Eating whatever and covering it w/ insulin..

[n1000paul]

Is that a smart thing to do? :confused:

[ant hill]

Yes Paul, If you can count the carbs and match that to the amount of insulin then you are doing quite well.
I still have to do a test to see how to get the Insulin : Carbohydrate ratio sorted so then I can just inject the right amount of fast acting insulin for that meal. :D

[HelenM]

I think it depends what you mean. If you mean can I eat the same non healthy diet full of over refined starches and sugars as many (most?) people in the US /UK and other Western countries have adopted. I think no. It might lead to all sorts of other problems in the future , from obesity and increased insulin resistance to bowel cancer (just as for anyone diabetic or not). If you mean eating a diet with enough wholegrain and other carbs for your needs and 'covering ' it with the right amount of insulin. Why not?

If you want to eat 'unhealthily' on the odd occassion again I would think,why not? The only problem with this is that if you don't do it very often its more difficult to work out the insulin doseage.

[Gary_W]

IMO, using insulin is all about learning how insulin works in you (in terms of speed and duration) vs certain foods. One half of succesful carb counting is getting the amount right, the other is ensuring that the speed that those carbs gets into your body matches the speed that the insulin is working at.

If you count the carbs correctly, your BG reading will come right 3-5 hours after you have eaten the food. So in theory you can eat absolutely anything you like as long as the amount of carbs is correct. The problem is that the fastest insulin available is still slower to absorb than the fastest acting foods (the refined carbs such as white bread, sugar etc). So in practice, you also have to see how badly the food spikes you. I always test my BG 2 hours after a meal to see how it's doing. If you're very high at hour 2, it will either be because you stuffed up the carb counting or because the food you ate absorbed much quicker than the insulin. If it comes down by itself by hour 4 then you know that the food you ate doesn't suit you too well and you can decide how to handle that food in the future. This can be anywhere between pre-injecting, super bolus (on the pump), smaller portion or avoidance of the food.

I do eat anything I like, but I'm fortunate that my preferences tend to be fairly healthy anyway. I'm not a cake-a-holic so my 'eating what I like' is different to some other people's definition...

Oh, and none of the carb counting works if your basal is off; before you do anything ensure that your basal isn't aiding and abetting your bolus :)

Gary

[morrisma]

While you can cover what you eat if you count carbs, injecting insulin is not quite the same as a real pancreas. If you eat c**p, requiring more insulin, you risk more highs & lows and you risk weight gain which may add insulin resistance to the mix requiring still more insulin and likely causing more bg swings.

In the end, you are better off eating a healthier diet and minimizing the amount of insulin you need to use.

[Jill-O]

Yes, you can do it. You still want to be sensible but I would rather more calories come from carbs than from protein and fat... so I am on insulin and happy to have this as an option over oral meds.

[Alice]

I eat pretty much "whatever"...but that needs prefacing that I'm not a big "SuperSizeMe at the TruckStop" kind of eater...or a huge dessert eater...although I certainly do eat desserts they are more than likely just a few bites...not the whole serving.

Weight watching keeps me behaving pretty well...but I don't limit my carbs like some people do...I bolus responsibly and get on with my day.

[grace girl]

I'm a lot like Alice...I eat whatever I want, but I've never been one to over-eat, rarely eat fast food, and rarely eat between meals. At meals, I have what I want. If I want dessert, I have dessert. I don't low-carb, but I eat pretty healthily over-all.

[RobiJo]

Same as above. Eat responsibly, and enjoy the freedom to eat whenever and not at dictated times. When you're not hungry, you don't have to eat as much because the dose is based on how many carbs you eat.

[xMenace]

Absolutely not!

Try some white toast with jam and a large glass of OJ for breakfast some day. Add some fresh strawberries for fun, There's no way in **** I can keep my sugars even near normal with such a meal in the morning.

Listen to your meter. It will tell you the truth.

[Scrabblechick]

It's probably a good thing I'm not on insulin. I like biscuits too well. Heh. Metformin alone keeps me honest about my eating. LOL.

[solox316]

I used to subscribe to the notion that I could literally eat ANYTHING I wanted... Once I started watching more closely and eating more whole grains, fruits, veggies... and less processed and sweets, my numbers "magically" got better. Believe me though, I still eat the ocassional chips, ice cream, etc... but more of a treat.

[BrianSCohen]

I am not yet on insulin, so take what I say with a grain of salt. If you read Bernstein, he makes a pretty logical argument that while you might be able to "cover" any level of carbs with a correct does of insulin, you can't dispense the insulin in a continuous manner to keep your blood glucose down as it varies. If you eat high carb and dose high insulin your are going to suffer large variances, both high and low even tho you might hit your target at two hours.

I think if you really want to tightly control your diabetes, you have to limit your wild swings of blood sugar. My suggestion is to consider limiting your carbs as a way of more tightly controlling your blood sugar swings.

[JohnHenry]

I have the same suggestion as some of the other posts. Try to make it a habit to eat healthy foods and consume a quantity of calories that is in balance with your activity level. Chronic conditions like diabetes require you to do everything you can to keep yourself in good health.

That said, you should feel free to eat food that you like, as long as you understand the effect that the food has on your BG levels in conjunction with the insulin you take. You should be willing to give up or limit foods that may have significant negative effects on your BG control. For me, tortilla chips seem to do crazy things, so I don't eat them. I miss them, but that's life!

In general, insulin can cover just about any meal. Just be careful with the beer ;)

[dar917]

I agree with everyone else--you can still eat the things you like, but within reason. If there's something that really messes up your numbers though you'd have to limit it. I love french fries, but it seems every time I eat them my numbers two hours after eating will be on target, only to shoot up over 200 again later. Boiled/mashed and baked potatoes don't seem to do that to me. :/

Just today at work I had to explain to someone--one of the cake decorators was showing me some new ice cream we got at the store, then she goes oh, you can't have it, you're diabetic! I told her I can have it, I'm on insulin! (I loves me some ice cream.) :D But she was leaving and I had to get back to a phone call so I had to cut the conversation short. Bah.

[matingara]

If you read Bernstein, he makes a pretty logical argument that while you might be able to "cover" any level of carbs with a correct does of insulin, you can't dispense the insulin in a continuous manner to keep your blood glucose down as it varies. If you eat high carb and dose high insulin your are going to suffer large variances, both high and low even tho you might hit your target at two hours.

Bernstein calls this "the Law of Small Numbers".

It makes sense for T1 and T2 in my opinion.

Diabetes In Control Dot Com. The FREE weekly newsletter for Medical Professionals in Diabetes care. (http://www.diabetesincontrol.com/issue177/smallnumbers.shtml)

-- Joel.

[ant hill]

Just today at work I had to explain to someone--one of the cake decorators was showing me some new ice cream we got at the store, then she goes oh, you can't have it, you're diabetic! I told her I can have it, I'm on insulin! (I loves me some ice cream.) :D But she was leaving and I had to get back to a phone call so I had to cut the conversation short. Bah.

Aww darlene, If you were here there is a icecream parlor that you would adore!! I like icecream too and I will take you there. :D

My sister is like that Darlene and she would make a good mud cake. Here I am drooling and she says "You cannot have that" as if she has done some reading in five minuets on the type 1 diabetes. DOH!!! Yeah right. :confused:

[dar917]

Aww darlene, If you were here there is a icecream parlor that you would adore!! I like icecream too and I will take you there. :D

ahahaha Peter. I will have to come visit Australia so we can hang out some time. :D

[PERKDOUG]

[Eating whatever and covering with Insulin.] This will guarantee poor glycemic control. Eating whatever, implies medium to large grams of carbs per meal which in turn implies medium to large Insulin doses to cover. You cannot know the exact amount of carbs in a meal, the exact amount of Insulin your are injecting, the exact strength of the insulin and on and on there are uncertainties or "errors in measurments" in every meal "covered". For illustration purposes lets presume the average errors encountered are 10%.
Consider 2 cases:
Case 1: A meal with an estimated 10 grams of carbohydrates with a 10 % error means a + or - error of 1 gram.
Case 2: A meal with an estimated 100 grams of carbohydrates with a 10 % error means a + or - error of 10 grams.
Now I ask you, would you rather have a Case 1 error of 1 gram or a case 2 error of 10 grams. Knowing your "numbers", what blood glucose levels would result from a 10 gram error? Small carb meals result in small errors. Small errors means tighter glucose control. Tighter control means lower A1C. You know what lower A1C gets you. The problem with this simple idea is that most of us love our carbs so much that we are willing to compromise our future health for food pleasure at the next meal and the next meal ect. ect. The pleasure of the moment is more important than our feet, eyesight and kidneys.

[sprzepiora]

For the past two days I was a little lower than my target of 100 like 85 or 90, anyway I had a huge salad and was able to not take any injection for lunch and still come out with great numbers.


It was sweet :)

[Jan B]

Kind of like xMenace said, your meter won't lie about whether it's a good idea to load up on carbs and insulin.

I also agree with Bernstein's law of small numbers. It keeps the swings to a minimum. Instead of getting 140 or better 2 hours after eating, you can be back at 90-100 (your goal) in 2 hours or less.

When I first started on Humalog, I loved the saying: match the insulin to your life, instead of making your life match the insulin. It's not quite that simple though for a lot of us.

[Gary_W]

[Eating whatever and covering with Insulin.] This will guarantee poor glycemic control. Eating whatever, implies medium to large grams of carbs per meal which in turn implies medium to large Insulin doses to cover. You cannot know the exact amount of carbs in a meal, the exact amount of Insulin your are injecting, the exact strength of the insulin and on and on there are uncertainties or "errors in measurments" in every meal "covered". For illustration purposes lets presume the average errors encountered are 10%.
Consider 2 cases:
Case 1: A meal with an estimated 10 grams of carbohydrates with a 10 % error means a + or - error of 1 gram.
Case 2: A meal with an estimated 100 grams of carbohydrates with a 10 % error means a + or - error of 10 grams.
Now I ask you, would you rather have a Case 1 error of 1 gram or a case 2 error of 10 grams. Knowing your "numbers", what blood glucose levels would result from a 10 gram error? Small carb meals result in small errors. Small errors means tighter glucose control. Tighter control means lower A1C. You know what lower A1C gets you. The problem with this simple idea is that most of us love our carbs so much that we are willing to compromise our future health for food pleasure at the next meal and the next meal ect. ect. The pleasure of the moment is more important than our feet, eyesight and kidneys.

Saying that 'eating what you like and covering' will 'guarantee' poor glycemic control is not always true. In my body, I have a much easier time covering carbs with insulin when they are not slowed down with excessive fat / protein. It is the high fat / high protein meals with a small amount of carbs that give me the most trouble. A big pile of bread and jam I can handle. Yes, I might be odd, but that's the truth.

I do eat less carbs today than I did 2 years ago, but still do 230g of carbs on average each day. I'm happy and healthy and have an HBA1c of 5.8. It can be done with some people. Others find it easier to low carb / impossible not to. Fair enough. But not everyone needs to obey the same rules.

And my reason for eating carbs is not always the 'pleasure of the moment'; I always worry about the fat / protein content of the low carb diet. Whilst I agree with the laws of low numbers etc etc I think that treating diabetes in isolation by doing a diet that suits diabetes is not necessarily the right way to go. If you look hard enough you'll find various bits of research showing that high fat or high protein diets aren't all that good for various bits of your body. Then you'll find other studies disagreeing. Moderation in all things is key (IMO) and whilst many people eat too many carbs the sensible alternative is to cut back, not cut out. Certainly from a variety point of view I would not gladly give up carbs. If there was no other way to achieve control (which may be the case for some folks here) then obviously I'd have to rethink matters but as it is, I'll carry on.

Gary

[shiftzor]

I agree with Gary_W, I have gone from 150g of carbs a day to 230g of carbs a day, I found that I just wasn't eating enough calories to sustain my body and all my activities. I was reading that some people get most people get 40% of their calories from carbs, so personally I would argue that eating a sensible amount of carbs is important, no matter how much I like Bernstein’s theory of small numbers. This depends on how active you and if you want to lose weight. Eating w/e is fine as long as you count those carbs and have a healthy diet i.e. little bit of green stuff and a little bit of the bad stuff.

[solox316]

Well said Gary. I fall into the balance and moderation school of thought, combined with the right carbs and not processed, refined junk food.

[The_QUIET_one]

I do this and it works for me, I have pretty good numbers and I eat healthy in general anyhow so it works for me, basically sure you can do it but dont forget also that you are human you shouldnt go crazy, try to stay healthy and also I would keep away from eating pure sugar or drinking pure sugar unless you are low or if necassary have it with some protein, thats what I do and it seems to work for me.

[PERKDOUG]

Good reply to me, Gary. I am new to the diabetes forums. It would be interesting to know how many other members can acheive an A1C under 6% and eat heavy carbs? Chime in brothers and sisters. And if you are a heavy carb eater and acheive above 6% sound off also.

[bryan42]

It's probably a good thing I'm not on insulin. I like biscuits too well. Heh. Metformin alone keeps me honest about my eating. LOL.

I agree!! We Type 2's have to be more diligent when making food choices. Metformin is the only thing keeping us in line :T

[xMenace]

Good reply to me, Gary. I am new to the diabetes forums. It would be interesting to know how many other members can acheive an A1C under 6% and eat heavy carbs? Chime in brothers and sisters. And if you are a heavy carb eater and acheive above 6% sound off also.


I've hit 6.0% my last two quarters. If anything, I've reduced the protein in my diet. I have added much complexity and more veggies and fruits. I am avoiding pretty much all food found in a box, all store bought bread, and anything all-white floured. I do agree with Gary that it's easier to dose for carbs when fat and proteins are not involved. Chinese, pizza, even my sirloin last night cause problems.

[poodlebone]

Good reply to me, Gary. I am new to the diabetes forums. It would be interesting to know how many other members can acheive an A1C under 6% and eat heavy carbs? Chime in brothers and sisters. And if you are a heavy carb eater and acheive above 6% sound off also.

I am Type 1 using a pump. I do much better with carbs than protein & fat - especially fat. Fat screws everything up for me. My biggest problem time is morning. You know how a lot of people (both types) seem to have problems with carbs for breakfast? Not me. Every time I try to have protein it comes back to bite me in the butt a few hours later.

This morning I decided to try it. I had an omelet made with Egg Beaters (3 servings), fat free cheese and turkey pepperoni. I also had a low carb tortilla/wrap thing (15g carb, 9g fiber, 15g protein). Final makeup of my breakfast was:

5g fat
21g carb
9g fiber
40g protein

I tested my BG a little less than 2 hours after eating and was 120. Not bad. 1 hour 20 minutes later I was 156. I corrected and was 108 1 1/2 hours later.

I could set a dual wave bolus but whenever I've tried that I end up going low. I would have to remember to set it maybe an hour or so after eating, to cover the next few hours before lunch. Fat obviously wasn't the culprit here, it was the protein.

If I had a big bowl of hot high fiber cereal, or a waffle, or a muffin my BG numbers would have been much more predicatble. They would not have been fine at 2 hours and then gone up. I would have dropped some more before lunch with a meal that was mostly carbs.

I often eat very high fiber hot cereal, like Wheatena with a bunch of extra added wheat bran. It doesn't really slow down the digestion much but it does keep me full (and regular!). I add whatever fruit I have at home which can be fresh, frozen or dried. Very low fat, low protein.

My last A1c was 5.8 and I am usually in the 5s. My highest in the past 10 years or so was 6.4.

I have a pump. I'm Type 1 and very sensitive to insulin. It makes it much easier for me than for someone on injections or oral meds or with bad insulin resistance.

[Gary_W]

I've hit 6.0% my last two quarters. If anything, I've reduced the protein in my diet. I have added much complexity and more veggies and fruits. I am avoiding pretty much all food found in a box, all store bought bread, and anything all-white floured. I do agree with Gary that it's easier to dose for carbs when fat and proteins are not involved. Chinese, pizza, even my sirloin last night cause problems.

Bread is a weird one. Some shop-bought bread I can do fine with, others do spike me badly and it isn't the white vs brown thing that you'd expect.

I recently bought a book called 'bread matters' which goes on a lot about the state of the baking industry, all the enzymes added etc. And I've started making my own sourdoughs. I'm only about 5 loaves in and I must say that none of them spike me that badly at all. The all-rye sourdough is very kind on the blood glucose. But this morning I had the 'Cromaty Cob' with raspberry jam (sorry folks but I did). 100g of bread and 20g of jam. Oh, and some butter. The bread is very dense, and I treated it as French bread in terms of carb counting. In total, I bolused for 73g of carbs. I super-bolused (as I do every morning) and was in range two hours later....

The ingredients of this bread are mostly white organic flour, some plain flour, some wholemeal and a sour made from rye flour. Other than that, it's salt, water and time... It tastes completely different to the shop bought stuff. If only I had the time / organisational skills to always have some on the go. We'll see how long I manage to keep it up :)

Gary

[someone]

I eat whatever I want, drink regular soda and am able to stay in control. Averaging 300-400 carbs a day, my a1c a couple months ago was 5.4. If weight gain is not an issue and you can keep your blood glucose under control, go for it. You just need to be aware that any error you make with your carb counting/bolus will be multiplied the more carbs you intake.

[Stuboy]

if you can have control by eating whatever and taking the insulin for it, and not living in a high state most of the time, then i would say yes, it's a very smart thing to do... simply becasue it means YOU have control, and diabetes is not controlling you. which is the way it should be :)

im the same. i eat whatever i want (even sweets, cakes, biscuits and dohnuts, if i couldn't have krispy kreme's i dont know what i'd do!!! lol)

The only problem with doing this is if you're around people who know you're diabetic, you will frequently be asked (or told) are you allowed to eat that? You're not allowed that.

But you'll learn some favourite answers to those remarks :D

[volleyball]

I eat whatever I want, drink regular soda and am able to stay in control. Averaging 300-400 carbs a day, my a1c a couple months ago was 5.4. If weight gain is not an issue and you can keep your blood glucose under control, go for it. You just need to be aware that any error you make with your carb counting/bolus will be multiplied the more carbs you intake.


this too shall pass. An active teenager will have it a lot easier than someone old enough to be their parent. The years that naturally take toll on he body plus all our indiscretions at the dinner table ad up and it will naturally become harder.
The more you tow the line now, although less fun will pay dividends in the future. I say be very good most of the time so that you can do the party when the occasion arises.
Think of it like a savings account. You save now when your friends are out blowing theirs so that in the future, you won't be homeless ( complications) like them. But life is balance.




There has been lots of seemingly conflicting advice that is all good. Type 1 or 2, male or female , active or not, age and amount of body fat require us to do this differently.

Eliminating or limiting the sin foods such as corn syrup and cheap processed foods that are more a miricle of science than nutrition will help us all.