9 Responses

  1. Mary Dexter
    Mary Dexter December 5, 2013 at 5:19 am | | Reply

    The FDA requires that the nutritional information listed on the package be at least 80% of the total, but has no guidelines for how much it can go over that number. Therefore, the grams of carbohydrate listed on a package may be that number, 80% below, or any amount higher. We can algebraically calculate the exact number of carbohydrates per serving and divide by our current insulin:carb ratio, but if the number we start with is wrong, our result will be way off.

    Also, because most of the public associates carb-counting with fad diets rather than blood sugar control, businesses are likely to underestimate the amount of carbs so that people will believe they can eat their product.

    Is it any wonder we often guess wrong?

  2. June S.
    June S. December 5, 2013 at 6:01 am | | Reply

    I am happy for the years I spent using the ADA Food Exchange Lists. I learned to eat a balanced diet, while many PWDs I meet who were diagnosed after carb. counting came into fashion think only about carbohydrates, and not about good nutrition. I do carb. count now, since I’m pumping insulin, but find that on work days I eat exactly the same breakfast and lunch, without any variation, since I know exactly how much insulin it will take to cover those foods and not go high or low while at work. In terms of those meals, it is boring and monotonous, but I enjoy the predictability of blood glucose levels that I get by not varying those meals at all.

  3. Gretchen
    Gretchen December 5, 2013 at 6:24 am | | Reply

    The FII sounds a lot like the “substance glycemic index” (SGI) that diabetic engineer Derek Paice came up with some years ago. He measured his BG excursions with a variety of foods, carby and noncarby, and assigned them a number in relation to 60 g of whole-wheat bread (not the best control as whole-wheat bread varies a lot in composition, but it’s a start).

    You can see his results at Click on “Diabetes and Diet.” He has a list of his personal SGIs.

    Because Derek is a patient and not an academic, no one paid much attention to his idea. And of course YMMV. But I suspect it’s like the glycemic index: different absolute numbers but relatively the same.

    Also, Derek is supposed to be type 2, but he controls with about 8 U of insulin a day, so he may be some other type.

    Even if you’re not interested in SGI, his booklet, which is free for download, has lots of interesting experiments that are graphed. One, response to an apple, included both type 2 and type1. That’s in the second booklet, “Effects of Aging.”

  4. Melissa K
    Melissa K December 5, 2013 at 6:29 am | | Reply

    I always bolus for protein and fat. For me, 10% of fat and 35% of protein turn into carbs. I put those carbs in an extended bolus for 3.5 to 5 hours depending on how much fat is in the meal. Lowered my A1C from high 6s to 5.7 (the 5.7 was only one month on the program) so I am excited to see what my next A1C will bring. Rarely do I see a blood sugar over 140.

  5. David
    David December 5, 2013 at 7:31 am | | Reply

    My method is carb-counting plus crib notes for high fat/high protein meals. I dunno if any system can work universally for all PWD because the effect of fat/protein varies in amount and timing from person to person. For me, Chinese food is a 6-8 hour fat bomb. By trial and error, I figured out my fav cheese enchilada platter requires a whopping 15.4 units spread out over 4 boluses over 4.5 hours. My pump’s bolus calculator would always require adjustment so I don’t use it. There’s a lot of potential in touch screen pumps to allow meal presets (with ability to deliver Combo/Extended) and a Note taking function.

  6. susan f
    susan f December 5, 2013 at 7:43 am | | Reply

    First off, damn Melissa, super jealous of your a1c!

    I think what scares me about a new scale is the combination of YMMV and autonomic neuropathy.

    I do NOT bolus any extra for fat and protein, and I eat a lot of it as a low carb-er, and that does seem to work for me. So clearly Melissa and I digest very very differently, so how can one scale work for us both?

    I do think that how fat and protein slow digestion does need to be addressed in training. For example, if I drink a glass of Bud’s eggnog (OMG good), I don’t need to bolus for a full HOUR after I take it. If the newly diagnosed aren’t being given examples like that, that is downright dangerous.

    Oddly, I have very slow digestion due to gastroparesis, yet have yet to need a square or dual wave bolus (the eggnog is the first thing I’ve encountered where I need to change my bolus behavior in 30+ years of diabetes).

    One scale will not fit us all here due to the variability in each individual patient’s digestion.

    With pure simple carbs, the scale fits more patients accurately than I think a new scale incorporating this data would.

  7. Gretchen
    Gretchen December 5, 2013 at 9:28 am | | Reply

    Oops. I indicated wrong link. The apple results are in Potpourri 1.

  8. Lloyd M
    Lloyd M December 5, 2013 at 11:58 pm | | Reply

    I count carbohydrates, and limit my carbohydrates to 80 a day. If I eat no carbohydrates at all for breakfast, then I need to bolus a bit for protein.

    My A1c has been in the low 5′s every time for more than 6 years, with a standard deviation of 14 to 17. I’m Type II for 20 years, pumping for 7.

    For me, carbohydrate counting works very well.


  9. Ange J.
    Ange J. December 11, 2013 at 9:10 pm | | Reply

    My aunt who’s diabetic does the same thing. Initially she’d calculate her intake based on how much carbs the food has based on the package and at times her insulin levels would peak. I showed her this post to help her understand more about the efficiency of what she does.

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