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carb counting or figuring out total calories?

Discussion in 'Parents of Children with Type 1' started by dk10, Nov 15, 2008.

  1. dk10

    dk10 Approved members

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    My daughter is not on the pump, and has a fairly low insulin dose - 9 units a day, of which only 2 units is Lantus.

    We started initially with trying to figure out calories, and then moved on to carb counting. We found carb counting working well for foods which have 60-70% calories coming from carbs. However, if there are a lot of calories that come from fat (i.e. over 40%), it seems to throw things badly (not immediately, but over several hours). I try to work backwards where I equate about 70% of the total calories to approximate the number of carbs that are there in the food. I then ignore the printed carb count, and take the approximation as the carb count. Does this make any kind of sense, or am I just complicating life for all of us?

    From some posts, I see that for fibre, there's no need to count calories. Also, for sugar alcohols, count as 1/2 the number of carbs stated for sugar alcohols. Are these two assumptions right?

    Any obvious thing I'm missing?

    More details in case it helps: She gets 5 units of Novomix 30 in the morning, 2 Novorapid with her evening meal and 2 Lantus at bedtime. Funny combination, I know, but seems to be working ok for now. A1C at diagnosis in June was 9.9. 3 months later in September was 7.4. Her bg range per week (except for the one off crazy ones everynow and then) tends to be 80% normal, almost 20% highs (low 200s), few lows. We don't do the regular bolus/basal combination because she has a long day at school, and I'm not confident they'll be able to cope with frequent testing and injections. We were advised to wait for a bit before we put her on the pump. Plan to see the endo next week to review.


    Thank you
     
  2. KellyMama

    KellyMama Approved members

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    You're right about the fat. Foods that have a high fat content cause a delay in the body's carb absorbtion which often results in a "fat spike" later on even if you bolused correctly for the carbs. Lots of people use combo bolus features on their pump for this. We used to use NPH to cover it because it has a delayed peak.

    I'm not familiar with your particular insulins, other than Lantus, but I would recommend reading "Think Like a Pancreas" because it finally helped us truly grasp what is going on with carb counting and how the body processes carbs etc. Another great one for helping with carb counting is "The Ultimate Guide to Accurate Carb Counting."

    HTH!
     
  3. dk10

    dk10 Approved members

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    insulin explained

    Thanks! I will check out those books. But is there a rule of thumb that one can use?

    The Novomix is essentially the same as a Humalog 25 mix, and the Novorapid is the same as Humalog (different companies, one element seems marginally different).
     
  4. danismom79

    danismom79 Approved members

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    I don't look at calories at all - just carbs and fat grams. It's true that higher fat foods will cause the carbs to digest slower, and then the rapid insulin is pretty much done, so it can't help with lowering the blood sugar.

    There are threads on here about how to adjust for the fat. Just do a search of the threads for "fat," "fat spike," etc. Some people delay the shot of rapid acting, some do a partial dose up front, then give the rest later, some use a mix of different insulins.
     

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