

So I’d eat the same breakfast weekdays, and a different (but also consistent) breakfast at weekends. And the same with lunch... eat the same lunch and take the dose that ‘works’. For evening meals I’d mix it up, but always aim for the same total carbs, and again take a fairly consistent dose with whatever timing/split ‘worked’ for that particular meal.

Saved working it out every time!
 
One of the things i have noticed is that if i eat a carbohydrate meat for example total 60g i need 12 units of novo rapid with my insulin resistance of about 4.9g to 1. if i inject before the meal my levels can drop from say 5.5% to 4.0% even 3.6% very quickly.before they start to rise as my body needs time to absorb the carbs i am eating. i therefor find i need to inject either directly after my meal or halfway through it to stop this from happening even though i have be told to inject before each meal. getting the timing right is hard, to stabilise and maintain a level within range i difficult because of the differences in absorption rates for different foods..is anyone else experiencing this or is this just the way my body is using Novo rapid ?

Well done on getting the hang of insulin. It is a big change @delboy A couple of things: 1 unit to 4.9g is your meal ratio (I’d just call it 1:5g), and your blood sugar levels of 5.5 and 4.0 are measured in mmols not percentages. Does your blood sugar drop quickly every time you inject before food or just at some meals? Where are you injecting the Novorapid (which body area)? But yes, it can be difficult to get the timing right, and yes, foods are absorbed at different rates. You could keep a note of what works for each meal. Don’t aim for perfection. It’s not possible.
 
I try to be consistant with where i inject. Belly has quick effect, leg and thigh, middling, bum slow. I use bum for basal, thigh for meals when i can prebolus, tummy for corrections or if i can't prebolus.
Its like a science experiment... best to keep everything the same and just change one thing at a time to see what effect it has.
If you digest slowly perfectly finecto do insulin after eating. Whatever works with your diabetes
 
Upset Racoon said:
then fell into a hypo ( was on its way anyway ) after me dosing 5 for a 52g banana protein pot thing
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What exactly was the banana protein pot thing? Could you have read the carbs wrong on that? The protein yoghurts are normally about 5g carb not 50g
 
Inka said:
One of the things i have noticed is that if i eat a carbohydrate meat for example total 60g i need 12 units of novo rapid with my insulin resistance of about 4.9g to 1. if i inject before the meal my levels can drop from say 5.5% to 4.0% even 3.6% very quickly.before they start to rise as my body needs time to absorb the carbs i am eating. i therefor find i need to inject either directly after my meal or halfway through it to stop this from happening even though i have be told to inject before each meal. getting the timing right is hard, to stabilise and maintain a level within range i difficult because of the differences in absorption rates for different foods..is anyone else experiencing this or is this just the way my body is using Novo rapid ?

Well done on getting the hang of insulin. It is a big change @delboy A couple of things: 1 unit to 4.9g is your meal ratio (I’d just call it 1:5g), and your blood sugar levels of 5.5 and 4.0 are measured in mmols not percentages. Does your blood sugar drop quickly every time you inject before food or just at some meals? Where are you injecting the Novorapid (which body area)? But yes, it can be difficult to get the timing right, and yes, foods are absorbed at different rates. You could keep a note of what works for each meal. Don’t aim for perfection. It’s not possible.
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Thanks for the reply. I just need a little feedback to insure I’m doing the right thing. since I’ve been dairying what I’m eating this is helping and I’m not guessing as much what on the plate. and yes, I do mean 5.5% on the old scale or 37mmol because that’s how my CGM reports it. I do find it odd that test strips and my CGM both report back a % of glucose when you really need mmol. I usually find it drops dependant on the amount of novo rapid units. If for example If have a 50-carb meal that’s 10 clicks for me, I can usually inject before the meal. any more than 10 units then I need to consider when to take it. what I have found that works for me is I tend to have my phone on the table next to me and when I start to see a rise of more than 0.3% on my CGM I inject in the belly of leg. maybe I’m asking too much It’s like a game to me and very satisfying when you get it spot on and the line just stays flat with no rise or dips.
 
@delboy I used to use the Libre 2 - that’s what you’re using? It reports blood sugar in mmol. Look at your current blood sugar to work out your insulin/timing and ignore the HbA1C prediction or anything.
 
Lucyr said:
What exactly was the banana protein pot thing? Could you have read the carbs wrong on that? The protein yoghurts are normally about 5g carb not 50g
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I find high protein, low carb food like these spike my BG unless I bolus for the protein on top of the carbs.
For me, this was a huge pain because the insulin to protein ratio was different to the insulin to carb ratio and could be different for different protein. On top of that, the insulin timing is different (protein is converted to glucose slower than carbs).
I decided it wasn't worth the extra brain power and definitely showed no reward.
My advice to @Upset Racoon would be to master normal carb meals and insulin to carb ratios before trying low carb substitutes like this.

Others with Type 1, find they can manage it which is another indication we are all different.
 
Upset Racoon said:
Does porridge unfortunately look like it’s not suitable for me
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Hi @Upset Racoon

I was amazed when I got my sensors at what was happening to my glucose levels when I ate porridge. I had had that for years thinking that it was a healthy breakfast. It may well be but I found it very hard to dose my bolus insulin and avoid spikes. I took it off my list and now make my own porridge using Quinoa flakes, mixed with lots of seeds and nuts. Much lower carbs (14% of the weight of mix, rather than 50%of the weight of oats) and now a blip after breakfast rather than a big spike.

I hope that helps. Let me know how you get on.
 
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