Question...

[Persil]

Hi all!

I hope I find you all well! I'm still struggling with the whole carb counting/diabetic diet thing and have a couple of questions...

1) Are diabetics supposed to follow a low carb diet? As I know I don't, as if I cut out or lower the carb, I constantly run either low sugar levels or end up hypo. I try to make sure that I have at least one long-acting carbohydrate with each meal, and just want to check that what I'm doing is right?!

2) I'm assuming I'm supposed to bolus for all the fruit I eat as well, as it's still carb? I had an appointment with a doctor a little while ago, and he mentioned bolusing for bread, cereal, pasta etc etc but I went to eat some grapes the other day just as a snack and was unsure whether or not to bolus to cover it (I did, as I don't suffer greatly with hypos like I do with hypers).

3) Finally, how did you all get on your carb counting courses? I've been told lots about it, but I don't actually know how to get enrolled on a course or put on a waiting list.

Sorry for the list of questions!!

Vicki 🙂
xxx

 

[Northerner]

Hi Vicki! A lot of Type 2 diabetics have a low carb diet because they aren't able to counter the rise in levels they bring by injecting insulin. Some Type 1s also prefer to eat a reduced carb diet as they find control easier - but as you know we are all different, and a lot may depend on your activity levels too as carbs are the easiest form of energy for the body to use. A balanced, low GI diet is probably the most appropriate diet generally for people with diabetes - and also for those without it!

You have already answered your question about fruit, I think - you have found that youre levels will go high if you don't. Grapes are particularly sugary!

As for carb-counting courses, there are various different ones run up and down the country. The best way to find out what is on offer in your area is to ask your DSN or consultant.

 

[AlisonM]

When initially diagnosed as a Type 2 I was told to go on a low carb diet as it would help bring my BGs down, the advice now I'm a 1.5 seems to be the same. I was told to my great distress that I should cut out almost all the fruit and just have it as an occasional treat because of the high sugar content. Bananas, grapes and mango were particularly mentioned a huge no-no, although I was told that small amounts of berries should be OK, hence the love affair with blueberries, blackberries and raspberries. Also, no fruit juice unless you make it yourself because the shop bought ones all have sugar added.

I've stuck to the low carb, low sodium, low fat thing partly in the hope that it will help control my BGs but mostly because it's a pretty healthy diet. I do fall off the wagon from time to time though.

 

[novorapidboi26]

1.
I think having some starchy carbs at every meal is an old strategy, as my brother was brought up on that method, but he was on 2 jags a day, so he needed to have X amount of carbs with the insulin he took....however everyone has different ways which may work for them........

On MDI you should be able to eat as little or as much of carb or non carb meals......

2.
Anything with carbs need insulin, there are lots of book out there, even just the internet that will make you familiar with how much is in what.

3.
I went on DAFNE and it changed my life and understanding of diabetes managment, was reffered by the sraff at my clinic......

 

[aymes]

Hi Vicki

On the carb counting course issue, are you registered at the hospital in Norwich for uni or are you treated back home? The N&N deliver DAFNE, I was originally told 18months for a waiting list but was on a course within 4 as I said I could go on short notice. I don't know if they still do but thru used to regularly run evenings where they spoke about DAFNE and you could put your name down then, these were either advertised in the waiting room or the doctors could put you on. If you want I can pm you the names and contact details of the DSNs who delivered mine, they should be helpful!
Are you coming to the Circle D Norwich meet this weekend?

 

[Persil]

Thanks for all your responses, it is much appreciated.

And Aymes, everything's all over the place at the moment -- my consultant is in Kent (but I'm looking to change this very soon), my GP is here in Norwich (on campus), and I don't even know about my DSN!! I should really enquire about these things now you come to mention it. And I am coming to the meet this weekend 🙂

Vicki 🙂
xxx

 

[Persil]

Ok, just been on the Circle D Norwich Facebook page to see where the meet is, and it says that the date's the 26th of February?!?! Confused!!

Vicki 🙂
xxx

 

[aymes]

Well, that will explain the low response rate then, oops! Think I was choosing between the two dates and managed to put one in my diary and one to everyone else...I really shouldn't be in charge of anything it seems!!
We'll stick to the advertised Feb one then! I am around all weekend though so if you're in the city and fancy a mini meet up drink just send me a pm here or a fb message as I know I've been keeping you all waiting so long to get the group going properly!!

 

[Liz!]

Grapes as a snack are delicious and refreshing but very full of very quick to digest carbohydrate. You need to do a test just before your snack. If your blood sugar is very low then the grapes not quick enough to bring your blood sugar up. If it is a bit low they may be ideal, but thy will be digested very quickly and not last until your next meal. If your blood sugar is normal or a bit high you do need to bolus - but you will find that as the grapes are digested quickly there will be insulin hanging around for longer than needed and you might go hypo later. So grapes are not the best type of snack to have.

It's very irritating when you feel as if you are doing the healthy thing, when in fact a digestive biscuit would last longer!

 

[FM001]

Without any doubt a carb counting course is the way forward for any person living with diabetes, my experience like so many others was very positive and it has vastly improved my diabetes control and outlook.

 

[alisonz]

I wasn't told anything about my diet when I was diagnosed and when I did see a nurse I told her I was eating 2/3 bananas a day! She said that was fine, how confused am I then?
Actually I still haven't been given any diet advice even more confusing.

 

[everydayupsanddowns]

when I did see a nurse I told her I was eating 2/3 bananas a day! She said that was fine, how confused am I then?

ARGH! This sort of thing really gets on my wick! A very small banana is perhaps 12-15g carbs. Your standard-sized supermarket ones (about 6-7 inches long) are more like 25+g. And because of the way the carbs are so easily digestible this means that three times a day you'd have been spiking your BGs.

Think about the number of sporty types like tennis players who can be seen scoffing bananas at end changes. Why? Because they are working really hard and need a quick boost of energy right then and there. Which is fine... if your body is still equipped to absorb that energy. Not really the case for us lot!

So many T2s seem to be advised to 'eat lots of fruit and veg'. But this is just because that is 'standard' healthy eating advice. I can't imagine the same nurse saying, "Make sure you eat things which will push your BGs into the teens several times every day". But then again they may be the same HCPs who trot out the "Type 2's don't need to test" nonsense. Bah! </rant>

Truth is, Alisonz the only way to know if your body can cope with bananas (or other sorts of fruit) is to eat one and then test after an hour and two hours on a few different days and look at the results.



Persil

One of the reasons why many T1s find a moderated carb diet easier to control is because it reduces the 'margin of error' for every meal if you are working with insulin:carb ratios

The technique gives you an expectation of how many carbs your body can deal with for every unit of insulin. Once you have an idea of this figure (or figures if you find it varies through the day) it makes eating different sorts and amounts of food much easier.

Say your ratio was 1u:10g of carbs. If your meal contained 80g of carbs you could work out that you'd need 8 units (80g = 8 lots of 10g, so 8 units). If it was just a sandwich and piece of fruit, say 40g you'd expect to need only 4 units (40 divided by 10).

That's the basic carb-counting theory. And it's a very helpful way to look at doses.

The snag is that your ratio might not be 1:10, or 2:10 or some other nice round number. It might be 1:7 or 1:9.6 (!). This is where a moderate carb diet helps. A moderate carb intake might be 130-150g a day, low carb is sometimes thought of as less than 100g per day total. Moderate carb diets can help to reduce the margin for error in your doses. It doesn't mean you can't have a splurge every once in a while but more regular meals will need lower doses. For larger meals (and larger doses) you might find that, because the food takes longer to digest you need to split the dose into two parts (a bit like a pump dual wave) so that the activity of the insulin is spread over a longer time to match the food.

Good luck with finding a carb counting course.

In the meantime you could look up the BDEC online one to get you started:
http://www.bdec-e-learning.com/

 

[Persil]

Thanks again for all the additional responses.

And Aymes, unfortuneately I'm busy this weekend, but definitely another time, yeah?! I also saw your note about training for your Three Peaks Challenge (I think that's what it's called), and am interested in joining you for a few walks. Just looking to get a bit fitter this year 🙂

And Mike, thanks for the link to the bdec website. I'll have a look at that later!!

Vicki 🙂