Carbing day 2

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no arguing on my carby thread peeps 🙂

down to 11.0 now - keeping an eye as i have a funny feeling i may have rage bolused earlier on...oh joy of joys

really annoyed about dinner though. Korma tomorrow night...I hope that won't be as bad :(
 
Northerner said:
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:D 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!
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If you carb count - you will have the carbs/ratio correct, so if you do go high at the 2 hour mark - then yes its a question of timing - and the reason for this is because of the food you have eaten - i.e. fatty food. I personally dont want Alex to be high for 4 hours - so i correct at 2 hours and deal with any fallout at the 4 hour mark - but mostly he is in range at the 4 hour mark if we have corrected.

If you have only needed to correct twice since diagnosis - thats amazing! I do think your probably not a 'real type 1'! Did you have the c-peptide test done?
Overlapping of doses is a regular occurence for us - i dont know if thats a good thing or not - but the hba1c is coming down - so that tells me something. Sometimes we live on corrections! I think that is the nature of diabetes in a child to be honest.

I dont think it matters whether you achieve a good hba1c through corrections or being on top of the game all of the time -the end result is the same. Alex is on 220% basal at the moment because he has a cold - so in effect this is a correction - but why is this wrong?🙂Bev
 
hehehehehehe😛
 
Adrienne said:
hehehehehehe😛
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Whoops, wasn't laughing at you Bev, I agree with you, I was laughing at Sam's 'don't argue on my thread' bit which I thought was funny.

No worries, Sam, just healthy debate.


Bev, I do hope Alex is ok. Becca has done this and gone up to 400% before now due to illness.
 
bev said:
Sometimes we live on corrections! I think that is the nature of diabetes in a child to be honest.
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Seems to be the same for this 21 year old at the moment too :(😛

Adrienne said:
hehehehehehe
Whoops, wasn't laughing at you Bev, I agree with you, I was laughing at Sam's 'don't argue on my thread' bit which I thought was funny.

No worries, Sam, just healthy debate.
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:Dmade me giggle:D
 
You guys are such a fountain of knowledge!!

I found whilst being on the CGM that my levels would go up to 13 or 14 after eating but then take quite a while (over 2 hrs) to come down. They would come down though, so i wouldnt want to do more bolus because i would end up needing to eat more, which isn't practical for me. Do you think splitting the dose may help to stop this?

When my levels were lower before eating (around 4) and i didnt inject until after i;d eaten, my levels stayed lower.
 
I'm not really arguing Sam, just trying to understand! I know I am very lucky compared to many people. I think my point is simply that, when you are first learning to carb count, doing corrections and having overlapping doses just seems to add a whole extra level of confusion and obfuscation to the learning process. I have never yoyoed with my levels as many do, so I've not really had to think about it too deeply. My highest level since diagnosis was a 15.x in about August 2008, plus a couple of 13.x after meals out where I've been cautious with my dose and preferring to be high rather than low, so explainable.

Gawd, I sound so smug, and I really don't mean to!😱
 
Flower87 said:
You guys are such a fountain of knowledge!!

I found whilst being on the CGM that my levels would go up to 13 or 14 after eating but then take quite a while (over 2 hrs) to come down. They would come down though, so i wouldnt want to do more bolus because i would end up needing to eat more, which isn't practical for me. Do you think splitting the dose may help to stop this?

When my levels were lower before eating (around 4) and i didnt inject until after i;d eaten, my levels stayed lower.
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It really depends on the foods your eating. If its a high fat food - then i would say yes - split the dose. If you have fish and chips for example, have half the dose up front and then the rest at the 2 or 3 hour stage as it takes about 5 or 6 hours to digest this sort of food.🙂Bev
 
bev said:
It really depends on the foods your eating. If its a high fat food - then i would say yes - split the dose. If you have fish and chips for example, have half the dose up front and then the rest at the 2 or 3 hour stage as it takes about 5 or 6 hours to digest this sort of food.🙂Bev
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...unless you're me, and following the fish and chip cure!😉

http://www.diabetessupport.co.uk/boards/showthread.php?t=6921
 
Northerner said:
I'm not really arguing Sam, just trying to understand! I know I am very lucky compared to many people. I think my point is simply that, when you are first learning to carb count, doing corrections and having overlapping doses just seems to add a whole extra level of confusion and obfuscation to the learning process. I have never yoyoed with my levels as many do, so I've not really had to think about it too deeply. My highest level since diagnosis was a 15.x in about August 2008, plus a couple of 13.x after meals out where I've been cautious with my dose and preferring to be high rather than low, so explainable.

Gawd, I sound so smug, and I really don't mean to!😱
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yes northe, you are soooooo smug 😛 and a very very lucky bloke with such awesome levels. I am jealous...really very jealous!!!

i was only joking bout the arguing 🙄 lol

you're right though, it is SO confusing......and I dislike it immensly at the moment :(
 
Thank you.

Northerner - i can understand your point, I agree it's hard to work out timings and ratios if there are too many corrections going on. When i did my carb counting course i was told only to test before meals and do any corrections then. Obviously this doesnt always work if you're feeling rubbish and its hours before your next meal.

Its all so complicated!! 🙄

I wonder how you all remember the rules and timings for different foods? (e.g fish and chips makes me do this so i need to give extra etc.) do you write it down?
 
Northerner said:
I'm not really arguing Sam, just trying to understand! I know I am very lucky compared to many people. I think my point is simply that, when you are first learning to carb count, doing corrections and having overlapping doses just seems to add a whole extra level of confusion and obfuscation to the learning process. I have never yoyoed with my levels as many do, so I've not really had to think about it too deeply. My highest level since diagnosis was a 15.x in about August 2008, plus a couple of 13.x after meals out where I've been cautious with my dose and preferring to be high rather than low, so explainable.

Gawd, I sound so smug, and I really don't mean to!😱
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Hiya

You don't smug. I do agree with you actually. When you start carb counting it is much easier if you just learn the carb counting. But then if you do it wrong you do have to correct. Also if you are just starting then it is no good going for the complicated foods like pasta, pizza etc. However most people aren't told that, we only know that from experience. Sam and Louise as starting out and I agree with you that correcting for under 10 is a no go area at the moment as they may have not got their ratios right so they need to get a feel for the food they are eating and what insulin ratios work for them.

I correct over 9 now but the pump doesn't always allow it and depending on what she has been doing depends on whether I override or not.
 
Flower87 said:
Thank you.

Northerner - i can understand your point, I agree it's hard to work out timings and ratios if there are too many corrections going on. When i did my carb counting course i was told only to test before meals and do any corrections then. Obviously this doesnt always work if you're feeling rubbish and its hours before your next meal.

Its all so complicated!! 🙄

I wonder how you all remember the rules and timings for different foods? (e.g fish and chips makes me do this so i need to give extra etc.) do you write it down?
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Yes some people write it down. I spent about 6 years doing graphs etc but got fed up so don't write anything down and just work it out in my head but I need to start writing it down as if something works sometimes I forget what I did !!!

Not sure I understand why you were told to only correct before meals.

The only way to work out your ratios is to test two hours after insulin (for a meal). You should aim to have your levels within 2 mmol either side of what they were before you ate. If they aren't then you may need to change your ratio but if you are very high then you may need to correct so you can start again at the next meal. You can't test your ratio if you have to add in a correction to your meal time insulin. You can only know if it is right if you start at a good level. Does that make sense?
 
Yep that makes total sense. However, like i was saying I've now noticed that in actual fact my insulin takes longer to come through so if i corrected after 2 hours this would cause me to go low. So perhaps a correction after 3 or 4 hours if blood sugar still hasnt come down? Again, everyone is different!
 
Adrienne said:
...Not sure I understand why you were told to only correct before meals.

The only way to work out your ratios is to test two hours after insulin (for a meal). You should aim to have your levels within 2 mmol either side of what they were before you ate. If they aren't then you may need to change your ratio but if you are very high then you may need to correct so you can start again at the next meal. You can't test your ratio if you have to add in a correction to your meal time insulin. You can only know if it is right if you start at a good level. Does that make sense?
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That's basically what I do. If I'm a little higher than I'd like before a meal, I'll add an extra unit in. Not sure if I was told to do it that way - I think I might have read it in Think like a Pancreas.
 
I don't think that the carb counting course I did was particularly great - however, the other reason not to correct at the beginning is that the pattern from before meal a to 2 hours after to the next meal can also indicate whether there is a problem in basal levels. If you are a lot lower at the next meal it can indicate that the basal is too high. The nurses said not to worry about running high for a few weeks whilst sorting things out as the long term benefits were worth it.
 
margie said:
I don't think that the carb counting course I did was particularly great - however, the other reason not to correct at the beginning is that the pattern from before meal a to 2 hours after to the next meal can also indicate whether there is a problem in basal levels. If you are a lot lower at the next meal it can indicate that the basal is too high. The nurses said not to worry about running high for a few weeks whilst sorting things out as the long term benefits were worth it.
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Absolutely Margie, you are totally right.
 
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