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How much carb is in my lunch? (pics included)

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High fat plus high carb is still a nightmare for me even with a pump. So that's most things with rice, most things with pasta, most things with a jacket spud. (I have butter on them too, whatever I slop on top) I still eat em to be sure - but the ruddy spike can be anything up to 6 or 7 hours later - after I'm already in bed. PITA.

I wondered why you had 30g carb to treat a hypo, it only needed to come up c 1.5, cos you weren't even THAT hypo .... LOL we've all done it.

I always count a slice of bread from a large sliced loaf as 20 - unless I'm only 4ish pre meal. That's because the packet says +/- 17 or 18g a slice. definitely not as low as 15. Some browns can be as high as 23g but if you don't have the benefit of the packet of course it's harder.

You need to know exactly what carbs and insulin do to your BG.

Soooo take a day when you haven't had a hypo in the last ?12 hours. You haven't had a bolus or eaten for at least 4 hours. Eat exactly 10g of fast acting carb (you can have it in coke or eh a digestive biscuit, whatever) and test as many times as yer like for as long as yer like up to say, 3 hours to see what it does.

Then another day do the opposite, same thing but your BG needs to be high enough so the 1u of fast-acting ain't gonna send you hypo and wreck the experiment. Take the 1u and test, test test!

BUT - have you tested your basal yet? the information about the 24 hours is correct - but how long is it actually lasting, for you personally? see

http://www.diabetes-support.org.uk/info/?page_id=120

and also

http://www.diabetes-support.org.uk/info/?page_id=408

but the latter is only the theory. Lantus can last anything from ?18 to ?36 hours ......
 
Hi Ollie,
Just a few pointers for you if I may 🙂
1st if you are above 14 then most would have insulin resistance. So would need more of a correction dose. IE, 15% more insulin.
If you haven't done so invest in a good carb counting book and a set of scales plus a calculater if your maths are not good.
Weigh all foods untill you know what it looks like on your plate. So when out can guestimate easier. 🙂

But first of all though you do need to sort out your basal insulin (long acting) Because if thats wrong so is everything else.

Also do remember that many people also have a different carb ratio for each meal time.
Hope that's of some help to you.
 
Hi Ollie

First of all congrats on your logging, recording, questioning and enthusiasm. If you carry on like this you will *certainly* get your control whipped into shape. Now the hard bit- it's not going to be a quick fix. You may have to slog away for several months, possibly longer. And there may well be times in that period where you think it is impossible. But many folks around here, myself included, have taken steps to improve control from what they thought was OKish to 'not bad, almost there really' (this is, I think, about as good as it ever gets)

Haven't looked at your numbers in detail, but one other 'rule of thumb' that might apply to you is to do with portion sizes. It seems up to a certain point, ratios work reliably. After that you may find they stop working so well, even when you count accurately. That point seems to be approx half your weight in pounds as grams of carb.

So weight: 160lbs - anything under 80g CHO should be fine. But larger meals may need extra insulin on top of 'standard' ratio, and this larger dose may need to act over a longer period (as you found with pizza, sometime stuff takes ages to digest). You can spread the action by splitting the meal dose (say 60:40 or 70:30) with some before eating, the rest after.

There's a whole lot of experimentation to get that to work well too!
 
I've been learning so much from you all over the last few days 🙂

I want to write a quick summary to help these lessons stick.

  • Test up to 8-10 times a day and record everything (that app is great for this, I feel this change has gelled quickly for me)
  • Take the bolus injection at the same time each day (makes so much sense, alarm now set for 11pm every day).
  • 15 rule for hypos - 15 units, retest in 15 minutes.
  • Lots of fat and carb together make for difficult meals with spikes and delayed reactions.
  • Humalog takes 30mins to take effect then lasts for 1-3 hours (handy graphs). This is really good to know, I had been going on old and incorrect information that humalog took effect immediately and worked for 30 minutes.
  • Testing before a meal, then 1, 2 and 3 hours after lets you see the full effect of the food and insulin (pizza or fatty + carb heavy foods excluded!)
  • Insulin ratios break down with large amounts of carbs. I'm going to aim to eat low-med carb meals (up to 60g) to work out my ratios.

I seem to be around 1u : 5g carb for breakfast based on today and the last two days.

This sounds really high, I'm concerned I might have insulin resistance. Although I feel really good to be doing all of these tests and all of this thinking (it's good to be getting in control), I'm also feeling really anxious about the damage I might have done so far and what kind of shape my heart's in. I'm seeing my doctor on Tuesday, can I ask for a 'heart check up' or something to get a picture of what condition I'm in?

@trophywench I like your two experiments, definitely going to try these soon. I'd love to work out my ratios.

It's good to be building up all this data, I used my records from yesterday to consider how much insulin to take with breakfast today.

@pumper_sue, is insulin resistance something that I either have or don't, or can it be temporary? You talked about having insulin resistance if a result was above 14, did you mean I might be resistant temporarily, while my blood sugar was high, or in general?

@everydayupsanddowns thank you, it's really good to hear that. For years I've felt that the hospital would just criticise and tell me I'm never doing anything right, but actually I think the goal is 'good enough'. It really got to me over the years... anyway, very grateful to hear you say it now and perhaps I can rebuild a useful relationship with the doctors when I next visit.

Ollie

p.s. blood sugar has come down since last night, going to test again 2 hours after breakfast to see if it's lower. Breakfast was 150g of 2% fat yogurt (at 8g carb per 100g, so 12g) plus a nectarine (15g), then a black coffee around 11.30 (no carbs - does coffee have an effect on blood sugar?).

t5EQp.png


p.p.s. yes, another lie in! Back to work tomorrow so will have a more regular routine.
 
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Hi Ollie.

Just a quick note. You mention your bolus at 11.30pm. The lantus is the basal and the humalog is the bolus. They're only words but can make a big difference if someone thinks you're meaning the other 😱:D

Also, humalog can start to act a lot quicker (10 minutes or even less) for some people, depending on where you inject, how low you are, how much exercise you've been doing, temperature, phase of the moon, inside leg measurement, etc.

Don't take what we say as gospel. What t does for us may not be what it does for you but you need to do the testing to work it out, so use what we say as a guide only.

I mentioned resistance to my DSN and she said T2s have resistance, T1s have sensitivity. I'm not sure what she meant by that and don't necessarily agree with her, but I think there is a difference. Insulin resistance is seemingly caused by fat round the organs. Sensitivity can be affected by all the above things listed for timings, and more.

But the higher youare, the harder it seems to be to bring it down. Unless you inject a correction, wait maybe half an hour, then go for a brisk walk and it can plummet like a stone.

Again, you need to find out what happens for you at different times.🙂

Looks like you're getting there. The breakfast sounds healthy enough and the night time high was a lot lower.

And you don't need to test any more than you feel will give you the right info. If you can get away with 5 times in a day, then that's enough. But right now, more seems to be needed.

Rob
 
@pumper_sue, is insulin resistance something that I either have or don't, or can it be temporary? You talked about having insulin resistance if a result was above 14, did you mean I might be resistant temporarily, while my blood sugar was high, or in general?
Click to expand...

The higher your blood sugar ie, over 14 the more insulin you need to correct, this is called insulin resistance. So if it's a rare occ then it's temp 🙂

Have you thought about having a set amount of carbs at each meal time and sticking to this until you have sorted yourself out? You might find it easier this way.
But as already been said you must sort out your correct dose of long acting 1st. You are wasting your time if this isn't right.
Humalog for your info also works a lot longer than 1-3 hours. 🙂
 
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