Measuring carbs and insulin

[mairik]

Hi all,

I'm quite new to this and was disappointed recently when I went to see the dietician for the first time and she told me the only way to work out how much insulin take for a given amount of carbs was 'trial and error'. Is there any way of measuring carbs and therefore working out how much insulin I should inject? I realise this may be different for everyone but I've read posts where people talk about a weight of carbs and therefore an amount of insulin they take - is this taken from the carbs on the nutritional info on food packets?

Sorry to seem so dim!

Thanks

Mairi

 

[Northerner]

Hi Mairi, what you are referring to is known as 'carb counting'. Essentially, this means calculating your insulin doses based on the number of grams of carbohydrate in the food you are about to consume (or have consumed if you inject after eating). People work out ratios of carbs:insulin, which may vary through the day - you may need more insulin in the morning for example, as insulin resistance is often higher at that time.

As you suggest, people can vary quite a bit, so there is some trial and error involved to begin with and you won't always get it right. You should ask your DSN if there are any courses available to you. Alternatively, and if you want to understand the concept more, try this excellent online course:

http://www.bdec-e-learning.com/

 

[HelenM]

The course mentioned is really worth following
You find how many g carbs are in various foods from packets, from books (as sold to dieters). It's worth investing in a set of digital scales.

Unfortunately working out how much insulin for a given amount of carbs is a bit trial and error but you can make the trial much more 'scientific' by controling the amount of carbs each time, then recording before, 2 hours after and next meal glucose levels. As you are fairly newly diagnosed you may need quite small amounts of insulin and its important to take care with any 'experiments', only adjust insulin by small amounts until you know it's effect on your body.
This link has some carb counts for basic foods and a link at the bottom of the page descirbes how to do a test meal. It's worth remembering that most of us vary slightly according to the time of day so if you want to work out lunch or dinner carb ratios, its best to test at these times as well. The test meals suggested also use very fast carbs. I can see why they do this but you might find that if you eat lower gi foods or meals higher in fat that it will still need some tweaking.

http://www.leedsteachinghospitals.com/sites/diabetes/food/CarbohydrateCountingRef.php

 

[Lizzie]

Hi Mairi

Don't worry about seeming dim, I knew nothing about this for 15 years after diagnosis. I think it isn't our fault, it is often doctors and medical professionals who do not keep up to date or don't bother to tell us about developments, so if we don't know, how can we do anything?

Do you have a DAFNE course running in your area? There is a list here: http://www.dafne.uk.com/downloads/DAFNE_centres_uk.pdf and their website is here: http://www.dafne.uk.com/. There is also a forum at http://www.dafneonline.co.uk/ where you can chat to others about DAFNE. Some areas have their own courses, like the Bertie one already mentioned. I learned about carb-insulin ratios on a DAFNE course. It can be hard to get a week off if you work but if you possibly can and there is a course in your area, it is well worth doing. I learned a lot. DAFNE is basically 5 days solid diabetes education, run by nurses and dietitians. You learn about ratios, also exercise, pregnancy, hypos, how to avoid hospitalisation with ketones...loads of stuff. The e-learning course is good but some people learn better with face to face contact. I am a person who would probably sign up with the e-learning course and then forget to go back and actually learn, and others might be nervous about making changes without being overseen by a nurse or dietitian. It depends on how you learn best.

 

[shiv]

Hi Mairi

I just wanted to clarify on the trial and error thing - it definitely is, but a good starting place many people find (nb this is not advice!) is taking 1u of insulin for 10g carbs. From there, you would moniter your BG levels to see if you need to make an adjustment to this ratio. After that begins the trials and errors - tweaking ratios etc! 🙂