Hello everyone

[AdamType1]

Hi I am new to the forum but not new to diabetes. Been type 1 for 10 years. I have a quick question about carb counting and in recent times I have got slightly lazy with it and have forgot the details around carb counting so wanted to get some advice and tips so I can start calculating my meals more precisely again.

 

[SB2015]

Hi I am new to the forum but not new to diabetes. Been type 1 for 10 years. I have a quick question about carb counting and in recent times I have got slightly lazy with it and have forgot the details around carb counting so I can start calculating my meals more precisely again.

Welcome to the forum Adam.

Getting your carb counting as accurate as possible will help you to get more accurate insulin doses, and therefor better control. When I am at home I take the trouble to weigh the raw ingredients used, and then use the info on the back of packaging to calculate the carbs. When I am out I find that the app Carbs and Cals in my mobile phone to make a best guess. This includes photos of portion sizes to help.

Alongside that I need to adjust my insulin:carbs ratios, which vary through the day, at intervals when things seem to be on a wobble.

I hope that helps.

 

[AdamType1]

Welcome to the forum Adam.

Getting your carb counting as accurate as possible will help you to get more accurate insulin doses, and therefor better control. When I am at home I take the trouble to weigh the raw ingredients used, and then use the info on the back of packaging to calculate the carbs. When I am out I find that the app Carbs and Cals in my mobile phone to make a best guess. This includes photos of portion sizes to help.

Alongside that I need to adjust my insulin:carbs ratios, which vary through the day, at intervals when things seem to be on a wobble.

I hope that helps.

Hi, that’s great thank you for the info. The carb counting itself is not new to me and many of the practices are familiar. However I’m struggling to get an understanding of how the amount of carbs relates to how much insulin you need to take. I’ve had a brief look online and calculated that I would need 1 unit of insulin per 8g or carbohydrates. Does this sound reasonable to you? Or do you know a way to calculate the carb to insulin ratio without seeing your specialist (have appointment but want to be on top of it). Thanks for your help.

 

[SB2015]

Everyone has different ratios that suit them. I started on 1 unit of insulin for 10 g of carbs, but this has gradually changed, and I now have a different ratio for the morning, lunch and for the evening.

The most important thing is to get the background insulin doses correct before trying to fiddle with Bolus ratios.
What basal insulin are you using? Have you recently done a fasting test to check whether this is correct for you?

There are so many adjustments that we can make and it is useful to do one thing at a a time otherwise it is impossible to know which change was correct.

 

[AdamType1]

This is great advice! I’m sure that at some point I was on specific ratio’s but due to the laziness I have simply got into a routine of knowing insulin for certain foods and adapting my doses based off that, so trying to snap out of that habit now. 1 to 10g seems like a good start, I am on novorapid as my fast acting insulin and glargine as my background insulin. I’m pretty sure my background is correct as it has been changed a number of times over the years. It’s more about getting a better understand of my fast acting ratio’s with regards to carbs. Will keep testing and make necessary changes if the blood readings are not in line. Another quick question but I’ve heard lots of different HbA1c readings thrown around in different formats in this forum. My readings have always been given to me in a double digit number (for example 64). Wondered if there was a guide to follow for this style of reading etc and what to aim for? I am usually told by my specialist that my readings are fine but I’m a worrier unfortunately!

 

[trophywench]

To check your insulin to carb ratio, firstly make sure your BG is around 5 before you eat,ie what it should be - then have an exact amount of carb - if it's 20g, jab 2u, 30g 3u, whatever.

Don't eat anything else or do anything else for at least 4 hours, preferably longer, then retest your blood, and it should be the same number you started with. If it's less then you need less insulin per 10g and if it's more then you need more per 10g - or reduce the number of grams of carbs per 1u.

Of course unless you've got your basal insulin ****-on - it's an utter waste of time trying to nail down your insulin to carb ratio - so I'd make sure your basal's correct before you attempt it!

 

[AdamType1]

To check your insulin to carb ratio, firstly make sure your BG is around 5 before you eat,ie what it should be - then have an exact amount of carb - if it's 20g, jab 2u, 30g 3u, whatever.

Don't eat anything else or do anything else for at least 4 hours, preferably longer, then retest your blood, and it should be the same number you started with. If it's less then you need less insulin per 10g and if it's more then you need more per 10g - or reduce the number of grams of carbs per 1u.

Of course unless you've got your basal insulin ****-on - it's an utter waste of time trying to nail down your insulin to carb ratio - so I'd make sure your basal's correct before you attempt it!

Thank you for that Jenny, great information!

 

[SB2015]

Good morning @AdamType1 you say that your background ‘has been changed’ a number of times. That makes it sound like someone else is suggesting the changes you need. Have you been to told how to check this and adjust it yourself? There is a link to how to do this in the pumping section here
https://forum.diabetes.org.uk/boards/threads/basal-testing-made-easy.19060/ .
The principles are the same in MDI.

I remember thinking that my fasting test for this was something I should do once a year before my consultant appointment. It was only when I joined this forum that I understood that this is the first thing to check when things are going wrong, and that it may need changing two or three times a year! I find mine needs a change with changes in the weather, levels of tiredness, ....

I realise that the responses you have had so far must give the impression that we have just one idea between us. Basal rate testing!!! It is just that as @trophywench says, if this bit of your management is not right then the tweaking that you do to carb ratios will be irrelevant.

 

[AdamType1]

Good morning, I haven’t heard of that technique before no, my usual process is to take my blood meter readings to my review appointments and my specialist makes changes based on my overall bloods, so will certainly start to make minor changes myself! Once again thank you for the information.

Good morning @AdamType1 you say that your background ‘has been changed’ a number of times. That makes it sound like someone else is suggesting the changes you need. Have you been to told how to check this and adjust it yourself? There is a link to how to do this in the pumping section here
https://forum.diabetes.org.uk/boards/threads/basal-testing-made-easy.19060/ .
The principles are the same in MDI.

I remember thinking that my fasting test for this was something I should do once a year before my consultant appointment. It was only when I joined this forum that I understood that this is the first thing to check when things are going wrong, and that it may need changing two or three times a year! I find mine needs a change with changes in the weather, levels of tiredness, ....

I realise that the responses you have had so far must give the impression that we have just one idea between us. Basal rate testing!!! It is just that as @trophywench says, if this bit of your management is not right then the tweaking that you do to carb ratios will be irrelevant.

odnl

 

[Bruce Stephens]

I’ve had a brief look online and calculated that I would need 1 unit of insulin per 8g or carbohydrates. Does this sound reasonable to you?

It's completely plausible, but it's also plausible that you'd need 1 unit for 4g of carbohydrate. Or 1 unit for 4g for breakfast but 1unit for 8g at lunch (though such a big difference would be a bit unusual, I think). It's an individual thing that your team can advise on (by looking at what you're eating and your typical insulin doses) and something that you'll need to adjust based on how well the ratios work. (There are crude guidelines based on bodyweight and things, but they're not going to be useful except as a first guess.)