Carbing day 2

[SilentAssassin1642]

Started out well with the following:

breakfast woke on 5.8 - had porridge again with 7u, 2 hours later 7.5

lunch: 4.5 got it right today with 6u nr and a cheese and marmite sandwich, half a bag of crisps and a kitkat. 2 hours later 9.8 (made a mistake and corrected this...ended up at 2.2!)

dinner: 4.2 (chicken nuggets and chips, worked out as something like 99g carbs so 10u novorapid) - thought it would be ok...but thought I would test hourly just incase...1 hour later and I was 14.6. Hour after that 15.6 😡

It's all gone wrong. I am never having that for dinner again...feeling really rubbish too 😡

18u levemir gone in, due next test ina minute

 

[bev]

Started out well with the following:

breakfast woke on 5.8 - had porridge again with 7u, 2 hours later 7.5

lunch: 4.5 got it right today with 6u nr and a cheese and marmite sandwich, half a bag of crisps and a kitkat. 2 hours later 9.8 (made a mistake and corrected this...ended up at 2.2!)

dinner: 4.2 (chicken nuggets and chips, worked out as something like 99g carbs so 10u novorapid) - thought it would be ok...but thought I would test hourly just incase...1 hour later and I was 14.6. Hour after that 15.6 😡

It's all gone wrong. I am never having that for dinner again...feeling really rubbish too 😡

18u levemir gone in, due next test ina minute

Hi Sam, cheese and chocolate delay absorption due to the fat hence the rise to 9.8 as its missed the insulin - if you were on a pump you could do a dual wave - but perhaps you could have done a split injection for this meal.

Breaded and deep fried things like nuggets and chips are a nightmare! Also a split injection is needed for things like this - a dual wave would have it sorted on the pump.

You got your breakfast perfect - so well done!🙂Bev

 

[SilentAssassin1642]

Hi Sam, cheese and chocolate delay absorption due to the fat hence the rise to 9.8 as its missed the insulin - if you were on a pump you could do a dual wave - but perhaps you could have done a split injection for this meal.

Breaded and deep fried things like nuggets and chips are a nightmare! Also a split injection is needed for things like this - a dual wave would have it sorted on the pump.

You got your breakfast perfect - so well done!🙂Bev

i thought about splitting for dinner, but then thought I'd give a go of having the whole lot in one go. It failed. I never want to eat it ever again feeling really quite rubbish. Lunch wasn't so bad...at least I was below 10 which is what nursey said I should aim for...but well...I still feel like i failed a bit today

 

[bev]

Sam, you didnt fail at all! Your just trying different methods of dealing with things and you will find the best way for you once you have tried and tested!🙂

You are trying - and that is the best thing you can do - your being pro-active instead of just sitting back and letting things happen - so be proud of yourself!🙂Bev

 

[Adrienne]

i thought about splitting for dinner, but then thought I'd give a go of having the whole lot in one go. It failed. I never want to eat it ever again feeling really quite rubbish. Lunch wasn't so bad...at least I was below 10 which is what nursey said I should aim for...but well...I still feel like i failed a bit today

No no no no, you have not failed. You have had a fantastic day which has showed you loads of things. Bev is right. If the nuggets were just breaded and cooked in oven, they are normally ok. It would be the chips that would be the nightmare. As Bev says a split dose. Maybe you could say that every time you have a meal where the whole lot is 20 g or more of fat you split the dose. You could try having half, with the meal, and then maybe the other half an hour later and go from there. Just a thought.

As you are new at carb counting, personally I wouldn't correct anything under 10.0 for a few weeks. Maybe others will disagree with that but get yourself into the swing of things first.

If you have cheese and then chocolate, as Bev says it delays absorption, so maybe do your injection after you eat rather than before. Just another thought.

I think you have had a great day two ! 🙂

 

[Northerner]

i thought about splitting for dinner, but then thought I'd give a go of having the whole lot in one go. It failed. I never want to eat it ever again feeling really quite rubbish. Lunch wasn't so bad...at least I was below 10 which is what nursey said I should aim for...but well...I still feel like i failed a bit today

I thought you did well for lunch - I would have gone to about the same after 2hrs after eating that, but I wouldn't have corrected. In my opinion, it's not worth correcting within 4 hours of your meal injection as you're just confusing the whole carb-counting thing - you've dosed for the meal so you still have enough insulin to cover it, it's just that the meal spiked you a little so maybe the timing of the injection was slightly out (but pretty darned close to get only 9.8). I wouldn't have been at all worried about the lunch levels - and remember, I'm Mr Perfect Levels!🙂

 

[margie]

Ah Sam

Don't they say you have to fail to succeed. Its what you do with the failure that counts ie turn it in to a success, and really on your second day you shouldn't be too upset with yourself you are just learning how certain foods effect you. You'll get there.

 

[Northerner]

...As you are new at carb counting, personally I could correct anything under 10.0 for a few weeks. Maybe others will disagree with that but get yourself into the swing of things first.
...

Yup! I'd disagree (as I think I just did!). You do your carb count, inject and then wait to see if it worked i.e. did your insulin dose match the food? If you correct before 4 hours (5 for me) at only a slightly high level you're bound to hypo if your original carb count was correct.😱😉 It's only after the meal bolus has gone that you can make a judgement about whether you got the dose right and then maybe consider changing the timings or your bolus/ratio for the next time you eat that meal.

 

[bev]

Yup! I'd disagree (as I think I just did!). You do your carb count, inject and then wait to see if it worked i.e. did your insulin dose match the food? If you correct before 4 hours (5 for me) at only a slightly high level you're bound to hypo if your original carb count was correct.😱😉 It's only after the meal bolus has gone that you can make a judgement about whether you got the dose right and then maybe consider changing the timings or your bolus/ratio for the next time you eat that meal.

Northey - not so! It all depends on what you have eaten. If you have had a very fatty meal - then the likelihood is that you will go even higher! So correcting a high at 2 hours for a level you werent expecting can sometimes be the right thing to do.🙂Bev

 

[Flower87]

No no no no, you have not failed. You have had a fantastic day which has showed you loads of things. Bev is right. If the nuggets were just breaded and cooked in oven, they are normally ok. It would be the chips that would be the nightmare. As Bev says a split dose. Maybe you could say that every time you have a meal where the whole lot is 20 g or more of fat you split the dose. You could try having half, with the meal, and then maybe the other half an hour later and go from there. Just a thought.


If you have cheese and then chocolate, as Bev says it delays absorption, so maybe do your injection after you eat rather than before. Just another thought.
)

Does fat stop the absporbtion of insulin as well as carbs?? What is the aim of splitting the dose - to stop a possible hypo or a possible spike??

 

[Flower87]

p.s i think this is a very good 2nd day!!! well done!

 

[Adrienne]

Yup! I'd disagree (as I think I just did!). You do your carb count, inject and then wait to see if it worked i.e. did your insulin dose match the food? If you correct before 4 hours (5 for me) at only a slightly high level you're bound to hypo if your original carb count was correct.😱😉 It's only after the meal bolus has gone that you can make a judgement about whether you got the dose right and then maybe consider changing the timings or your bolus/ratio for the next time you eat that meal.

Ooops I meant 'I wouldn't correct anything under 10....... will edit !

 

[Northerner]

Ooops I meant 'I wouldn't correct anything under 10....... will edit !

I'll let you off! Proof reading class for you young lady!😉

 

[bev]

Does fat stop the absporbtion of insulin as well as carbs?? What is the aim of splitting the dose - to stop a possible hypo or a possible spike??

Insulin peaks at 2 hours - so if you dont inject at the right time i.e when your food is likely to also hit its peak of aborption - then you will suffer a hypo and then later a rise. So the aim of a split dose is to spread the peak over a 4 hour period and therefore avoid the inevitable rise from spiky foods.

Fat stops the aborption of food so therefore makes it hard for the peak of insulin to find the peak of food absorption.🙂Bev

 

[Flower87]

Thanks Bev 🙂 I notice in another thread you've said about having a CGM. I've been using 1 for the last 2 weeks and actually noticed that my insulin seems to come through really slowly - so even when my food is slow to come through, i don't suffer a hypo because the insulin hasnt come through yet.

I know your son is on a pump - is it a different type of insulin? I'm on novorapid but after these 2 weeks i feel it should be called novomediumspeed!!! Perhaps its the places i'm injecting?

Sorry to go a little off topic!

 

[Adrienne]

Does fat stop the absporbtion of insulin as well as carbs?? What is the aim of splitting the dose - to stop a possible hypo or a possible spike??[/QUOTE

No, only the food.

As an example :

If you eat a cheese sandwich with lots of cheese and kitkat, the fat from the cheese and chocolate will slow down the absorption of the whole meal and instead of the food being absorbed in say 2 or 3 hours if perhaps had marmite instead of cheese, the fat will make the meal take say 4 to 5 hours to absorb.

If you give insulin before eating, the insulin will start working after about 20 to 30 minutes and the peak is at about say 2, 3 hours then it slows down, it will miss the food spike at 4 or 5 hours so sending levels up !

If you split the dose, the first lot will cover the early absorption of food but if you wait an hour or bit more (depending on what works for you) it will cover the spike at 4 or 5 hours.

It is trial and error and doesn't work for everyone.

By being on a pump (or rather working with my daughter who is on one) you actually learn more about basic food and what it does to the body and levels because it is easier to give more complicated bolus' on a pump where you can't on injections. There are people on our children's email group on MDI who do now regularly do split doses dependant on fat content and even a pasta meal. It works but hard to do and hard to get right.

Hope that explains it a bit better but remember I am not a qualified expert, only a mum, so there will be other, better explanations etc from a qualified bod, I can only go on my own experience. 🙂

 

[Northerner]

Northey - not so! It all depends on what you have eaten. If you have had a very fatty meal - then the likelihood is that you will go even higher! So correcting a high at 2 hours for a level you werent expecting can sometimes be the right thing to do.🙂Bev

Nope, I don't accept that - if you've counted the meal correctly you've got the insulin right - any spike is down to timing. In the example you suggest I'd discover that I was too high before my next meal and realise that I needed to change the timing of my injection. I would then add in an adjustment to my next meal bolus.

But, of course, we are all different I have corrected twice since diagnosis, and my pre-meal levels are practically always well within range, so I'm probably biased (and unusual!). I just think corrections are sometimes given too freely as a panic measure rather than waiting and learning. I guess it's a lot different on the pump because you can calculate on-board insulin, but it would just mean a lot of confusion and overlapping doses for me I'm afraid!

 

[am64]

sam..just want to say i think you are doing really well your levels seem to not be swinging so voliently recently.. good luck xxx

 

[Adrienne]

Thanks Bev 🙂 I notice in another thread you've said about having a CGM. I've been using 1 for the last 2 weeks and actually noticed that my insulin seems to come through really slowly - so even when my food is slow to come through, i don't suffer a hypo because the insulin hasnt come through yet.

I know your son is on a pump - is it a different type of insulin? I'm on novorapid but after these 2 weeks i feel it should be called novomediumspeed!!! Perhaps its the places i'm injecting?

Sorry to go a little off topic!

Hi Flower

Insulin gets absorbed differently in different people. The say that it should be gone after 5 hours (novorapid that is) but who knows !

Yes it will depend where you inject. The tummy is fastest so what some people do is if they have pasta or rice or fatty food they inject in leg or arm. If something without those added complications then in the tummy. Mashed potato is very quick absorption so a tummy injection would be great.

If you have lumps then those needed to be avoided at all costs, they just absorb the insulin and it does nothing.

 

[Adrienne]

Nope, I don't accept that - if you've counted the meal correctly you've got the insulin right - any spike is down to timing. In the example you suggest I'd discover that I was too high before my next meal and realise that I needed to change the timing of my injection. I would then add in an adjustment to my next meal bolus.

But, of course, we are all different I have corrected twice since diagnosis, and my pre-meal levels are practically always well within range, so I'm probably biased (and unusual!). I just think corrections are sometimes given too freely as a panic measure rather than waiting and learning. I guess it's a lot different on the pump because you can calculate on-board insulin, but it would just mean a lot of confusion and overlapping doses for me I'm afraid!

Sorry Northe, Bev is right. It is not just about the timing of the injection, it is all to do with the food as well. Timing is crucial but so is the scientific knowledge of what the food can do.

Plus the fact that each person is different. If you, Sam, Louise, Alex, Jessica all ate the same meals and did the same in a 24 hour period the difference would be remarkable. You say that you have great levels and can sort that out with timings, that is fantastic to be able to have that work for you. I can guarantee you that the others won't have that. From what I know now of Sam and Louise and of course the kids, they are not as easy to manage like that. Please don't take that wrongly. I know it is not easy, I don't mean it like that as I know diabetes isn't easy but I hope you get what I mean.

You could eat say two slices of white bread at 30 carbs and 100 g of basmati rice also at 30 carbs.

The bread you would need to inject before eating as it is extremely quick working and the rice you would have to inject after as it is very slow. It doesn't actually start working for about 30 minutes and creeps along.