Carb counting question

[RoseH]

Hello everyone
Really sorry if this is a stupid question but I’m just learning carb counting, my diabetes team said to not insulin a snack even if it’s higher carb if you’ve had your meal insulin in the last 4 hours as it works for that long. My question is if I’ve put the right amount in for say dinner and a few hours later I want a high carb snack would I not put insulin in even though there is no insulin to account for it or would I insulin it.
Thanks

 

[Inka]

Hi @RoseH Are you using some kind of calculator app to work out your carb counting/doses? I wasn’t quite sure from what you wrote.

Yes, bolus (fast/meal) insulin lasts for around 4 hours so you need to be aware that you’ll still have insulin working if, say, you test at two hours post-meal. It’s likely that your blood sugar will continue to fall and be lower by the time you test again before your next meal.

I bolus for higher carb snacks but I’ve had Type 1 decades. I suggest you don’t bolus to start with. You need to get experience in what you’re doing. Stick to lower carb snacks eg below 20g for now, or carb-free snacks like cheese, etc. Once you get the hang of carb-counting and get a feel for how your body reacts, then you can be more flexible. For now, stick to what you’ve been told and keep your snacks lowish carb with no bolus insulin for them.

 

[Inka]

It would also be helpful to jot down notes about your blood sugar and your snacks, so you know good low carb snacks and are aware of how your body is reacting. I think you’re fairly recently diagnosed, so remember too that you’ll probably be making some of your own insulin too. This can kick in at odd times and cause your blood sugar to go low randomly, hence why it’s best to be cautious.

 

[RoseH]

Hi @RoseH Are you using some kind of calculator app to work out your carb counting/doses? I wasn’t quite sure from what you wrote.

Yes, bolus (fast/meal) insulin lasts for around 4 hours so you need to be aware that you’ll still have insulin working if, say, you test at two hours post-meal. It’s likely that your blood sugar will continue to fall and be lower by the time you test again before your next meal.

I bolus for higher carb snacks but I’ve had Type 1 decades. I suggest you don’t bolus to start with. You need to get experience in what you’re doing. Stick to lower carb snacks eg below 20g for now, or carb-free snacks like cheese, etc. Once you get the hang of carb-counting and get a feel for how your body reacts, then you can be more flexible. For now, stick to what you’ve been told and keep your snacks lowish carb with no bolus insulin for them.

I’ve only been doing it like a week but I have one unit to every ten carbs , thank you this is really helpful.

 

[RoseH]

It would also be helpful to jot down notes about your blood sugar and your snacks, so you know good low carb snacks and are aware of how your body is reacting. I think you’re fairly recently diagnosed, so remember too that you’ll probably be making some of your own insulin too. This can kick in at odd times and cause your blood sugar to go low randomly, hence why it’s best to be cautious.

Thank you that’s really helpful and yeah I was diagnosed from a serious DKA in august so still in very early stages feel like there’s so much to learn it’s never ending haha ! Thanks again

 

[Inka]

You’re welcome 🙂 Always be cautious early on in diagnosis. It’s best to be a bit high than risk a bad hypo.

P.S - your question wasn’t stupid at all. No question here is stupid 🙂

 

[Inka]

I’ve only been doing it like a week but I have one unit to every ten carbs , thank you this is really helpful.

Over time you may find your ratio (yours is currently 1:10g) might be slightly different for each meal eg higher for breakfast, lower for evening meal or whatever. 1:10g is a good starting place and makes the Maths easy.

 

[trophywench]

I've been T1 for yonks and my ratio is still 1u to 10g; I don't very often snack between meals but have found that when I decide to eat cake with my afternoon cuppa which is quite frequently 30g-ish, I need less so 1u to 12g (ish) otherwise I'll be hypo before dinner.

It's all a balancing act - and I've normally learned such things from my own 'mistakes' ! It's a lifelong experiment on yourself !

 

[helli]

@RoseH there are a number of things to consider when snacking between meals
- active bolus insulin currently in your body, Most fast acting insulins we inject remain active for about 4 hours. If you inject more during this time, you risk "stacking" and having too much insulin.
-slow acting insulin is taken once or twice a day. A "good" slow acting insulin is one with a flat profile. However, our liver drips a different amount of glucose at different times of the day so, in reality , out slow acting (basal) insulin needs are not constant. As a result, we may have "spare" slow acting insulin active and a mid meal snack can "mop up" this insulin.
- we are all different. We eat different things. We do different amounts of exercise. We live with different amounts of stress. Our bodies react differently at different times of the day. ...

These reasons are why it is often advised not to dose for snacks between meals.
If you keep track of what you eat and what your levels are, you will start to learn if there are some snacks or some times of the day that could require extra insulin. But as, @Inka mentioned, it is better to play it safe when first diagnosed to avoid hypos with all that extra insulin sloshing around our bodies.

(Sorry, maybe "sloshing" is not the best word - it has conjured up some bizarre images in my weirdly wired brain 🙄).

 

[RoseH]

Over time you may find your ratio (yours is currently 1:10g) might be slightly different for each meal eg higher for breakfast, lower for evening meal or whatever. 1:10g is a good starting place and makes the Maths easy.

Yeah I do find my sugars react different at different times of day

 

[RoseH]

I've been T1 for yonks and my ratio is still 1u to 10g; I don't very often snack between meals but have found that when I decide to eat cake with my afternoon cuppa which is quite frequently 30g-ish, I need less so 1u to 12g (ish) otherwise I'll be hypo before dinner.

It's all a balancing act - and I've normally learned such things from my own 'mistakes' ! It's a lifelong experiment on yourself !

Yeah I figured it will be a case of learning from mistakes , just feels quite nervy making them mistakes it’s all quite new but I’ll get there , thank you x

 

[RoseH]

@RoseH there are a number of things to consider when snacking between meals
- active bolus insulin currently in your body, Most fast acting insulins we inject remain active for about 4 hours. If you inject more during this time, you risk "stacking" and having too much insulin.
-slow acting insulin is taken once or twice a day. A "good" slow acting insulin is one with a flat profile. However, our liver drips a different amount of glucose at different times of the day so, in reality , out slow acting (basal) insulin needs are not constant. As a result, we may have "spare" slow acting insulin active and a mid meal snack can "mop up" this insulin.
- we are all different. We eat different things. We do different amounts of exercise. We live with different amounts of stress. Our bodies react differently at different times of the day. ...

These reasons are why it is often advised not to dose for snacks between meals.
If you keep track of what you eat and what your levels are, you will start to learn if there are some snacks or some times of the day that could require extra insulin. But as, @Inka mentioned, it is better to play it safe when first diagnosed to avoid hypos with all that extra insulin sloshing around our bodies.

(Sorry, maybe "sloshing" is not the best word - it has conjured up some bizarre images in my weirdly wired brain 🙄).

Yeah I don’t often snack just if it’s going a little low with two young children that can happen quite a lot , thank you for all the info much appreciated x

 

[RoseH]

Nothing to add but... best of luck. Takes a while to get to know your body and its metabolism. You are questioning enough that you will get there after a while 🙂

Thank you means a lot ☺️

 

[trophywench]

Never stop asking questions, Rose! I haven't, yet .......

And this lifetime's experiment we all had no choice about volunteering for - you gradually realise that most times, it doesn't usually turn out to have been a complete disaster very very quickly - so you usually have time to do something to rectify it before having to be blue lighted to A&E.

 

[RoseH]

Never stop asking questions, Rose! I haven't, yet .......

And this lifetime's experiment we all had no choice about volunteering for - you gradually realise that most times, it doesn't usually turn out to have been a complete disaster very very quickly - so you usually have time to do something to rectify it before having to be blue lighted to A&E.

Yeah I agree think I’m still a little cautious I was a normal 25 year old a few months ago and I caught a sickness bug of my young kids and next thing I know I wake up in hospital with severe DKA in a very bad way and learn I’m type 1, I’m sure I’ll get used to it I’m only a week or so into carb counting just all a lot of learning especially judging doses when I’m always up on my feet with the children but I’ll get there , i more just want to eat all the nice Christmas food haha x

 

[Thebearcametoo]

What works for us (11 year old so using more carbs just growing & existing than an adult tends to) is to bolus for a snack above 20g carbs but not to put a correction in for if he’s above target. At the moment we’re dealing with a growth spurt so that seems to mean 15* meals a day and lots of insulin


*only a slight exaggeration

 

[trophywench]

What works for us (11 year old so using more carbs just growing & existing than an adult tends to) is to bolus for a snack above 20g carbs but not to put a correction in for if he’s above target. At the moment we’re dealing with a growth spurt so that seems to mean 15* meals a day and lots of insulin


*only a slight exaggeration

Think you have a clone of our grandson who inhaled food and became slightly better padded in the summer despite the cricket. New uniform to go back to school in Sept, then shot up another 2 inches ready for the rugger season. I christened his tapeworm Ravenous Reggie. Seems to have settled at 6ft 3 since age 18 but RR is evidently still alive since Tim still inhales food aged 24 and never puts on weight. His dad was exactly the same and so was his dad .......

 

[trophywench]

PS of course RR doesn't exist and never has.