No Use Carb Counting...I'm A Type 2!?!

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Ellowyne

Ellowyne

Well-Known Member
Relationship to Diabetes
Type 2
Hi all, just a quick message really.

I am a bit worried about what my DSN said today and need to get some clarification if I can please?.....I phoned in for my regular summary of levels ect. She said that overall it sounds as if I am doing ok, though my fasting is still averaging a 10 in the morning!...Anyway, I explained that I was really not sure of how to work out my Insulin, like carb/ratio ect ans could she give me any guidance at all.

My DSN said that, as I'm a Type 2 Diabetic, that carb counting isn't really possible or useful to do :confused: It's a bit confusing, but she basically said that, unlike Type1, Type 2 Diabetic are still producing their 'Own Insulin'....so, although it is useful to keep an 'Eye' on carbs, Type 2's producing Insulin will not be able to work out their carb/ratio because it is ever changing....:confused:

So, in the bin with the carb counting books? As a Type 2 it kinda feels like a punishment sometimes, we told you this would happen...it's like...well, I feel like a Fake Diabetic, and I am begining to think that I am only doing more damage by taking the Insulin if it's not going to get any better. Oh, yes, she said the other reason for not counting is that...again, because I am a Type 2 'You are still Insulin resistant' so it's harder work with the Insulin.

Every time to speak to Drs or DSN I just feel like I am being judged and they are always so full of doom and gloom....What is the point in trying!

Hope someone can help me understand this more please...any help?

Thank you....Elowyne xXx
 
Are YOU getting better reading since you started carb counting? Ignore her for the mo and ask your self how you feel. how have your levels changed? My doc thinks I'm type 2 and never mentioned carb counting but my DSN did and that at the mo there wasnt any in the area which is why I asked Adrienne for help.
 
That's really not very constructive advice at all is it? Hopefully, other type 2s on insulin will be able to give you their perspective, but to me it's a bit like telling a honeymooning Type 1 not to carb count. If you consistently find that the insulin you are injecting (coupled with your own insulin production) is producing highs, then you need to inject more insulin and you need some way of determining the amount! You might only be 'topping up' but you need to know how much to top up with :confused:

Also, being insulin resistant simply means that you're not using insulin as efficiently as a person who is non-diabetic or insulin sensitive. So? It just means you need more of it surely? You're still on relatively low doses Ellowyne, by the way.

I'll have a dig around and see if I can find anything else on this (unhelpful) advice from the DSN.
 
Surely you cant be producing a high amount of natural insulin, or they wouldnt have put you on insulin....
 
smile4loubie said:
Are YOU getting better reading since you started carb counting? Ignore her for the mo and ask your self how you feel. how have your levels changed? My doc thinks I'm type 2 and never mentioned carb counting but my DSN did and that at the mo there wasnt any in the area which is why I asked Adrienne for help.
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I'm not actually Carb Counting as such, I am unsure how to?....I have some books ect, but they are mostly confusing!....That is why I asked my DSN for advice about it. I do watch that I cut down my Carbs on my plate, but, well, I am taking more Novorapid, 3 times aday now, with Breakfast, Lunch, Dinner and Levimer at night. She says that she thinks my Levimer still isn't high enough to get my morning levels down, so I am putting it up by 2 each time now...I guess untill I get better fasting readings!

Hope you are ok Lou 🙂
 
Been better hun but surviving at mo. Ask Adrienne to help. Shes a star! Have you got the Collins Gem Carb Counter book (will try and find a link unless Northe beats me to it).

I use the ratio of 1 unit for every 5 grams of carbs so for a sandwich thats 20 carbs I'd take 4 units.
The carb book tells you how much carbs in is 100g for hundreds of different foods.
You have to weigh your food and there is some maths invovled but it does get easier.

xx
 
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Thank you Northerner, I would'nt know where to start looking to get more information....It is just so very difficult when you are consisitantly being given advice in a way that seems like, well?...When they put me on Insulin it was said at the time that they would prefer me 'Idealy' to be on Metformin. However, beacaus of other complications with my health and the severe side effects on Metformin, it was no good, as was the Glicazide!...But, they made me feel like it was my fault, and when they put me on Insulin it was given with an attitude of this being the 'Last Resort' lIke, there's no turning back now!!...I just feel fake the way they talk to me, all I get it 'well, because you are a Type 2!...ect, ect'...Even the other week, when my Gall bladder was infected, the Paramedic, when my partner said I was Diabetic he asked what type, when my partner said Type 2, should of seen the disaproving look I got!....I'm not really a Diabetic, I've just done this to myself because I am fat!...You really can not fight it, it just gets in the way all the time and hinders my treatment because they close the doors on so many options...like this time with the carb counting, no point, no good....Your Insulin resisitant Type 2!'
 
I think it's very poor that they are so negative Ellowyne. They probably don't even realise they are doing it, they're so used to coming out with this stuff (and possibly prejuduced like many people because of the bad press diabetes gets). Don't let her attitude get you down {{{{hugs}}}}
 
Ellowyne said:
Thank you Northerner, I would'nt know where to start looking to get more information....It is just so very difficult when you are consisitantly being given advice in a way that seems like, well?...When they put me on Insulin it was said at the time that they would prefer me 'Idealy' to be on Metformin. However, beacaus of other complications with my health and the severe side effects on Metformin, it was no good, as was the Glicazide!...But, they made me feel like it was my fault, and when they put me on Insulin it was given with an attitude of this being the 'Last Resort' lIke, there's no turning back now!!...I just feel fake the way they talk to me, all I get it 'well, because you are a Type 2!...ect, ect'...Even the other week, when my Gall bladder was infected, the Paramedic, when my partner said I was Diabetic he asked what type, when my partner said Type 2, should of seen the disaproving look I got!....I'm not really a Diabetic, I've just done this to myself because I am fat!...You really can not fight it, it just gets in the way all the time and hinders my treatment because they close the doors on so many options...like this time with the carb counting, no point, no good....Your Insulin resisitant Type 2!'
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This is disgusting. Can you change docs? If you could I would because all though this is care it is **** care and you'd almost be better off with no care than this care. Please try to change doc or at least your DSN xx
 
What is wrong with these medical people?

You should get help from your DSN getting your ratios. Kick up and contact PALS. http://www.pals.nhs.uk

Ellowyne, here's what I did/do/learnt.

I'm on Metformin. BGs were high so I got the Collins Gem book and worked out how many carbs I was eating. Well over 300g a day! A set of digital scales is an excellent purchase.

The recommended daily amount according to the sides of food labels is about 240g a day.

My goal when I started carb counting was to have anything I wanted as long as the 240g target was met. I have gently cut down and am now at about 200-220g a day. After a few months I didn't notice I was eating half what I had before diagnosis till my sister told me.

I also have more fresh veg and fruit, I eased off the rice and pasta and white bread. I cut down the fat and salt to almost nothing added.

Slowly my numbers have come down, with a lot of help walking everywhere I can instead of using the car or public transport. The exercise has reduced my insulin resistance quite a lot. Had a 3.9 this morning...😱 A biscuit fixed it!:D

I still enjoy a curry once a month. It's not the one in the creamy sauce anymore.

Regarding insulin ratios, my T2 friend said what you could do is to do some experiments. Once you get your basal right then you can try this. Now bear in mind basal changes take a few days to settle down.

Before eating note your BG. Note down how many carbs are in your meal and then test a few hours later when your bolus has run out and see what your BG is. If your ratio is correct your pre and post BG should be similar. Then work out how much carbs to insulin you had and write it down. If your BG is too high try a little more bolus. If you hypo then the opposite is true.
Try changing your ratios in small amounts. The other thing I learned is not to try and correct big amounts while it insulin therapy is new, coz if you hypo your BG can yo-yo and you'll hate that.

I hope that helps you.
 
I am type 2 on insulin and metformin and last year was told my by dietician and DSN that I should try carb counting.. I use the ratio 1u to 10g of carbs, she did say that it won't be as easy as I may still be producing some insulin so they can't work out set ratios like they do for a type 1.. it just means that you adjust the amount of insulin to what you are eating, which will be a bit scary for a fist time insulin user I would imagine.. I would have thought they would work out how much insulin you need to take to get you within reasonable levels before letting you start to work things out, but don't take my word for it... I have base levels for my Novorapid of 22 at brekkie 24 at lunch and 28 for evening meal then I work out what carbs I have eaten and adjust my insulin as required, so if I ate something for evening meal that came to 120g I would add 12 units of insulin to to the 28 and give myself 40 units of insulin, it works for me but we are all different..
 
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Squdge, that's precisely what I would expect to happen. OK it's not getting all precise about ratios, but you at least have a method. Ellowyne's nurse appeared to be telling her it was random and she should just suck it up and lump it! (so to speak🙂)
 
Northerner said:
Squdge, that's precisely what I would expect to happen. OK it's not getting all precise about ratios, but you at least have a method. Ellowyne's nurse appeared to be telling her it was random and she should just suck it up and lump it! (so to speak🙂)
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I know, it is disgraceful, but last year when I saw the dietician she said they it was "new" for type 2's to be put on carb counting, so maybe that dsn hasn't got up to date with stuff which is bad.. the dsn needs to be complained about and Ellowyne should contact PALS like Tez said.
 
I am T2 on Byetta and Metformin- Byetta since last October - some of you may have seen me post about that adventure!

I can't really get my head around this insulin resistant thing- I know and elderly friend was put on insulin about a year ago having failed to control her levels on Metformin alone - but she was never givent the full dose which I thought might have been the 1st step? She never has to test before dosing - they just tell her a fixed amount to take each morning so I am assuming she has some sort of cocktail of slow and fast release - told you I was confused!

Anyway, all I can offer is my own experiences of the carb question and that is I followed Wallycorker's example of how he cut carbs - gently and one step at a time - as he stressed, he evolved his regime over years of trying and testing.

My DSN was happy that Byetta brought my fasting levels down to under 8 but I felt I wanted to achieve better plus I felt bloated after sandwiches etc at lunchtime. So I did a test over 3 weeks, gradually cutting out carbs for breakfast and halving lunchtime ones (substituted Ryvita and the like for the bread). Evening meals are still as they were- sensible healthier choices which include modest amount of carbs. This is still a work in progress!

My levels have come down quite a bit doing this - fasting is usually under 7 and the other levels have come down too - 2 hours after lunch now is usually under 6. DSN says this is the level which a non-diabetic would return so I was really pleased with that and losing a few pounds into the bargain.

I don't count carbs to get a total but use the Collins Gem book to make sensible choices and try to aim for foods with the lowest carbs. I don't know how someone on insulin should apporach the carb question but if your health team are not telling you to count the carbs then maybe another approach for you would be to go back to square one and try out cutting some carbs one meal at a time and see what results you get- say, breakfasts for a week and see what a difference it makes. Then at least you will have some ammunition for a discussion.

Good luck with whatever you do🙂
 
Thank you for all the great advice...I am going to try to get my head around all the new information...and start using my carb counting book!....You won't belive this but, my DSN is the head DSN at the clinic 😱 So, if she is giving this information to me then, it's pretty much a certainty that this attitude will also be given out by the other DSN's under her charge!....I just wish the atticyude toward Type 2's would change, it really does hinder the issues surrounding a perosn health and wellbeing.

Thank you again, great advice for me to digest 🙂
 
Ellowyne said:
Thank you for all the great advice...I am going to try to get my head around all the new information...and start using my carb counting book!....You won't belive this but, my DSN is the head DSN at the clinic 😱 So, if she is giving this information to me then, it's pretty much a certainty that this attitude will also be given out by the other DSN's under her charge!....I just wish the atticyude toward Type 2's would change, it really does hinder the issues surrounding a perosn health and wellbeing.

Thank you again, great advice for me to digest 🙂
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My DSN is lovely- supportive and always has time to listen and she takes on board the info I bring back from discussions on here and takes it all on board. However, she appears sceptical about the carb issue - as was I up to recently. This was, in part as it was easier to grab and go with a carby sandwich than to face the reality of what I was doing to myself.

I have a theory that my DSN would love to embrace the new ideas we are all posting but has to be conservative in her advice - she has to abide by current thinking and I can see the need for a lot of research before the NHS starts laying down new guidelines. That is why I think it is so important that people like us - people who live with our conditions - can discuss and experiment and report our findings. If I can lose some of this weight which has been the focus of my life for nearly 60 years and get down my BS levels which have been an added burden for nearly the last decade, then not only do I feel better and understand better what is best for me, I can give back in the form of advice. I am lucky to have my DSN who will take on board my comments- she collects the graphs I make showing my results and has my permission to show them to anyone who is interested. As I am one of her first Byetta guinea pigs, I do have a platform at the moment, but I feel that if restrained use of carbs works for me, it could help anyone - the Byetta has done a great job but I am improving on it I hope! This makes me more determined to carry on the fight so it is a win win situation. Sadly, not all health teams are this enlightened and there we have the root of the problems which some people face:(

Oh dear, that turned into a bit of a rant! Sorry! But better out than in eh?😉
 
Ellowyne (HUGS) I know exactly where you are coming from. Its like everyone I see (Dr / nurse) has a different opinion on my treatment and its no wonder sometimes I am so confused and guilty of admitting I choose to ignore the fact I have Diabetes (Type 2) as I am so confused and feel I have so little support and respect. I have to remind myself though that its what I feel like and its up to me to find out the info. Its not my fault and it wont go away!

Keep plodding on theres great people on here who may not have medical letters after their names but they have good FRIENDLY advice!

🙂
 
Ghost Hunter said:
Ellowyne (HUGS) I know exactly where you are coming from. Its like everyone I see (Dr / nurse) has a different opinion on my treatment and its no wonder sometimes I am so confused and guilty of admitting I choose to ignore the fact I have Diabetes (Type 2) as I am so confused and feel I have so little support and respect.
🙂
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This is exactly how I felt before I came onto this site =)
 
I think carb counting is a personal call for type 2s. There are many here who feel it makes a difference, it works for them. I personal don't carb count, but am trying to cut down on my carbs (an extra portion of vege instead of potatoes, an apple for afters instead of a slice of cake, half a bowl of cereal for breakfast and a portion of fruit).

My advice would be do what you feel most comfortable doing, I know carbohydrates affect our glucose levels, and it is only by experimenting and testing that we find out wht works for us as individuals.
 
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