CHO Counting Course

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MCH

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I have attended the first day of the CHO counting course. It was extremely interesting and useful and both the DSN and dietician are very knowledgeable and have a very realistic notion of what being diabetic is like.

We have all been given a way of calculating the carbohydrate content of various foods ?based on the BDEC stuff AND a free copy of the GEM Calorie counting book ? which apparently is better than some of the other versions because it has the values per 100g of food ? AND a free calculator (courtesy of a drug company) which I have now discovered is small enough to fit inside my blood testing machine holder! 😉

We also have been given individual initial CHO to insulin ratios to use once we have worked out how much CHO we are eating as well as a correction ratio to use. For the time being, we are to try to correct ONLY if our level is greater than 10 and only to try to correct down to 8 ? though I think these values will change next week once we begin (hopefully) to get to grips with what we are trying to do. (Our initial ratio was worked out by dividing 500 by the TOTAL amount of both long and short acting insulin that we usually take, and our correction dose, by dividing 100 by the total amount of insulin).

We were also told/reminded that we should pinch when we inject and keep it pinched until the needle is taken out, we should use a new needle every time and remove it immediately, we should not be injecting through our clothes, that we should wash our hands before every blood test and that you need to be careful what you wash your hands with as some of the liquid soaps, can have sugar in them! From the silence when some of these were mentioned, I can only assume that I wasn?t the only one not exactly doing things correctly 😱? I now consider my hands firmly slapped (in a nice way mind you!)

Between now and next week, we are to try to check our basal levels -overnight is easy as we can do this by checking our level before going to bed and again first thing in the morning, though during the day is a little more difficult as we will need to test before our usual lunchtime, postpone lunch for a coupe of hours ? or not have any at all ? and then test to see whether or not our ?during the day? level is stable ? whether is not difficulty trying to work out whether it has been affected by food or short acting insulin. The slightly disconcerting bit is that next week, we are to bring along our results and the food we have eaten to be looked at and discussed by the rest of our group 😱 ? apparently we do this every week so I am hoping that the first time will be the worst!

I have thoroughly enjoyed getting together with other diabetics and at the moment am feeling extremely positive about the whole CHO counting thing ? even though I am aware that the chances of it being easy are non- existent -but then who said things that are worthwhile are easy?

One comment I must share with your all from the dietician is ?the only difference between us is that I have automatic insulin and you are all on manual? ? what a great way of describing it! :D
 
For the time being, we are to try to correct ONLY if our level is greater than 10 and only to try to correct down to 8 – though I think these values will change next week once we begin (hopefully) to get to grips with what we are trying to do.
So if our blood sugar is greater than 10 mmols take some insulin to correct it. And once it gets to 8 mmols leave it there?

(Our initial ratio was worked out by dividing 500 by the TOTAL amount of both long and short acting insulin that we usually take, and our correction dose, by dividing 100 by the total amount of insulin).
Already knew my ratio is about 1:11 but the correction bit is something I'd not been told how to work out before. So if I divide 100 into my total amount of insulin daily I get how much insulin I need to take to correct a high blood sugar?

One comment I must share with your all from the dietician is “the only difference between us is that I have automatic insulin and you are all on manual” – what a great way of describing it! :D
We should get better rates of acceleration and fuel consumption then? :D
 
So if our blood sugar is greater than 10 mmols take some insulin to correct it. And once it gets to 8 mmols leave it there?

Already knew my ratio is about 1:11 but the correction bit is something I'd not been told how to work out before. So if I divide 100 into my total amount of insulin daily I get how much insulin I need to take to correct a high blood sugar?

We should get better rates of acceleration and fuel consumption then? :D

Sorry, I haven't quite worked out how to separate posts and reply to each section properly.

Yes to the first part - at least those are the numbers we are trying for this week ie correct if its above 10 before the next meal, but only take enough correction to get down to 8 - I think this is to keep us all from having hypos all over the place till we get the hang of it.

The correction (once you've divided 100 by your insulin) tells you how many mmol one unit of insulin should reduce your blood sugar by. So for me, my total insulin is about 23 units per day, 100/23 is about 4, so one unit of insulin should reduce my blood sugar by 4mmol. ie, If I tested before tea and my reading was say 12, I would work out the insulin for my food, and then add on 1 unit of insulin to hopefully bring my next test down to around 8 - at least that's the theory! 😉
 
The correction (once you've divided 100 by your insulin) tells you how many mmol one unit of insulin should reduce your blood sugar by. So for me, my total insulin is about 23 units per day, 100/23 is about 4, so one unit of insulin should reduce my blood sugar by 4mmol. ie, If I tested before tea and my reading was say 12, I would work out the insulin for my food, and then add on 1 unit of insulin to hopefully bring my next test down to around 8 - at least that's the theory! 😉
Gotcha. Thanks. 🙂

As for replying to posts in parts. You need to have the [ quote=MCH;56208 ] at the beginning and [ /quote ] at the end to make a quote which you can then reply to individually. You'll need to remove the spaces between the ['s and the next character to make it actually work.
 
SOunds interesting, let us know how you get on, keep us up to date with progress...
 
sounds good, I hope to get able to get on a course soon.

Will be interesting to hear how things progress so if you can would be great to get an update each week.

What do they say about testing after meals? as I know DAFNE doesn't really encourage it.
 
Gotcha. Thanks. 🙂

As for replying to posts in parts. You need to have the [ quote=MCH;56208 ] at the beginning and [ /quote ] at the end to make a quote which you can then reply to individually. You'll need to remove the spaces between the ['s and the next character to make it actually work.

Thanks Mark. I will try that when I have more time.
 
Gotcha. Thanks. 🙂

As for replying to posts in parts. You need to have the [ quote=MCH;56208 ] at the beginning and [ /quote ] at the end to make a quote which you can then reply to individually. You'll need to remove the spaces between the ['s and the next character to make it actually work.

I think I see what you mean now, Marc as I think I now have a post with both yours and Sofaraways in it. I will see in a minute.

sounds good, I hope to get able to get on a course soon.

Will be interesting to hear how things progress so if you can would be great to get an update each week.

What do they say about testing after meals? as I know DAFNE doesn't really encourage it.


So far they aren't keen on too many tests in general and have kind of limited us to six results per day -though if we are driving or going to the gym we can do more. Also the before meals ones seem to be the ones they want rather than as you say after, though at the moment we are trying to check our basal rates so that might change.

I do intend to update you all each week as I know I would have found this interesting before I started the course which is running for another 3 weeks.
 
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Glad to hear it's all been useful so far. If anyone else is interested, or if you come to want a reminder, there's an onlince course on carb counting at http://www.bdec-e-learning.com/ . it's run by Bournemouth PCT and approved by Diabetes UK. I did it a few months ago as a refresher and learnt a few new things too!
 
I think I see what you mean now, Marc as I think I now have a post with both yours and Sofarawys in it. I will see in a minute.
Woo! You dunnit. 🙂
 
...I have automatic insulin and you are all on manual

I never would want to drive an automatic car so sounds good to me!

How long is this course?? You mention you're going on for three weeks? Surely can't be that long, or is it one day a week for several weeks??

Glad you're enjoying it, I'm tempted myself, one day I might!
 
How long is this course?? You mention you're going on for three weeks? Surely can't be that long, or is it one day a week for several weeks??


Yes, one day a week for 4 weeks with a final day some time later. (I am particularly lucky as the course is being held 5 minutes walk from where I stay - and doesn't start till 9.15 - the luxury of a long lie once a week! 😉😉
 
Yes, one day a week for 4 weeks with a final day some time later. (I am particularly lucky as the course is being held 5 minutes walk from where I stay - and doesn't start till 9.15 - the luxury of a long lie once a week! 😉😉

The long lie in has to be a very good added bonus. Do keep us up to date on how you get on withthe course.
 
Hey all,

Im going on the dafne course tommorow for 5 days 🙂

should be good, wish me luck :D xx

P.s hope ur all well, been too busy to come on but will keep u all updated during my course :D xx
 
Hey all,

Im going on the dafne course tommorow for 5 days 🙂

should be good, wish me luck :D xx

P.s hope ur all well, been too busy to come on but will keep u all updated during my course :D xx

Good luck with it Loz, be good to hear what you think of it at the end! I hope you learn a couple of things at least:D
 
Hey all,

Im going on the dafne course tommorow for 5 days 🙂

should be good, wish me luck :D xx

P.s hope ur all well, been too busy to come on but will keep u all updated during my course :D xx

Hope you enjoy and get a lot out of it. I found dafne invaluable, although the week itself was very tiring. Let us knwo how it goes.
 
well hope you enjoy the 5 days loz and please report back let us all know how you got on x
 
Hey all,

Im going on the dafne course tommorow for 5 days 🙂

should be good, wish me luck :D xx

P.s hope ur all well, been too busy to come on but will keep u all updated during my course :D xx

Hope your first day went well.

Please let us know how you got on when you have time (- if my course is anything to go by, you will be busy working out carbs :confused: in all your food at the moment!)
 
Second day of CHO course.

At last, I have had time to let you all know how this went.

We started off reviewing everyone’s results to ascertain if the bolus insulin amounts we were using were all correct. I had looked at my results and thought my bolus (having altered it a little towards the end of the week) were OK and I am glad to say that this was confirmed. 🙂 This made the fact that I avoided most exercise last week so that I could test before bed without having to worry about the fact I had been exercising – and I couldn’t believe how stressed out I was not going to the gym!-worthwhile.

The nurse and dietician also think that my food ratio (currently 1:20) seems all right but wondered if the correction ratio of !:4 might need altered to 1:3. It was decided that I should leave it alone but keep monitoring. I have a feeling that once I get back to exercising as normal, it might be OK but we will see later on this week

We also revised the causes and treatments of hypos – apparently the wine gums I have been using (as per my DSN’s recommendation) is not the best :confused: and Glucotabs (because they don’t seem to go as hard as dextrose tablets) or Jelly Babies (easier to eat and quicker than wine gums) were the preferred options. We were told that one of the reasons we can have more than 1 hypo in a day, is because your liver uses up its sugar stores and then the CHO you eat is taken up by it leaving you short again. (Once you hear this, it is obvious, but it is good to have it pointed out.) Also, I had always thought 10g of quick acting + a digestive were fine, but apparently we are supposed to take 15g of quick acting (and having tried it once since Wednesday it seemed to work) and a lot of us under treat hypos!

Another thing we did was to look at our portion sizes of pasta, rice and potato so that we can eat a portion without having to worry too much about the CHO. Interestingly, they said that some of the book seem to have the wrong CHO per 100g for baked potato (the books seem to indicate that the potato loses a lot more water in cooking than it does :( ) and the easiest way to calculate this is to weigh the potato raw and use this weight to calculate your CHO rather than cook it and use the books. We also looked at the labels on a lot of pre-packed food and calculated the CHO in portions of these – some had less than I would have thought, but some – milkshakes were one – had a LOT more!

Again we had a very interesting day and our homework is to try to see how our food insulin ratios are – but from my point of view, next week we have a doctor coming to talk about exercise and we were told that if we had any questions to write them down and record any exercise we do this week along with our BG results. I therefore went to the gym last Wednesday after the course and am hoping tog go again tomorrow and then at my usual time on Monday night – I should have plenty to ask by then! 😉
 
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