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Vegetable bolus
- Thread starter Isma1123
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Lucyr
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- Type 1
It depends what your blood sugars are like and what kind of vegetables as everyone’s different. I estimate the carbs in everything and bolus for it. Some don’t bolus for veg or only bolus for high carb veg.
If you don’t bolus for high carb veg but then find your bg is still high by the next meal after eating them, then you probably needed to bolus for them.
If you don’t bolus for high carb veg but then find your bg is still high by the next meal after eating them, then you probably needed to bolus for them.
Inka
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- Type 1
@Isma1123 No. I was told to ignore all veg except parsnips, pulses/lentils/split peas and potatoes obviously. As an example, if I’m having a baked potato, salmon, carrots and broccoli, all I’d be counting was the carbs in the potato. This was advice given to me as a Type 1 and it’s worked well over 30 years.
If I were to eat just protein plus veg (ie no proper carbs), then I might bolus a tiny amount for the veg, but the bigger issue would be the protein and the annoying delayed rise, which is why I usually have proper carbs with my meals.
Proud to be erratic
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@Isma1123,
My Dose Adjustment For Normal Eating (DAFNE) course some 14 months ago had much the same guidance that @Inka has said above.
I saw in a recent (different) thread a comment about making vegetable soup (minestrone, I think?) and blending or blitzing the ingredients. I understand why, there are times when blitzed or smoother soup is nicer. But once veg have been blitzed the guidance that you don't need to count the carbs is no longer necessarily appropriate.
In general terms many veg, all colours, contain a lot of carbs in their fibre. Fibre does not routinely digest in our bodies, it is however an essential part of our digestion process, helping to "clean" our guts. Once fibres are blitzed thay almost certainly will 100% digest and convert into glucose, thus dramatically changing the carb counting.
I have not found any numerical guidance on what carb content to apply for blitzed vegetables, or fruit, but I'm personally cautious with blitzed foods and expect to see greater glucose arriving in my BG. At such times I monitor my CGM closely and either take extra insulin as a precautionary pre-bolus, but ready to eat some quicker extra carbs or ready to take a further correction bolus. Luckily I'm able to trust my G7 sensor readings, so spared the finger pricking for bolus adjustments.
My Dose Adjustment For Normal Eating (DAFNE) course some 14 months ago had much the same guidance that @Inka has said above.
I saw in a recent (different) thread a comment about making vegetable soup (minestrone, I think?) and blending or blitzing the ingredients. I understand why, there are times when blitzed or smoother soup is nicer. But once veg have been blitzed the guidance that you don't need to count the carbs is no longer necessarily appropriate.
In general terms many veg, all colours, contain a lot of carbs in their fibre. Fibre does not routinely digest in our bodies, it is however an essential part of our digestion process, helping to "clean" our guts. Once fibres are blitzed thay almost certainly will 100% digest and convert into glucose, thus dramatically changing the carb counting.
I have not found any numerical guidance on what carb content to apply for blitzed vegetables, or fruit, but I'm personally cautious with blitzed foods and expect to see greater glucose arriving in my BG. At such times I monitor my CGM closely and either take extra insulin as a precautionary pre-bolus, but ready to eat some quicker extra carbs or ready to take a further correction bolus. Luckily I'm able to trust my G7 sensor readings, so spared the finger pricking for bolus adjustments.
I didn’t bolus for the vegetable last night and only did it for the carbs, hence why there may have been a spike in my blood sugars in the morning. How much would you exactly bolus for broccoli and half a red bell pepper, I’m sure that covers one unit altogether dosent it, and what about for salmon, if you’re having that also, maybe cos I didn’t bolus for the salmon, could have also been the reason. But from what I know, you only bolus for the carbohydrates if you’re having protein also.
Lucyr
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- Type 1
I can’t tell you how many units to take for vegetables and salmon. I can only tell you what I do which is weigh the carby veg and work out carbs, or estimate the carbs then use my personal ratio. There aren’t any carbs in salmon so I don’t bolus for that.
Other people do not count the carbs in vegetables and do not take any insulin for them. You have to work out what works for your blood sugar.
Unfortunately, it is not as simple as always ignoring veg or protein.
I tend to consider (but not religiously weigh) the “carb-ier” veg like carrots and peas and parsnips. But pay little attention to things like cabbage or courgettes as the carbs in them is so low that, with the inaccuracies of carb contents and meters plus all the other things that can affect our blood sugars, it‘s all an approximation and the little carbs in cabbage get lost in the guesstimate.
In my experience, protein only affects my blood sugars if I eat very low carb. So, most of the time, I ignore the protein.
The other thing to consider is how “precise” is your insulin dose compared with your needs. When using an insulin pen, you can only dose down to one or half a unit. So, even if you were able to accurately count every carb and your insulin to carb ratio was 100% correct, you would have to round up or down on the dose.
An insulin pump allows me to dose 0.05 units so i do far less rounding up or down.
Finally, there is your insulin resistance/sensitivity. If your insulin to carb ratio was 1:3, the carbs in your broccoli could require an extra unit of insulin. But if your ratio was 1:15, you could not dose a small enough bolus for it.
I wish it was a simple case of saying “always carb count all vegetables“ or “never carb count them” but it is more complex with different carb contents in different vegetables, different things eaten with them and different things going on with your body.
I follow a similar guideline to those eating low carb - above the ground vegetables can be ignored whereas below the ground vegetables need to be carb counted.
And protein is ignored unless I am eating very low carb.
I tend to consider (but not religiously weigh) the “carb-ier” veg like carrots and peas and parsnips. But pay little attention to things like cabbage or courgettes as the carbs in them is so low that, with the inaccuracies of carb contents and meters plus all the other things that can affect our blood sugars, it‘s all an approximation and the little carbs in cabbage get lost in the guesstimate.
In my experience, protein only affects my blood sugars if I eat very low carb. So, most of the time, I ignore the protein.
The other thing to consider is how “precise” is your insulin dose compared with your needs. When using an insulin pen, you can only dose down to one or half a unit. So, even if you were able to accurately count every carb and your insulin to carb ratio was 100% correct, you would have to round up or down on the dose.
An insulin pump allows me to dose 0.05 units so i do far less rounding up or down.
Finally, there is your insulin resistance/sensitivity. If your insulin to carb ratio was 1:3, the carbs in your broccoli could require an extra unit of insulin. But if your ratio was 1:15, you could not dose a small enough bolus for it.
I wish it was a simple case of saying “always carb count all vegetables“ or “never carb count them” but it is more complex with different carb contents in different vegetables, different things eaten with them and different things going on with your body.
I follow a similar guideline to those eating low carb - above the ground vegetables can be ignored whereas below the ground vegetables need to be carb counted.
And protein is ignored unless I am eating very low carb.
Proud to be erratic
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As you put that question it is akin to asking how long is a piece of string! What, fairly exactly, was the spike? How big, how long after your 1st mouthful and for how many minutes did that spike prevail? Without those answers we don't really know if you even had a spike (as we would understand that) nor whether the apparent spike continued beyond the reasonable time that you had bolus insulin on board?
What I mean by that is first of all did you take a bolus just for your food or did you include an additional bolus component to correct a starting point higher than you wanted. Ifcyes was your correction ratio correct? Plus did you, after c. 4 or 5 hours, still end up higher than you wanted or was, in practice the spike eventually dissipated by the bolus? If it was eventually dissipated then was that because you took fairly urgent and unusual steps to cause that, eg by extra exercise or activity? So:
If the spike dissipated on its own then that suggests your bolus was correct in size of dose but the timing was wrong - the digested carbs arrived before your insulin and for that meal causing a spike and you should consider having a longer pre-bolus interval.
If exercise finally brought your spike down then you got a good result, but that may not be an acceptable routine for you overall (it may be too intrusive to your lifestyle). In this case your bolus needs increasing a little (how much depends on the carbs counted and the carb to insulin ratio).
If you simply ended the meal higher than you started and your bolus never gave you the reduction you sought, then your carb counting or your carb to insulin ratio needs reviewing. But don't rush to immediately change things - take note and when you repeat that set of circumstances (ie the same food with the same ratios and bolus doses) check to verify you get the same wrong result. Then make changes.
Metabolism is not a precise process and our bodies behave differently on different days, influenced by many, many different factors. The weather, your stress from the day, what exercise you have had during the day and the day (or 2) before, are just a few factors. Also carb counting is not a precise process; even when foods are accurately weighed and the carb content scrupulously read from a packet or book (with careful maths applied) this is still not really accurate. Carb counting is necessary but some pragmatism is needed about the final guestimate.
Personally I'd apply no extra bolus for those 2 vegetables. If my late mother had been the cook and stewed them into submission, then maybe I'd assume the fibres in the veg were breaking down and also being digested!! [Apologies to my late Mum] Fibre is pure carbohydrate, but is routinely ignored since fibre is not routinely digested by humans. (Cows have 4 stomachs to give them the best chance of getting some energy from grass - which is effectively pure fibre). But those 2 fresh veg moderately cooked would have no impact on my BG. That doesn't mean that this will definitely be the case for you or some other people.
You are clutching at straws now. Salmon has no carbs. As I've tried to explain earlier we need to see the full picture to try and explain why you spiked.
I have no idea where this concept has come from. If you are eating carbs, naked as icing sugar or smothered in protein or fat, pizzas and lasagnes, then those carbs should always be counted and insulin taken. Some complex meals, with carb digestion delayed by fats in particular, can get their transition into glucose delayed and reach your blood after the bolus insulin has been and gone. Now we are trying to turn you into a top equivalent of a sprinting hurdler - where its not just a case of getting a good time over a 100m sprint, but with every stride exactly right in length and each hurdle vaulted with no break in momentum and minimal disruption to the overall speed. So let's ignore this aspect of fatty food digestion speeds for now!
Inka
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- Type 1
But from what I know, you only bolus for the carbohydrates if you’re having protein also.
@Isma1123 You sound a little muddled. You bolus for all proper carbs whether you’re having protein with them or not. For example, if you had two slices of bread and butter, you’d add up the carbs in the two slices of bread and bolus for them. If you added some broccoli to your 2 slices of bread, you’d still only bolus for the bread because you don’t count the carbs in most veg. If you added a slice of chicken to your two bits of bread, you’d still only bolus for the bread carbs.
- All veg (except potatoes, parsnips and a few less common ones) ignore the carbs
- Protein - ignore if you’re having proper carbs with it
- proper carbs - count and bolus for them, ie bolus for bread, pasta, rice, quinoa, cereal, biscuits, cake, desserts, chocolate, etc, etc, etc
.
@Isma1123 You sound a little muddled. You bolus for all proper carbs whether you’re having protein with them or not. For example, if you had two slices of bread and butter, you’d add up the carbs in the two slices of bread and bolus for them. If you added some broccoli to your 2 slices of bread, you’d still only bolus for the bread because you don’t count the carbs in most veg. If you added a slice of chicken to your two bits of bread, you’d still only bolus for the bread carbs.
- All veg (except potatoes, parsnips and a few less common ones) ignore the carbs
- Protein - ignore if you’re having proper carbs with it
- proper carbs - count and bolus for them, ie bolus for bread, pasta, rice, quinoa, cereal, biscuits, cake, desserts, chocolate, etc, etc, etc
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