Is Nathan the only one not carb counting?

[sasha1]

Hi All,

Well after today's drama regarding Nathan taking mote NR than required and the following nightmare consequence's.
Reading all your replies has got me thinking, is everyone else on here carb counting?
We have been offered carb counting, don't get me wrong. But have found the intermediate way is good for both me and Nathan..Its what we were taught from the begining of diagnosis.. and find it an easy way of controlling his diabetes/insulin/food ratio.. Besides Nathan is adamant that he will continue this way. Despite us doing it this way..He has never neen admitted back into hospital, he has had illness which have caused trace ketones etc,he does have hypo's, has periods of running high but not consistantly..usually a 6 week cycle..which we have traced to hormone changes/growth spurts, despite this his overall control is excellent his last HbA1c was 6.8 apr 09.....2mths after dx he was 13.2 apr 07...since then he has never been above 7.6..
Am I not doing the right thing by Nathan not carb counting? Is the method I/we are using wrong?

Heidi
🙂

 

[Northerner]

Heidi, with those figures I wouldn't be too concerned, if Nathan is happy to do things this way. I was taught the rudiments of carb-counting - not to the same depth as DAFNE, but sufficient for my needs. I think I'd struggle a bit with the intermediate method, as my meals can vary a great deal, and I need to adjust doses accordingly or a) I'd end up on the floor or b) I'd have to eat more than I wanted.

But, as I say, the best method is the one he is happy with, providing the numbers are good, which his are🙂

 

[AmandaB]

What is the 'intermediate' way?
I did carb counting when first diagnosed (1969) and sort of carried on with it. Got persuaded to do Daphne (called Pastie here but guess it's the same thing) I keep telling them it told me nothing new and anyway it doesn't seem to take into account all the other things like stress, illness and the fact wholemeal bread and rice never seems to increase my sugars.
My consultant recently told me they moved away from carb counting for some years but have now returned to thinking it's the best thing after all.
I say, take your pick! But they wouldn't consider me for a pump (or transplant they're now talking about) until I'd done Pastie.

 

[sasha1]

Heidi, with those figures I wouldn't be too concerned, if Nathan is happy to do things this way. I was taught the rudiments of carb-counting - not to the same depth as DAFNE, but sufficient for my needs. I think I'd struggle a bit with the intermediate method, as my meals can vary a great deal, and I need to adjust doses accordingly or a) I'd end up on the floor or b) I'd have to eat more than I wanted.

But, as I say, the best method is the one he is happy with, providing the numbers are good, which his are🙂

Thanks Northerner,

Nathan is happy with the intermediate level and am myself, and its really easy to learn and put into practice...having said that I'm sure those who carb count/DAFNE feel exactly the same.🙂
Nathan, DSN, Consultant and myself are very happy with his Hb..even though some of his weeks are erratic...but would say even then 50% of his daily readings are within range

Heidi
🙂

 

[litto-miss-loz]

Hi All,

Well after today's drama regarding Nathan taking mote NR than required and the following nightmare consequence's.
Reading all your replies has got me thinking, is everyone else on here carb counting?
We have been offered carb counting, don't get me wrong. But have found the intermediate way is good for both me and Nathan..Its what we were taught from the begining of diagnosis.. and find it an easy way of controlling his diabetes/insulin/food ratio.. Besides Nathan is adamant that he will continue this way. Despite us doing it this way..He has never neen admitted back into hospital, he has had illness which have caused trace ketones etc,he does have hypo's, has periods of running high but not consistantly..usually a 6 week cycle..which we have traced to hormone changes/growth spurts, despite this his overall control is excellent his last HbA1c was 6.8 apr 09.....2mths after dx he was 13.2 apr 07...since then he has never been above 7.6..
Am I not doing the right thing by Nathan not carb counting? Is the method I/we are using wrong?

Heidi
🙂

I have been on 4 times a day injections with novorapid and lantus for nearly 2 years and its only been like 2-3 months since i started carb counting. I had never heard of it until last year...

 

[Adrienne]

Yes what is intermediate carb counting. Sorry not sure I understand that at all.

Is your son recently diagnosed, ie is he still on honeymoon? The HbA1c results are great, I take it though they are not due to swinging levels ie lots of hypos and lots of hypers.

The best results are by carb counting for BB (basal/bolus - new way of saying MDI) and definitely have to for pumping. I have some friends who now carb count for twice daily mixed insulin. When on mixes you feed the insulin, when on BB you give insulin to match the carbs.

I have never heard of intermediate carb counting though. Can you please let me know what that means. Thanks.

 

[bev]

Heidi,
I hope your not feeling got at? I wasnt trying to say your not doing the right thing - obviously you and Nathan are as he has a great hba1c! I dont entirely understand your method - but thats because i havent come across it ! If you and Nathe are happy doing it that way - then who are we to say otherwise? My only thoughts about this were that if Nathan had been familiar with carb counting - he could possibly have worked out the carbs or even just looked at the packet (mostly it does say on packaged things). As i am not familiar with your method - does Nathan have a way of working out how much extra insulin to add for a particular item? Maybe a sliding scale type thing? Sorry if i am being thick - i just dont really know what method you use! lol. But i suspect you would have the added stress of trying to teach a teenager a new way - when he is used to this way and also a little in denial. I would say though, that if you want to go down this road, its not as hard as you may think - if i can do it - anybody can! If you want any help with it let me know - or do your clinic do a dafne type course for children?Bev xxxxx

 

[aymes]

Hi All,

Well after today's drama regarding Nathan taking mote NR than required and the following nightmare consequence's.
Reading all your replies has got me thinking, is everyone else on here carb counting?
We have been offered carb counting, don't get me wrong. But have found the intermediate way is good for both me and Nathan..Its what we were taught from the begining of diagnosis.. and find it an easy way of controlling his diabetes/insulin/food ratio.. Besides Nathan is adamant that he will continue this way. Despite us doing it this way..He has never neen admitted back into hospital, he has had illness which have caused trace ketones etc,he does have hypo's, has periods of running high but not consistantly..usually a 6 week cycle..which we have traced to hormone changes/growth spurts, despite this his overall control is excellent his last HbA1c was 6.8 apr 09.....2mths after dx he was 13.2 apr 07...since then he has never been above 7.6..
Am I not doing the right thing by Nathan not carb counting? Is the method I/we are using wrong?

Heidi
🙂

You're certainly not the only ones not carb counting and if you have a method that works then I wouldn't worry too much about it. I have found that carb counting has worked wonders for me, but it is something you do need to commit to and it does take time to get it right, so if it's not something he wants to do at the moment there's probably little to gain from forcing the issue. It's good to know the option is there as and when he's ready for it.

 

[sasha1]

What is the 'intermediate' way?
I did carb counting when first diagnosed (1969) and sort of carried on with it. Got persuaded to do Daphne (called Pastie here but guess it's the same thing) I keep telling them it told me nothing new and anyway it doesn't seem to take into account all the other things like stress, illness and the fact wholemeal bread and rice never seems to increase my sugars.
My consultant recently told me they moved away from carb counting for some years but have now returned to thinking it's the best thing after all.
I say, take your pick! But they wouldn't consider me for a pump (or transplant they're now talking about) until I'd done Pastie.

Hi AmandaB,

Intermediate level is where you learn to recognise patterns of glucose response to carb intake and how it is modified by insulin and activity etc, also taking into account the bg reading at that meal time. You make your own adjustments to insulin doses, or alter carb intake or timing of exercise to acheive bg ranges. Alterations of insulin are made in response to a pattern of bg results over a few days, not based on a single high or low bg reading. Another way is to correct the premeal dose for changes in size of the carb content of a meal (without counting the extra carb content), insulin adjustments are used to manage the intake of carb at that meal

Heidi
🙂

 

[sasha1]

Heidi,
I hope your not feeling got at? I wasnt trying to say your not doing the right thing - obviously you and Nathan are as he has a great hba1c! I dont entirely understand your method - but thats because i havent come across it ! If you and Nathe are happy doing it that way - then who are we to say otherwise? My only thoughts about this were that if Nathan had been familiar with carb counting - he could possibly have worked out the carbs or even just looked at the packet (mostly it does say on packaged things). As i am not familiar with your method - does Nathan have a way of working out how much extra insulin to add for a particular item? Maybe a sliding scale type thing? Sorry if i am being thick - i just dont really know what method you use! lol. But i suspect you would have the added stress of trying to teach a teenager a new way - when he is used to this way and also a little in denial. I would say though, that if you want to go down this road, its not as hard as you may think - if i can do it - anybody can! If you want any help with it let me know - or do your clinic do a dafne type course for children?Bev xxxxx

Hi Bev,

No hun I certainly don't feel got at ...I was just interested if anyone else was using the method we were...
We work on a scale of 1 to 2 units if it is a new food...eg Breakfast bacon, eggs 2 slices of toast..but nathan wants a couple of hash browns...normal dose 6-8 depending on his bg...so would probably give him an extra 2 units to cover the hash browns...then follow what the bg was at mid morning and then at lunch.

Heidi
🙂

 

[SilentAssassin1642]

i don't carb count. They tried to get me to do it years ago but I'm kid of rubbish with numbers so it never stuck...it's something i'd like to do at some point though

 

[sasha1]

Yes what is intermediate carb counting. Sorry not sure I understand that at all.

Is your son recently diagnosed, ie is he still on honeymoon? The HbA1c results are great, I take it though they are not due to swinging levels ie lots of hypos and lots of hypers.

The best results are by carb counting for BB (basal/bolus - new way of saying MDI) and definitely have to for pumping. I have some friends who now carb count for twice daily mixed insulin. When on mixes you feed the insulin, when on BB you give insulin to match the carbs.

I have never heard of intermediate carb counting though. Can you please let me know what that means. Thanks.

Hi Adriene,

Nathan is well out of the honeymoon phase.. Nathan was diagnosed feb 07...out of the honeymoon about 8-9mths later.
I have posted what I do ..intermediate level..although it quiet hard to explain...🙂

Heidi
🙂

 

[SacredHeart]

No, I'm not carb counting. But I'm so new at this, I'm not surprised at this!

 

[katie]

It kinda sounds like it is carb counting... but the guessing stage after youve had a feel for how many carbs are in things

Does he have similar amounts of carbs in each meal every day?

 

[Steff]

Hi All,

.
Reading all your replies has got me thinking, is everyone else on here carb counting?

i aint and dont plan to

 

[Patricia]

We asked to carb count and were doing so within six weeks of diagnosis. The reason we asked to do it is because tracing E's numbers from one day to the next in response to foods and doses was driving us nuts! We couldn't deal with what we knew *must* be different responses to different foods, until it was over. It was all 'wait and see', then adjust and see again, etc...And while we knew that diabetes has that unpredictability at the core, it was all just *too* many variables for us. So we asked to start carb counting.

Carb counting was used, then not used, then has come back again, as someone pointed out. And as Heidi has proven, it's perfectly possible to get very good results without carb counting -- people did it for years and lived to tell the tale, reasonably often with few complications, from what I read.

I think it's all about what feels comfortable -- we were just *so* unsettled at taking what we felt to be so much time to stabilise, and always chasing numbers, so carb counting was a godsend for us, and helped us feel more in control. But some, I know from conversations, feel that the carb counting is hugely regimenting in their lives, too much so, and prefer always to 'guesstimate' and deal with the results later, a more relaxed attitude I suspect!

Anyway, eventually so much of carb counting becomes 'eyeing' the food -- as does the intermediate stage, it sounds like -- the difference with carb counting I guess is that the knowledge of the type of food and its carb content is more precise...

My only thought is for Nathan really. Eventually he may find carb counting liberates him, with fewer swings. I suspect that in adolescence there are so many swings anyway, it's difficult to judge how much more efficient carb counting would be, if at all?!

The pump, on the other hand...!

 

[Caroline]

I don't carb count, although I try to be aware of the carbs I am eating.

Must admit I get confused with the numbers too, especially with the sugars and the carbs.

 

[Munjeeta]

Despite us doing it this way..He has never neen admitted back into hospital, he has had illness which have caused trace ketones etc,he does have hypo's, has periods of running high but not consistantly..usually a 6 week cycle..which we have traced to hormone changes/growth spurts, despite this his overall control is excellent his last HbA1c was 6.8 apr 09.....2mths after dx he was 13.2 apr 07...since then he has never been above 7.6..QUOTE]

Wow 🙂 I'd kill for HbA1c's that low... It sounds like you're doing a great job with it and if it works for you and Nathan then stick with it. Carb counting is a lot of effort to begin with and if it ain't broke, don't fix it! I have beein diagnosed for 13 years now (I think I was diagnosed at the point in time where they'r stopped recommending carb counting) and only recently have I been recommended to do so.

I don't carb count, although I try to be aware of the carbs I am eating.

Must admit I get confused with the numbers too, especially with the sugars and the carbs.

Me too - constantly! I find there's so much information to store in my brain and I'm just not sure there's room...

 

[Patricia]

AND anyway -- when you look at the units taken day to day, there's usually a fixed range. In our case for instance it'll be 8-10 for breakfast, 7-9 for lunch, 8-10 for dinner, etc... The big thing carb counting can do much more easily is account for new situations and new foods faster? I suspect this is as much to do with the ratios giving a place to start as anything...

 

[sofaraway]

I'm not really carb counting at the moment, I know how to do it and have some rough ratios worked out, but mostly I am eyeballing my plate and estimating a dose on that, i guess it is similar to the intermediate method if I have understood it correctly. Things are ticking along quite nicely at the moment but when I start having problems I will go back to weighing and accuartly counting carbs.

Most people aren't counting carbs, alot of people aren't adjusting insulin doses at all day to day. Nathan is getting good results so for now I don't think it is necesarry to force the issue.