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Struggling with Carbs

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Sadieking13

New Member
Relationship to Diabetes
Type 1
How do you all count carbs without it becoming a headache and stressful. I work full time, married and have a handsome boy of 8. I find it really hard trying to find a routine that works around me.
 
Sadieking13 said:
How do you all count carbs without it becoming a headache and stressful. I work full time, married and have a handsome boy of 8. I find it really hard trying to find a routine that works around me.
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You build up a carb index in your brain - or a notebook 🙂 Keep things simply by having the same amount of cereal/pasta/rice each time; jot down meals with food weights, carbs and the bolus you took.

Most people eat the same 30 evening meals apparently so you’ll soon start to know your carbs. I also usually have similar breakfasts and lunches so I just know how much insulin to have without counting.

It is harder with children, but I find bolus-timing the hardest thing because there’s always some minor crisis pre-meal and it’s very hard to remember to bolus at the right time. All you can do is the best you can. X
 
Inka said:
You build up a carb index in your brain - or a notebook 🙂 Keep things simply by having the same amount of cereal/pasta/rice each time; jot down meals with food weights, carbs and the bolus you took.

Most people eat the same 30 evening meals apparently so you’ll soon start to know your carbs. I also usually have similar breakfasts and lunches so I just know how much insulin to have without counting.
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Thank you for replying. I don’t currently have breakfast (I know that’s not a good thing) and under the instruction of my specialist Iam only to take 10units of my novorapid before each meal. I was previously being treated as a T2 but now (as hba1c is 117) they have decided a T1 is a better fit. He didn’t really give me much info (and no one has) regarding the best way to help myself with carb counting etc. it’s just all confusing and stressful :-(
 
Ah, ok - thanks for explaining that. Right, well as you’re on a fixed dose of Novorapid, you need to determine how many carbs that 10 units ‘covers’. It might be a different amount of carbs for lunch than tea.

As an example, if your 10 units covered 50g carbs at lunch, then every day you’d aim to eat 50g carbs at lunch so that your blood sugar remained steady. You’d start by looking at, say, your bread and adding up the carbs for that. Let’s say 2 slices is 30g carbs. You can then add ‘free’ fillings like meat, cheese, eggs and salad to make your sandwich. Then you need to find another 20g carbs, so you might have an apple (15g carbs) and 1/2 a digestive or whatever.

Those figures are just examples.

You’d find it a lot easier to be on non-fixed doses which you could adjust according to the carbs you’re about to eat. This is the recommended regime for Type 1s.

I’m presuming you’re also on a basal/slow insulin?
 
Iam on 12units of lantus as well and have 2000mg SR metformin. I have another appointment with the specialist on the 17th. What’s the amount of carbs I should be having a day?
 
At the moment you should be having the amount of carbs your fixed dose Novorapid can ‘cover’. There is no max carb amount for Type 1s. The diet recommended for Type 1s is a normal healthy diet just as for anyone else. Once you’re on proper variable doses of Novorapid, you’ll just eat normally and take the amounts of Novorapid you need to do that.

However, currently you are limited by your fixed dose Novorapid. You need to find how many carbs it ‘covers’ or deals with. Your blood glucose tests will help you see that, but really you should have been told by your consultant. I was on fixed doses to start with but I was also told how many carbs to eat at each meal. Once I changed to variable doses, I just ate normally and took the insulin I needed to cover those carbs.

How are your blood sugars?
 
To be clear, with Type 1 you count your carbs simply to determine your mealtime insulin dose NOT to limit them. So when Type 1s talk about carb-counting, they mean counting their carbs and adjusting their insulin. They don’t mean they’re on a special limited diet.

I’ve had Type 1 almost 30 years. I just eat normally and take the insulin I need to control my blood sugar because my pancreas is unable to make enough insulin to do that.
 
Thank you. It’s helpful to know I can ask the questions.
My glucose Varys from around 9-15 depending. Which is why I think the 10units arnt really helping
 
Sadieking13 said:
Thank you. It’s helpful to know I can ask the questions.
My glucose Varys from around 9-15 depending. Which is why I think the 10units arnt really helping
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Yes, that’s a little high. The first thing to do would be to make sure your Lantus is sufficient. I suspect it might not be. If you’re not having the right dose of basal insulin, it makes it hard to get everything else right.
 
Ok thank you. Iam seeing my specialist again in the 17th so I will bring this all up. I have the freestyle libre2 so I’ve been recording everything to show them
 
Your basal insulin is supposed to keep your blood sugar in range and steady in the absence of food. Obviously, you don’t want to starve yourself for 24hrs to see if it does that, but you can split the day and night into segments and test one segment at a time. Having the Libre makes this easy.

https://forum.diabetes.org.uk/boards/attachments/basal-testing-pdf.19395/

I’m not sure if that link will work or not. You might need to look for the pdf file and download it.
 
Hi and welcome from me too.

How long have you been on insulin? They generally like to bring your levels down slowly to put less strain on the fine blood vessels in the eyes, so those levels might be reasonable for now but obviously your team will gradually want them to come down into range, which thanks to Libre is now generally considered 3.9-10. It is a slow learning process, both for you but also your team at the hospital to figure out the best balance of insulin doses for you and we are all individual in that. It is likely that your Lantus will need increasing but it takes time to get somewhere near the right dose and they certainly won't want to give you too big a dose and end up with you hypoing, so there should be a period of regular contact and small adjustments until they get you into range.
 
I’ve been on insulin since I was diagnosed in 2014 but was on novomix 30 until about 2 months ago. Originally I was treated as a T2 but now they say it’s more like T1 as my hba1c and glucose levels are so high all the time
 
Blooming heck! That is a long time. I hope your levels haven't been that high all that time! It sounds to me like you haven't had very good support with your diabetes management at all. It is a pity you didn't find the forum sooner. Have you only just been referred to the hospital team? Were you previously treated by staff at your surgery?

Good to hear that you have Libre as that should help both you and the hospital team. What do your levels do overnight?
ie Do they rise or remain steady or drop? That is usually a reasonable indication of whether your basal insulin (Lantus)
is holding you steady or not.

Whilst eating normally is recommended for Type 1 diabetics, I personally find following a low carb way of eating makes my BG levels much easier to manage and I carb count very little as a result and it is much more of an approximation. It may seem a bit boring, but I have the same breakfast almost every morning (creamy Greek style natural yoghurt with berries and seeds and a sprinkle of low carb granola, so I don't have to think about that. I often skip lunch or have something low carb which doesn't need insulin or maybe a bowl of soup that usually needs 2 units and then I have a few extra carbs on an evening which still need a reasonably small bolus of 3-5 units (30-50g carbs). This works for me as it removes a lot of the mental strain. I still eat very well. Last night I had mixed antipasti followed by rib-eye steak with mushrooms and 3 small pieces of sweet potato with a large plate of salad dressed with balsamic vinegar and a big dollop of cheese coleslaw, followed by a square of dark chocolate and a couple of spoons of peanut butter to bring my levels up high enough to go to sleep. I have a 1-10 insulin to carb ratio and that cost me 5 units.
I ate "normally but carefully" over Christmas and Boxing day and I needed masses of insulin (nearly 3x my normal doses) and my levels were like a roller coaster and I felt horrid so I am really relieved to be back to my low carb eating now. It will be a long time before I eat bread again, as that really is my nemesis.

An intensive education course would be really helpful to you, so if you can get your name down for a DAFNE (Dose Adjustment For Normal Eating) course or whatever your local equivalent is, that is definitely worthwhile but in the meantime there is a free online course called BERTIE which I have hopefully linked below...

Welcome - BERTIE Online

www.bertieonline.org.uk www.bertieonline.org.uk
 
You will get good advice from some very long standing and well experienced Type 1 folk but I think you should be pressing for more support from your diabetes team after all they have your complete medical history. Having to wait until the 17th, nearly 3 weeks away when you are not on the best regime to get your blood glucose levels in better place. At the very least you should have a contact number you can call for advice that has clearly been lacking from your team.
 
The basal is supposed to keep your levels flat.
If they are flat a 9mmol/l, basal will likely keep them at that level. It will not reduce them if you have the right dose of basal.
Your bolus should be used to correct/reduce your levels to "in range".
 
Yea it’s a long time and no I don’t think it’s been handled well on either part. My levels very rarely drop over night as I tend to eat a snack late. I think I really need to start a strict diet but it’s knowing where to start
 
Leadinglights said:
You will get good advice from some very long standing and well experienced Type 1 folk but I think you should be pressing for more support from your diabetes team after all they have your complete medical history. Having to wait until the 17th, nearly 3 weeks away when you are not on the best regime to get your blood glucose levels in better place. At the very least you should have a contact number you can call for advice that has clearly been lacking from your team.
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It took 18months to get the appointment I got a few weeks ago. Because of covid I had 2 appointments cancelled. I know I don’t help myself with what I eat but Iam not 100% sure how it all works and adjusting insulin etc considering I’ve been treated a type 2 but now it’s type 1, which is fine but I’ve not had the support in how I move forward. I understand the basics but that’s not enough I guess
 
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