[rak1978]

...so do you bolus equally?
I know, I know...everybody's body works differently and you have to figure out what works for YOU, but I'm still curious what you guys do and am learning a lot from your experiences.
When I eat a big salad with lots of veggies I really just guess on the carbs (I'm too lazy to look up every single veggie's carb content and to do the math). So, I'll usually guess about 20 carbs or so and bolus appropriately. Almost always, I go too low by the 2 hr mark.
When I eat something else with equal amounts of carbs (let's say, a cookie ..worst case), I usually double the recommended bolus on my pump and still am way too high at the 2 hr mark. I know what you're thinking....just don't eat cookies.

My question is...
Do you use the same insulin/carb ratio no matter what it is that you are eating? My body reacts differently to all foods, so I'm having a hard time nailing down a standard ratio that will keep me level all the time. I'm sure that consistency in the diet and keeping it on the lower end of the carb spectrum would help me tremendously. I have a hard time with consistency. Working on it.

Thanks!

[MCS]

Only a guess here. But all carbs are not created equal. The uncooked carbs are far harder for your body to convert to glucose, the white and overly cooked carbs are the easiest for your baody to convert to glucose, ergo the cookie. Dreamfields pasta, I can eat as much as I want and not see a spike worth mentioning. I put croutons on my salad and eat it with crackers, away we go.

[rak1978]

Whoops! I meant all carbs are NOT created equal. Wish I could change that.

[rak1978]

Nevermind, my title was "NOT all carbs are created equal".
Never tried the dreamfields pasta. Maybe I will this week.

[volleyball]

You bolus incorrectly repeatedly sound like you not only know the answer but are having trouble correcting.
While i am a natural controller of my diabetes, it is imperative for me to understand how they work on me. I tell casual people I am a low carber when in reality i am a good carber. I do well to eliminate/moderate the bad carbs while enjoying many of the good carbs.

[rak1978]

Originally Posted by volleyball

You bolus incorrectly repeatedly sound like you not only know the answer but are having trouble correcting.
While i am a natural controller of my diabetes, it is imperative for me to understand how they work on me. I tell casual people I am a low carber when in reality i am a good carber. I do well to eliminate/moderate the bad carbs while enjoying many of the good carbs.

You are right. But, even with the "good carbs", I have a hard time finding a ratio that works for all. I'm attempting to take the guess work out of it. I'm on a pump, so there is a set ratio that you program in. I'd like to be able to use this ratio for all meals.

[rak1978]

Originally Posted by rak1978

You are right. But, even with the "good carbs", I have a hard time finding a ratio that works for all. I'm attempting to take the guess work out of it. I'm on a pump, so there is a set ratio that you program in. I'd like to be able to use this ratio for all meals.

I guess I should rephrase my original question....
Is it realistic or unrealistic to find an insulin/carb ratio that will work for all food? If not, what does everyone here do to adjust and keep your bg level?

[e||ement]

i don't bolus at all for veggies unless they are uber starchy (corn, potatoes, cooked carrots).

i don't bolus for dairy/protein unless the combined carb total warrants a half unit of rapid. (for example, two hard boiled eggs i don't bolus, but if i had two hard boiled eggs, yogurt, cheese i probably would)

all carbs are not equal, even in the same food.

for example i can eat one small banana (which i blindly always count as 20 carbs) with no bolus and not spike, but add that with a little peanut butter and low carb toast and i MUST bolus for everything including the banana.

other things that are 20 carbs i could never get away with, without a bolus.

good luck...it's all very confusing and i'm learning more every day. test, test, test and take it one day...and one food...at a time.

[TommyC1]

Originally Posted by rak1978

I guess I should rephrase my original question....
Is it realistic or unrealistic to find an insulin/carb ratio that will work for all food? If not, what does everyone here do to adjust and keep your bg level?

Yeah I think it is a bit unrealistic.
Different foods with the same amount of carbs will affect your BS differently.
You might look into GI or glycemic index which has something to do with how fast the carbs pass through your gut and become glucose in your blood.
It also has to do with insulin resistance which can change depending on your current BS as well as fats in your meal.
Or you can do like I do and just figure that higher fat and or higher fiber foods will go through slower while refined sugars will go faster, while the fat may cause higher BS later.
At that point you will need to work out if you simply need to prebolus for the same carb load or actualy increase you insulin ratio. Trial and error is the name of the game as we all respond a bit differently to different meals.
It would be nice if it was simply a matter of getting the I:C ratio but that's really just the start. Hopefully you will get to a point where you have a pretty good idea as to how any given meal will affect you and be able to adjust your insulin as needed.

Tommy

[rak1978]

Thanks for the input. I really appreciate it. I am finally, after 5 yrs, trying to really nail down my pump settings and get the D monster under control. I'm finding it to be very tricky. I just thought someone might have some magic tricks up their sleeves. Consistency seems to be the key to finding out the right ratios for your/my body. I have the added component of an inconsistent pancreas also. Sometimes (rarely) it contributes, sometimes it doesn't.

[jenb]

Hmmm. I find that my carb ratio works regardless of the "type" of carb. I always use net carbs (even when eating a salad). Haven't had too many surprises. The thing that does come back to bite me is the slow processing of fat. I really watch my BG about 3 or 4 hours after a high fat adventure and have found it necessary to do a little correction at that time in many instances.

Jen

[shabbie]

rachel i can agrre with what everyone else here has said so far

the fact that you are still honeymooning clearly isnt helping matters for you.

little and often may work best for you

[shiftzor]

I would argue that you can find a ideal I:C which brings your bg into range at the 2 hour mark but unfortunately with certain carbs you may well spike at the 1 hour mark. While not all carbs are equal they still require the same amount of insulin from my experience. If I had a slice of cake with 100gs of carbs, I may well spike at the 1 hour mark and still be high at the 2 hour mark due to glycemic load but at 3 hours I will come back into range. If I had a raw carrot equalling 100gs of carbs I probably wouldn't spike and will probably be in range at 2 hour mark. In both scenarios my I:C is correct however the problem is my Novorapid cannot imitate phase 1 release of insulin from a healthy pancreas. The Novorapid best matches phase 2 release of insulin which is slower. Just try to do the best with the tools available today .

[rak1978]

Originally Posted by shiftzor

I would argue that you can find a ideal I:C which brings your bg into range at the 2 hour mark but unfortunately with certain carbs you may well spike at the 1 hour mark. While not all carbs are equal they still require the same amount of insulin from my experience. If I had a slice of cake with 100gs of carbs, I may well spike at the 1 hour mark and still be high at the 2 hour mark due to glycemic load but at 3 hours I will come back into range. If I had a raw carrot equalling 100gs of carbs I probably wouldn't spike and will probably be in range at 2 hour mark. In both scenarios my I:C is correct however the problem is my Novorapid cannot imitate phase 1 release of insulin from a healthy pancreas. The Novorapid best matches phase 2 release of insulin which is slower. Just try to do the best with the tools available today .

Thanks for the info! So, do you generally use the same ratio regardless of what you are eating? Trying to eliminate the guess work.

[DeusXM]

Just to stir things up even more, I find my insulin:carb ratios shift so much that I've largely stopped bothering to calculate and instead guestimate. For instance, I know that in the morning I am a lot more insulin resistant than I am in the evening. I know that during different months of the year, my ratios will change. And like you, I've found that food type also significantly shifts my ratios. If I'm eating in a restaurant I find I need to increase my insulin by about 25% to cover the same amount, and that pizza will require a 10% reduction in insulin initially followed by a further 20% of what I originally took after two hours.

I've found that my best bet is to largely ignore ratios and instead go on unscientific gut feeling, based on experience and testing. It sounds like it shouldn't work but generally it does.