me again!

[firefly60]

just wondering do people still carb counting ?
Speaking to my diabetic nurse at the hospital and she said no
totally confused
As I said before have so many health problems
keep trying to come onto this forum but I just read people's posts as I am a very private person
Anyway hello again will try to engage more often xx

 

[Skater P]

Yes, very much so, otherwise I wouldn't have a clue how much to inject.
Might be different with pumps as I don't know enough about how they work yet.

Also reading without posting is fine in my book.

 

[trophywench]

How on earth do their Type 1 patients know how much insulin to jab themselves with when they eat anything, if they don't count the amount of carbs in that food? I don't ! Reading and not posting surely is 100% fine with everyone. We can all use the forum as much or as little as we want or need to.

 

[khskel]

I think it's the nurse rather than you. I'd ask her what we do instead these days.

 

[everydayupsanddowns]

I can’t agree with that nurse’s opinion.

The ‘gold standard’ T1 treatment these days (and where the experts seem to want everyone who can benefit to move towards) is a hybrid closed loop insulin pump. And that requires a person to carb count to work effectively. It’s part of the set-up of the system.

Feel free to carry on lurking / browsing if that’s what works best for you. We have a fair few members who do far more reading than posting 🙂

 

[Inka]

Yes, yes, yes! Many years ago (maybe 25yrs or so?) they suddenly decided we didn’t have to carb count, we could just ‘eat healthily’. That was, and is, a stupid idea, and it soon fell by the wayside. They never admitted they were wrong with their idiocy, pretending it had never happened then pretending they’d cleverly just thought of carb counting and DAFNE was set up to spread this oh so incredible new idea - which we’d been doing for decades before!!

So, maybe your nurse is stuck back all those years ago? I’d ignore her. Not counting carbs doesn’t make things easier, it makes it very much harder and puts you at risk of hypers and hypos.

 

[mashedupmatt]

I winged it with carb counting for 2 years and my diabetes management was all over the place -then I discovered how good it is - it is vital to keep BG as controlled as possible

 

[SB2015]

I find it hard to imagine how you can manage T1 / T3c without carb counting.
It is. Absolutely essential for my management and the only bit of data that my pump requires when looping. To get a pump at the start I was required to go on a DAFNE course which taught us about carb counting.
Was the nurse you saw one at the GP who is more used to dealing with T2. I know many T2s are discouraged from counting the carbs. Certainly worth asking her how you should work out how much bolus to give yourself at a meal. She may also be more used to people using a mixed insulin for which there are fixed doses.

Happy lurking here or posting. Either is fine and it is great that people can use the forum in a way to suit them.

 

[Proud to be erratic]

Hello @firefly60. I would like to know what insulin (or insulins) you are using.

Looking back at your first posting here, you told us in Aug '20 you said: "I have been type one for 20 years , was straight onto insulin .I have a rare neurological condition called stiff person syndrome ,which causes me to have spasms and stiffness , i do not know when spasms will happen , i also have other auto - immune conditions". Also: "At the moment I carb count using my accu-chek Aviva expert and use tresiba in the morning. I have been on a Dafne course. My problem is my lovely diabetic nurse has told me they are going to stop producing my Aviva expert and there is no other replacement meter. Along with all my health issues I am getting quite anxious ... she did mention the abbot libra to me"

Tresiba is a very long lasting basal (=background) insulin and if that is your only insulin then I can understand why you managed with carb counting using My Sugar helping your carb counting, based on finger prick results.

In Sep '21, you asked again about carbs, carb counting and about Libre. It's not clear whether you now have Libre and if so are using a Libre Reader or a phone app. Nor is it clear from your few subsequent posts where you have got to with your carb counting since the demise of the Accu-chek Aviva Expert meter.

Today the vast majority of T1s who are not on a pump, use both a basal insulin along with a faster acting bolus insulin like NovoRapid which is taken with each meal. The combination of both basal and bolus insulins are often referred to as Multiple Daily Injections (MDI). Can you please confirm you are on MDI?

That bolus insulin is intended to deal with the glucose that comes from digested food and, as everyone has said, it is very normal (indeed essential to my mind) that some carb counting must be done. But it could be, after now 25 yrs as a T1, you have found by trial and learning sensible bolus doses for your meals and no longer find it necessary to give much thought to carb counting each bolus dose; it could be you know that a breakfast needs "x units" of insulin, a lunch needs "y units" and a dinner or supper needs "z units".

Because I am a relative newcomer to managing my diabetes I, personally, find it essential to carb count for almost everything I eat. Even if I have a snack, like a cup of coffee and a small biscuit I will count those carbs; if those carbs are small I might choose to not take a bolus insulin dose. But I've still carb counted. If my snack was a large milky coffee and a slice of cake, I would not only carb count, but take a bolus insulin dose.

So I'm struggling to reconcile how someone can be on MDI and not carb count unless you are a rare T1 who is only on Tresiba or a single mixed insulin. I'm even wondering if your rare medical condition led to a diagnosis of "as if T1", with a single insulin basal dose. But 25 yrs ago that insulin would have been some other insulin and I'm confused because I'm not medically qualified and can't relate your treatment today to what little I know about treatment for diabetes today.

I think we need to know a little more about your circumstances to allow us to better understand how to help you @firefly60.

 

[Proud to be erratic]

I find it hard to imagine how you can manage T1 / T3c without carb counting.

@SB2015, being slightly pedantic here and please forgive me:

The T3c diagnosis embraces a spectrum of treatments, ranging from oral meds (ie as if T2) through single daily doses (ie perhaps very carb aware, but not formally carb counting) and then full MDI or pump (ie as if T1). I find it easier to make it clear to many HCPs that I am as if T1 with extra, different, insulin needs.

 

[Proud to be erratic]

An afterthought @firefly60, and conscious that you are a very private individual, after your 25 yrs of being T1 - I suggest you ask to go on a refresher DAFNE course.

A huge amount has changed in D management, just in the last 5 yrs with CGM and it's transition from periodic scanning to full continuous data transfer from sensor to phone or reader. Most of us who have insulin dependency just naturally look at our CGM graphs and listen to the CGM alarms or alerts, then make informed treatment decisions. We may take a finger prick reading to verify something we are deducing from CGM, but I suspect the way I routinely manage my D is very, very different to how you managed 25 or even 6 years ago.

 

[trophywench]

The only way the Aviva Expert glucometer can calculate how much bolus insulin to give is because 'somebody' has entered the patient's insulin to carb ratio into it's memory. Turn meter on, go into Settings, then Time Blocks and see what it's set at for the different times of day - mine was 1 unit (of Novorapid) for 10g carb, all day, every day.

 

[SB2015]

@SB2015, being slightly pedantic here and please forgive me:

The T3c diagnosis embraces a spectrum of treatments, ranging from oral meds (ie as if T2) through single daily doses (ie perhaps very carb aware, but not formally carb counting) and then full MDI or pump (ie as if T1). I find it easier to make it clear to many HCPs that I am as if T1 with extra, different, insulin needs.

Thanks @Proud to be erratic from one pedant to another. Every day is a school day on here and I am happy to learn more about the different types of T3c.