First attempts at carb counting

[Riley19]

Hi folks. Had a chat with the dietician this morning about starting carb counting and whilst it all made sense when talking to her, looking at my notes and thinking about tea, I've got confused and was feeling rather nervous about it when working out lunch.

So can I run my attempt by you? From my hastily written notes, I put only count when +5g which I think was referring to different vegetables. But then also had, if snack under 15g don't count. I'm doing 1 unit of insulin for 10g carbs.

For lunch I had - 2 wholemeal slices of bread (34g), 30g crisps (17g) and 3 dark chocolate digestives (30g) which I added up to 81g carbs so took 8 novorapid. I had an apple too but didn't count it though did dither if I should. It was approx. 10g of carbs. Also didn't count cheese, cucumber, salad leaves, marg, mayo. Or my drink, cloudy lemonade, no added sugar.

Before lunch my level was 4.5 and 2 hours after I was 10.1 Silly me didn't ask what I was meant to be looking for in the post meal level but from the reading I've done this is perhaps too high and I should have taken more novorapid?

For tea we're planning sausages with carrot and swede mash, broccoli and asparagus. Label wise, 3 x sausages come to 5.4g carbs and the veg is all pretty low according to carb and cals book but added together may be 10-20g carbs. Not quite sure how to work it out. Dietician said to weigh things after it's cooked but if I have to take insulin 15 minutes before I eat...so cold food? 🙂

Argh sorry, I'm an overthinker!

Thanks!

 

[helli]

Hi Riley19

That looks a pretty good start.

A few pointers.
The 15g carb snack advice is regarding snacks between meals. If you ate your apple with your lunch, you should include it in your lunch carb count.

The 2 hours afterwards is something people with type 2 do to check if they are tolerant to the carbs in their food or not.
With Type 1, we need to consider whether the fast acting insulin is enough to bring us back down to original levels once the insulin has been used. NovoRapid has a life of about 4 hours (some say 5 hours). So to work out if dosed correctly, you need to look at your blood sugars after 4 hours.
If you peak high between thin, you may want to consider bolusing earlier but I would not worry about that at first.

Regarding veg, the easy thing to remember is that "above ground veg" are low carb. So I would not worry about broccoli and asparagus. Pulses (peas and beans are the exception to this rule). Carrots and swede are probably worth considering but I think the portion would be pretty big if you think this is 20g. I would underestimate to start with.

I always weigh my veg before cooking. It's not as if the carbs leak out into the water.
Unfortunately, some packets (e.g pasta and rice) annoyingly provide carbs for cooked weigh and cooking the pasta and rice absorb water so it is harder to work out carb content when uncooked. But it is usually possible with a bit of maths and portion sizes (e.g. pasta may tell you a packet contains 4 portions and then tell you the amount of carbs for a cooked portion).

Remember carb counting is approximate. Your monitor is approximate. The carb content of a slice of cake depends whether you get a slice with more (or less) fruit than usual, there are numerous varieties of apples with different carb contents, you may have a less ripe banana, etc. And then there are other things which can effect your blood sugars such as exercise or stress (e.g. the stress of carb counting the first time).

Did you nurse tell you about correction doses?
If your levels are 10mmol/l 5 hours after eating, you may want to consider a correction dose.

And finally, you could take a look at one of the carb counting courses online like BERTIE for some revision. But don't hesitate to ask for assistance.

 

[Inka]

@Riley19 Carb counting isn’t as complicated as they like to make out. I agree with @helli that you’ve made a really good start. If you’d counted the apple as you should have, your blood sugar would have been closer to your target so don’t worry about that too much. Remember too that 1:10 is an estimate of your ratio. That might be adjusted if needed.

I don’t count carrots or swede normally. Parsnips I do count. But it looks like your meal hasn’t got many carbs so you might need to count the swede. I wouldn’t count it this time and see how it goes.

And no, I don’t weigh veg hot or cold apart from potatoes!

Enjoy your food. Carb counting will never be 100% accurate because there’s always something else going on that might affect blood sugars.

My top tip is to keep a notebook and jot down the carb counts of meals and how much you had, then your bolus amount. That way if you eat the same meal again, you can just check the book, replicate the amounts of food and have your bolus. You’ll soon build up a big repertoire of ready-counted meals - and commit most carb values to memory too!

 

[Riley19]

@Inka and @helli Thank you both so much for the replies, really appreciate it. 🙂

 

[Riley19]

And then there are other things which can effect your blood sugars such as exercise or stress (e.g. the stress of carb counting the first time).

Ha yes! Maths/Numbers, never my strong point. 🙂

 

[trophywench]

You know mobile phones @Riley19 ? - most of them (our Android ones always have) are pre loaded with all sorts of things you can click on - and a calculator is one of em!

 

[Martin62]

Hi Riley, I too am new to carb counting and I'm using the carbs and cals book and phone app. I was using the 10-1 ratio but found it was making me go too low, so have adjusted it a little and that seems to work better for me. It's still a bit of trial and error but slowly getting to grips with it.

 

[trophywench]

I prefer the word 'gradually' @Martin62 than slowly - still a lot of intelligent guesswork in my life including with at least one of our daughters today. Knocking 40 and a grandma herself ....... drives me bats LOL

 

[Paulbreen]

Hi Riley19

That looks a pretty good start.

A few pointers.
The 15g carb snack advice is regarding snacks between meals. If you ate your apple with your lunch, you should include it in your lunch carb count.

The 2 hours afterwards is something people with type 2 do to check if they are tolerant to the carbs in their food or not.
With Type 1, we need to consider whether the fast acting insulin is enough to bring us back down to original levels once the insulin has been used. NovoRapid has a life of about 4 hours (some say 5 hours). So to work out if dosed correctly, you need to look at your blood sugars after 4 hours.
If you peak high between thin, you may want to consider bolusing earlier but I would not worry about that at first.

Regarding veg, the easy thing to remember is that "above ground veg" are low carb. So I would not worry about broccoli and asparagus. Pulses (peas and beans are the exception to this rule). Carrots and swede are probably worth considering but I think the portion would be pretty big if you think this is 20g. I would underestimate to start with.

I always weigh my veg before cooking. It's not as if the carbs leak out into the water.
Unfortunately, some packets (e.g pasta and rice) annoyingly provide carbs for cooked weigh and cooking the pasta and rice absorb water so it is harder to work out carb content when uncooked. But it is usually possible with a bit of maths and portion sizes (e.g. pasta may tell you a packet contains 4 portions and then tell you the amount of carbs for a cooked portion).

Remember carb counting is approximate. Your monitor is approximate. The carb content of a slice of cake depends whether you get a slice with more (or less) fruit than usual, there are numerous varieties of apples with different carb contents, you may have a less ripe banana, etc. And then there are other things which can effect your blood sugars such as exercise or stress (e.g. the stress of carb counting the first time).

Did you nurse tell you about correction doses?
If your levels are 10mmol/l 5 hours after eating, you may want to consider a correction dose.

And finally, you could take a look at one of the carb counting courses online like BERTIE for some revision. But don't hesitate to ask for assistance.

That was a very good outline @helli simple and precise, great advice

 

[SB2015]

Hi @Riley19

You have made a great start with your carb counting. As others have said it is all a bit approximate, and we just get as close as we can. I ten to count any veg grown underground and those grown above ground. It if grows on the ground (celery, lettuce) I ignore it. I weigh my veg and have a sheet with the carbs per 100 g. But we hardly need to look at it now as these have become so familiar now, along with the carb count of most biscuits that we buy. It becomes a lot easier as you become more familiar. Pasta packets are a bit of a problem as they seem to do their own thing. But with the portion size info once we have worked it out we keep a record so we don’t have to repeat the battle.

Your ratios will change over time with the seasons and so many other things. These are difficult to sort out if your basal insulin is not sorted first as @helli said. Work with your team and they will help you with how to test this once things settle.

You are getting your head round things already. Keep in touch and fire away with any questions.

 

[everydayupsanddowns]

Well done @Riley19

It WILL get easier, and you will relax into the groove of it before long. Pretty soon you‘ll be eyeballing carbs in dishes from 50 yards with plenty enough accuracy for an insulin dose

And don’t be too surprised if a carefully counted meal or snack misbehaves. For one thing there are plenty of other factors affecting your BG levels, not just insulin-food matches, but also over months and years you will begin to develop a mental map of the ‘exceptions to the rule’ that your individual diabetes seems to require, where some carbs or meals seem to benefit from slightly different handling.

But do stick with it! Carb counting really is a powerful tool in your diabetes management armoury 🙂