[grace girl]

I've just begun carb counting this week. The dietician told me that I wasn't eating enough before, so I'm now on 45-60 carbs per meal. I figured that this would increase my insulin. I've been averaging between 45-55 per meals since. At breakfast and lunch, my post meal bs is within range, but for the last two nights I'm over 300 post dinner. I take my Lantus at 9pm, and I'm wondering if it's petering out, or if I really need more Humalog at dinner. I'm not a heavy eater, and tend to avoid too much fat, so I'm at a loss. Any ideas?

[seacomp]

Originally Posted by grace girl

I take my Lantus at 9pm, and I'm wondering if it's petering out

Most likely you need two shots of Lantus per day. For many people, it does not really last 24 hours. You can start splitting the dose 50/50, 12 hours apart, but the two doses do not have to be equal or equally spaced, if you can get better results otherwise.

[Cinnabon]

Are you using your insulin to carb ratio? ..(ex. 10 carbs per 1 unit)

[grace girl]

Originally Posted by Cinnabon

Are you using your insulin to carb ratio? ..(ex. 10 carbs per 1 unit)

The dietician told me to keep using my sliding scale for now, count the carbs and that after I'd been carb counting for a few weeks the endo would set a scale for me. Is that the general procedure?

[Cinnabon]

With this ratio, set correctly, you will def not hit 300s. You will be able to cover your carbs completely. At first, you may be a bit off, but thats how you get to a pretty set ratio. More flexibility is also possible.

[grace girl]

How long do they usually take to set a ratio for you? I've been doing the carb counting for 4 days now...I'm supposed to fax in a detailed log of everything I've eaten each day with pre and post bs to the dietician some time next week, plus my endo want a copy of my bs 8 times a day weekly.
I'm hoping they will set a ratio for me sooner rather than later. Before I started carb counting I was having a hard enough time keeping my sugar under control. Now they've got me eating more, and the numbers are getting worse by the day. Due to poor medical care (and ignorance on my part) I lived in the 300 range for most of the past two years. The last month has been a wonderful experience, actually having readings below 200. I want to go forward, not backwards.

[Cinnabon]

Grace,
I believe you are doing all you can do for now. I would think that shortly after your logs are faxed and analyzed, the endo will get you on a ratio. Usually it will start at a standard 10:1 (10 carbs for every unit)
You will have control before you know it, but you do have to have a bit of patience.

[grace girl]

Originally Posted by Cinnabon

Grace,
I believe you are doing all you can do for now. I would think that shortly after your logs are faxed and analyzed, the endo will get you on a ratio. Usually it will start at a standard 10:1 (10 carbs for every unit)
You will have control before you know it, but you do have to have a bit of patience.

Thanks for that! I'm trying to be patient. I was just getting things settled down when they told me to eat more, so I'm on the roller coaster again, and really, really ready to get off. I hate roller coasters

[duck]

Grace,

Here's a rule of thumb to help you get started:

http://www.diabetesnet.com/diabetes_...arb_factor.php

BTW, there are a lot of diabetics and diabete's proponents who will tell you that carbs are our enemy, and what your dietitian said (you're not eating enough) is bunk. I don't necessarily subscribe to the "carbs are evil" school of thought, but if you are eating what you can comfortably eat now, don't try and accomodate more carbs just because...

Eesh, did that make sense? If your dietitian is an RD, ask them for alternatives to eating "more carbs" if you don't want to eat more carbs.

[grace girl]

Originally Posted by duck

what your dietitian said (you're not eating enough) is bunk. I don't necessarily subscribe to the "carbs are evil" school of thought, but if you are eating what you can comfortably eat now, don't try and accomodate more carbs just because...

I've been wondering about that. She said I need to eat 1600 calories a day, which is 45-60 grams of carbs per meal. I am struggling to cram in 45 a meal.
I'm a small person, I'm 38 years old, fairly active, I just don't have a huge appetite. I've been concerned that eating this way would cause me to gain weight, which she assured me it wouldn't but logic tell me that if I eat more....
I must be honest here, perhaps many of you understand....I think my bg is running high the last few days because I am growing increasingly frustrated with all of the answers and non-answers I'm getting from my supposed 'team'. I'm dreaming about all of this at night!

[Penny]

Originally Posted by grace girl

I've been wondering about that. She said I need to eat 1600 calories a day, which is 45-60 grams of carbs per meal. I am struggling to cram in 45 a meal.
I'm a small person, I'm 38 years old, fairly active, I just don't have a huge appetite. I've been concerned that eating this way would cause me to gain weight, which she assured me it wouldn't but logic tell me that if I eat more....
I must be honest here, perhaps many of you understand....I think my bg is running high the last few days because I am growing increasingly frustrated with all of the answers and non-answers I'm getting from my supposed 'team'. I'm dreaming about all of this at night!

Grace, my "Diabetic educator" insisted I was not having enough carbs, and I am not a small person, short, but not small. I tried her method for about a week, with consistantly high levels, and I did not feel good. I decided to figure out for myself what worked, and it was nowhere near what she wanted me to have. I think you need to experiment, figure out what works for you. When I talk to my educator and she asks, I tell her I am trying hard to keep my carbs at a good level. If she presses, I tell her that what I am doing is working, and I am not willing to change. Just being frustrated with your team can cause you problems, you have to look out for yourself.

[RickLV]

45-60 carbs per meal

Insane (IMHO). Equivalent to 3.8 to 5 oranges per meal.

[JediSkipdogg]

Originally Posted by RickLV

Insane (IMHO). Equivalent to 3.8 to 5 oranges per meal.

Heck, 45-60 carbs is a snack for me. One piece of pizza is around 20 carbs, a baked potato is 30 carbs, I could go on and on. 45-60 carbs per meal is very easy to hit. Heck, going to McDonalds and getting a double cheeseburger and dollar fry at McDonalds is 84 carbs.

[RickLV]

Originally Posted by JediSkipdogg

Heck, 45-60 carbs is a snack for me. One piece of pizza is around 20 carbs, a baked potato is 30 carbs, I could go on and on. 45-60 carbs per meal is very easy to hit. Heck, going to McDonalds and getting a double cheeseburger and dollar fry at McDonalds is 84 carbs.

Hi Jed,

Yeah, it’s really easy to chalk up those carbs. When I read your post I thought you were being facetious, but I’m not sure.

As a Type I, I hope you’ve got it down and are doing well.

I was told I had diabetes in 1992 (I think) and told to get my weight down. Did it; and was told I was no longer diabetic. About 3-4 years later I picked up weight again and was then told I was diabetic; get your weight down and watch what you eat. Did that. Then a few years later I was told my BG was a little on the high side and to loose some weight and go on a low fat diet. Did that (skim milk, no more meats, etc.). BG’s not doing well, I was told to get a meter and keep 2h PP below 180. Did that. No luck. Went on 500mg Metformin x 2. Time goes on. Went on 1000mg Met x 2 (if I remember).

Then my feet went dumb. Then my hands went dumb and my feet started burning/freezing.

Now the ADA says keep your PP below 140 and changed fasting down to 100.

So, you see, I’m very anti-ADA. I firmly believe they (ADA, AHA, AMA, edible oil industry, processed food manufactures, pharm’s, et al) are responsible for killing my father at age 71 as well as the epidemic of obesity/diabetes/CHD we have now.

So, if you follow the ADA, I think (MHO) you are pretty much guaranteed to experience continued (silent) diabetic damage and are assured more and more meds as time goes by. I’ll eat the things my grandparents ate (all farmers); they all lived to 88+ and never heard of diabetes or CHD.

All the best to you,
Rick

[JediSkipdogg]

I don't see why you say the ADA is bad for those reasons. The problem is, 10 years ago, insulin and pills couldn't control levels that well. 1 extra unit of NPH insulin could drop a person from 200 to 60. Now we have technology that can give you levels down to .05 units of insulin that can account for 1 carb of food. Also, 20 years ago it wasn't really known that carbs were the cause of sugars rising. It was all based on the food pyramid and eating starches and such. Research has come a long ways in the past 20 years to show what causes BG to rise and what makes it lower. Idealy, you want to get as close to 90 as possible, that is what a non-diabetic is. However, can you do that accurately? Some can, MANY cannot. If I stayed near 90 and ate pizza and gave 1 unit of insulin too many and drove a car, I'd probably kill someone. Therefore I stay around 120.

As for carbs, I eat about 200-300 grams a day average. I have gone as high as 500 carbs in a day before. Keep in mind though, I'm a type 1 with 0 insulin being produced by my body. I use a pump for my insulin and count my carbs, just like my pancreas is suppose to do. Type 2s are different, and low carb is what's recommended for them.

And eating things your grandparents ate is the best solution. Those items are healthy and not loaded with fat and carbs, and the carbs they do have are natural, not processed, which is a huge difference. Many other countries have higher life expectancies than the US and that's because they have totally different eating habits than us. USA Today recently said the US has the worst eating habits in the world. I concur with them 100%.

I wish you well my friend and good luck on your treatment method.