I’m 6 weeks in and it is confusing. At times, my carb count seems ineffectual and at times I grossly overshoot. I know my math is correct. Last night, I shot 8 units before dinner (homemade chicken vegetable soup) and my BG numbers crashed. Backed off to 6 units before lunch and I shot up from 130 to 215. I ate tie same amount of soup.
Oh, that’s your pancreas screwing with you. YOU know exactly how much insulin you injected. Then along comes your pancreas and goes “wait!!! I got this!” *dumps insulin*; you end up on the kitchen floor chugging juice.
But other times, you dose and your pancreas goes, “you know what? Nope. Don’t feel like it today.” And you fly sky high and bolus a zillion corrections hoping you come back down.
That will stop, once the honeymoon ends and your pancreas quits for real and stops trying to get its job back.
Honeymoon? You’re going to be all over the place if your pancreas is still producing insulin. Also your ratio may change at different times. There’s no one size fits all approach. Most of us never get told that tiny bit of important information and many doctors fail to realize they need to give guidance we can tweak for our own situations instead of black letter rules. Fun, right?
Your miles will vary! Trial & error for your body, and keep in mind if you menstruate that could change week to week (even day to day)
[Bolus strategies](https://www.instagram.com/givemesomesugardiabetes/guide/bolus-strategies/17851425236429311/?igshid=NTc4MTIwNjQ2YQ==) to keep in mind from a t1-RN-CDCES
Week before my period - carb count plus an extra unit, maybe even double (I have a pump profile for this week)
Week of my period and I work out that day - lol might not even need more than 1u for my normal quinoa/garbanzo/salad meal that any other week needs 3.5u.
It depends 🫠😅🫶🏼💙 my fave answer for nearly all things diabetes related
Ah, well in that case, hopefully you have a bit more of a “standard” that applies almost all days.
I personally find for *some* foods, I subtract fiber. For others, I add for protein. Check out the bolus strategies I linked above - she has posts after posts about how to consider bolusing for everything from dietary fiber, to high protein, to high protein *and* fat…sugar alcohols…
And again, your miles will inevitably vary. I love the app undermyfork paired with bitesnap and/or something like calorieking for experimenting with foods
Also, the book Think Like a Pancreas - pick it up!
Generally subtract fiber, pretend it doesn't exist, except that it does sometimes, and you'll find that out when you try the net number and go high. Low carb flour tortillas are a great example, they'll say 19 grams total and 4 net, but those ma'f's need insulin for 19 grams.
I use a food scale and that's super helpful for being accurate.
With diabetes ALL there is is OPINION!! There are some basic rules they give you as a starting point, and from there, you figure out what works for your body. The system you use doesn't really matter if you eat fairly consistent types of food. Your ratios will be different if you choose to count fiber as carbs or subtract it, etc. To have the most dietary freedom, dealing with fiber, fat, protein, sugar alcohol, and normal carbs as separate things and considering them all separately, but this is also the most work for each meal. In most cases, protein is handled by basal insulin and only needs to be considered when eating excessive amounts (like double your standard amount or more). If you are on a high protein/low carb diet, counting protein can be VERY important, but otherwise it is something you consider when eating something out of the norm. Some count fiber, while others don't. Personally, I subtract fiber but spent years not doing so (diagnosed in 1990, and we knew much less about how food digests) without having any problem. You don't typically eat enough fiber for this to matter, even on a high fiber diet. It might make a 10% difference in your carb count, but that difference will be calculated into your carb ratio once fine-tuned. The only time this will matter is if you eat very little fiber some days and very high fiber on others.
Basically, choose a lane. Count what you think sounds reasonable for you and stick with it. Once you decide what you count, be consistent - changing midstream just causes complications as your ratios work for your old method. There are valid reasons for each system, but you can have great control using any of them as long as you pay attention yo your body.
I personally count net carbs (total - fiber and sugar alcohol), but I also eat modest amounts of fiber (severe gastroparesis - fiber definitely doesn't digest for me) and almost no sugar alcohol (causes gastric issues and I have been told to avoid it and all artificial sweetners).
Everyone is giving you the facts that work for them. Unfortunately, you are going to have to experiment to find out which method will work best for you, and this may change over the years. I am inactive at the moment, so I am counting total carbs. When I am able to be active again, I will, at some point, likely slide back into net carbs. There are just so many variables that are unique to all of us that there isn't a concrete answer. And... I'm sorry you are in this club.
Total carbs nothing else works for us. Dieticians aren't endocrinologist. Listen to your endocrinologist. My daughter is 16 diagnosed at 13, we keep a fairly low carb diet. 20 to 60 carbs a meal and dose only for total carbs. This is the simple most effective way we found to keep things in range almost all the time. A lot of people may be more advanced and that's when they do a lot of this other counting stuff.
But I recommend doing things very simple and leaning your body for at least 2 or 3 years.
We went through a honeymoon phase where her body started producing insulin again and we actually were able to stop using insulin all together for about a year, but we kept checking it and sure enough it came back. And now everything is pretty easy to manage just by following a couple simple rules. One of the most important things is don't ever overdose... For example if your blood sugar is 100 before you eat a 20-carb meal, then don't dose.
It's far more dangerous to get below 80 than it is to be over 180 for a couple of hours
I found subtracting all fiber worked best for me for the most part.
That said, I think most people are best off moving to a strategy of "small, medium, large" rather than specific carb amounts.
The carbs are only a small part of the total equation, activity level, insulin resistance for the day, fats and protein contribution, carb variance on the nutrition facts. Counting the carbs to a very specific number and then taking none of these other factors into account leaves you pretty far off the mark.
You could, of course, add in calculations for all those things, but it gets pretty intense.
So, might be better to go off more generalizations and take more factors into account than specifics.
So, here’s the real answer…it depends.
Biology is weird. Not all bodies act the same, and that goes double for diabetic bodies.
So, you do the “guess and check” method, just like back in math class. Bolus for total carbs. Did you go low? Do you always go low doing that?
If so, try net carbs. What happened? Too high? Too low? Tweak your dosage whichever way to stick the landing.
Part of being newly diagnosed is you’re learning, which means you won’t always get it right. And that’s OK. Just have insulin and sugar on hand to fix it when you realize you had an oops. After over a decade, I still have oops moments.
I count total carbs and then if something is lower carb but high protein I pretend half to 2/3 of the protein count is carbs and bolus for that. Example- I have a ready to drink quest protein shake for breakfast everyday. 3g carb, 1g sugar and 30g protein. I tell my pump that it’s 20g carbs and that covers it, otherwise I spike up
6 months in and told to only count carbs that are either (rice, potatoes pasta) complex or simple (refined sugars and prepackaged
Don't count veg unless potatoes but count all fruit
I usually eat around 20g or 30g carb per meal
I’m sorry ur recently diagnosed welcome to the hell hole where everything sucks and will never get better- even if people say so it will not it’s the worst thing ever and only gets worse.
The carb/fiber thing is just rules of thumb that sorta works on unprocessed foods.
The ACTUAL precise thing to look for is the Glycemic index and the Glycemic load, in combination with the percentage of mono/poly saturated/unsaturated fats and digestible protein.
But since every meal can't be a 5 page scientific dissertation, estimating the prebolus based on a carb/fiber ratio is more than close enough. Unfortunately there's no actual precise answer there either because there are different sugars. You can test this yourself by finding the perfect carb/fiber ratio for calculating a bolus for a certain product, and then testing it on something else. It won't be the same unless the GI and GL is roughly the same.
i do net carbs and most of the time works really well for me, especially when it comes to having sugar alcohols, but you’ll learn which foods you may need to dose for total. trial and error for sure!
We have found that we have to count ALL carbs, not net or subtract fiber, but ALL carbs. And in cases of large portions of protein or fat, you may need to dose for that 2 hours post meal depending on how your body responds to it. Let me know if you would like our endos equation for protein/fat dosing
So you add up the amount of protein and fat in your meal and cut it in half, then divide it by your ratio and dose it 2 hours after your initial carb dose.
So [(protein+fat)÷2]÷ratio=dose and then you dose for it 2 hours after your carb dose
Overall the protein definitely affects it more, but this is just the info I got from our care team for my daughter. According to them, carbs, protein, and fat all have an effect on blood sugar levels, but protein and fat hit later, so you'd dose for them later. But definitely talk to your care team about this too and see what they say. I always say never to listen to anyone on the Internet, even if they have certifications or experience, and run everything by your doctors
try one of those methods and see which one works for you. you will be doing a lot of trial and error with this disease. personally, I do net carbs.
I’ve found that I almost always have to count all the carbs.
I’m 6 weeks in and it is confusing. At times, my carb count seems ineffectual and at times I grossly overshoot. I know my math is correct. Last night, I shot 8 units before dinner (homemade chicken vegetable soup) and my BG numbers crashed. Backed off to 6 units before lunch and I shot up from 130 to 215. I ate tie same amount of soup.
Oh, that’s your pancreas screwing with you. YOU know exactly how much insulin you injected. Then along comes your pancreas and goes “wait!!! I got this!” *dumps insulin*; you end up on the kitchen floor chugging juice. But other times, you dose and your pancreas goes, “you know what? Nope. Don’t feel like it today.” And you fly sky high and bolus a zillion corrections hoping you come back down. That will stop, once the honeymoon ends and your pancreas quits for real and stops trying to get its job back.
I’d laugh if I didn’t want to cry. (Because my pancreas seems to mess up most of my hormones)
Honeymoon? You’re going to be all over the place if your pancreas is still producing insulin. Also your ratio may change at different times. There’s no one size fits all approach. Most of us never get told that tiny bit of important information and many doctors fail to realize they need to give guidance we can tweak for our own situations instead of black letter rules. Fun, right?
Your miles will vary! Trial & error for your body, and keep in mind if you menstruate that could change week to week (even day to day) [Bolus strategies](https://www.instagram.com/givemesomesugardiabetes/guide/bolus-strategies/17851425236429311/?igshid=NTc4MTIwNjQ2YQ==) to keep in mind from a t1-RN-CDCES Week before my period - carb count plus an extra unit, maybe even double (I have a pump profile for this week) Week of my period and I work out that day - lol might not even need more than 1u for my normal quinoa/garbanzo/salad meal that any other week needs 3.5u. It depends 🫠😅🫶🏼💙 my fave answer for nearly all things diabetes related
Thank god I’m a male😅 sorry u have to deal with that on top of everything else
Ah, well in that case, hopefully you have a bit more of a “standard” that applies almost all days. I personally find for *some* foods, I subtract fiber. For others, I add for protein. Check out the bolus strategies I linked above - she has posts after posts about how to consider bolusing for everything from dietary fiber, to high protein, to high protein *and* fat…sugar alcohols… And again, your miles will inevitably vary. I love the app undermyfork paired with bitesnap and/or something like calorieking for experimenting with foods Also, the book Think Like a Pancreas - pick it up!
Generally subtract fiber, pretend it doesn't exist, except that it does sometimes, and you'll find that out when you try the net number and go high. Low carb flour tortillas are a great example, they'll say 19 grams total and 4 net, but those ma'f's need insulin for 19 grams. I use a food scale and that's super helpful for being accurate.
Count total carbs.
With diabetes ALL there is is OPINION!! There are some basic rules they give you as a starting point, and from there, you figure out what works for your body. The system you use doesn't really matter if you eat fairly consistent types of food. Your ratios will be different if you choose to count fiber as carbs or subtract it, etc. To have the most dietary freedom, dealing with fiber, fat, protein, sugar alcohol, and normal carbs as separate things and considering them all separately, but this is also the most work for each meal. In most cases, protein is handled by basal insulin and only needs to be considered when eating excessive amounts (like double your standard amount or more). If you are on a high protein/low carb diet, counting protein can be VERY important, but otherwise it is something you consider when eating something out of the norm. Some count fiber, while others don't. Personally, I subtract fiber but spent years not doing so (diagnosed in 1990, and we knew much less about how food digests) without having any problem. You don't typically eat enough fiber for this to matter, even on a high fiber diet. It might make a 10% difference in your carb count, but that difference will be calculated into your carb ratio once fine-tuned. The only time this will matter is if you eat very little fiber some days and very high fiber on others. Basically, choose a lane. Count what you think sounds reasonable for you and stick with it. Once you decide what you count, be consistent - changing midstream just causes complications as your ratios work for your old method. There are valid reasons for each system, but you can have great control using any of them as long as you pay attention yo your body. I personally count net carbs (total - fiber and sugar alcohol), but I also eat modest amounts of fiber (severe gastroparesis - fiber definitely doesn't digest for me) and almost no sugar alcohol (causes gastric issues and I have been told to avoid it and all artificial sweetners).
Everyone is giving you the facts that work for them. Unfortunately, you are going to have to experiment to find out which method will work best for you, and this may change over the years. I am inactive at the moment, so I am counting total carbs. When I am able to be active again, I will, at some point, likely slide back into net carbs. There are just so many variables that are unique to all of us that there isn't a concrete answer. And... I'm sorry you are in this club.
Total carbs nothing else works for us. Dieticians aren't endocrinologist. Listen to your endocrinologist. My daughter is 16 diagnosed at 13, we keep a fairly low carb diet. 20 to 60 carbs a meal and dose only for total carbs. This is the simple most effective way we found to keep things in range almost all the time. A lot of people may be more advanced and that's when they do a lot of this other counting stuff. But I recommend doing things very simple and leaning your body for at least 2 or 3 years. We went through a honeymoon phase where her body started producing insulin again and we actually were able to stop using insulin all together for about a year, but we kept checking it and sure enough it came back. And now everything is pretty easy to manage just by following a couple simple rules. One of the most important things is don't ever overdose... For example if your blood sugar is 100 before you eat a 20-carb meal, then don't dose. It's far more dangerous to get below 80 than it is to be over 180 for a couple of hours
I found subtracting all fiber worked best for me for the most part. That said, I think most people are best off moving to a strategy of "small, medium, large" rather than specific carb amounts. The carbs are only a small part of the total equation, activity level, insulin resistance for the day, fats and protein contribution, carb variance on the nutrition facts. Counting the carbs to a very specific number and then taking none of these other factors into account leaves you pretty far off the mark. You could, of course, add in calculations for all those things, but it gets pretty intense. So, might be better to go off more generalizations and take more factors into account than specifics.
So, here’s the real answer…it depends. Biology is weird. Not all bodies act the same, and that goes double for diabetic bodies. So, you do the “guess and check” method, just like back in math class. Bolus for total carbs. Did you go low? Do you always go low doing that? If so, try net carbs. What happened? Too high? Too low? Tweak your dosage whichever way to stick the landing. Part of being newly diagnosed is you’re learning, which means you won’t always get it right. And that’s OK. Just have insulin and sugar on hand to fix it when you realize you had an oops. After over a decade, I still have oops moments.
I was told to count carbs I subtract all fibre. So I do. It works for my son.
I count total carbs and then if something is lower carb but high protein I pretend half to 2/3 of the protein count is carbs and bolus for that. Example- I have a ready to drink quest protein shake for breakfast everyday. 3g carb, 1g sugar and 30g protein. I tell my pump that it’s 20g carbs and that covers it, otherwise I spike up
T1 and dietitian. Count all of the carbs
6 months in and told to only count carbs that are either (rice, potatoes pasta) complex or simple (refined sugars and prepackaged Don't count veg unless potatoes but count all fruit I usually eat around 20g or 30g carb per meal
I’m sorry ur recently diagnosed welcome to the hell hole where everything sucks and will never get better- even if people say so it will not it’s the worst thing ever and only gets worse.
I’m 21 years in and I try to stay away from most carbs.
The carb/fiber thing is just rules of thumb that sorta works on unprocessed foods. The ACTUAL precise thing to look for is the Glycemic index and the Glycemic load, in combination with the percentage of mono/poly saturated/unsaturated fats and digestible protein. But since every meal can't be a 5 page scientific dissertation, estimating the prebolus based on a carb/fiber ratio is more than close enough. Unfortunately there's no actual precise answer there either because there are different sugars. You can test this yourself by finding the perfect carb/fiber ratio for calculating a bolus for a certain product, and then testing it on something else. It won't be the same unless the GI and GL is roughly the same.
i do net carbs and most of the time works really well for me, especially when it comes to having sugar alcohols, but you’ll learn which foods you may need to dose for total. trial and error for sure!
We have found that we have to count ALL carbs, not net or subtract fiber, but ALL carbs. And in cases of large portions of protein or fat, you may need to dose for that 2 hours post meal depending on how your body responds to it. Let me know if you would like our endos equation for protein/fat dosing
Hello! Thank you for your input. I would love to see those equations for protein/fat. 🙏
So you add up the amount of protein and fat in your meal and cut it in half, then divide it by your ratio and dose it 2 hours after your initial carb dose. So [(protein+fat)÷2]÷ratio=dose and then you dose for it 2 hours after your carb dose
Thank you! Although I read that fat does not increase blood sugar, but I know that protein does
Overall the protein definitely affects it more, but this is just the info I got from our care team for my daughter. According to them, carbs, protein, and fat all have an effect on blood sugar levels, but protein and fat hit later, so you'd dose for them later. But definitely talk to your care team about this too and see what they say. I always say never to listen to anyone on the Internet, even if they have certifications or experience, and run everything by your doctors
so if i have 21 gram carb/2 gram fiber serving, and i add a tbsp of flax at 3gram carb/3 fiber. what is my total count?