[Jodie]

I am doing the DAFNE course soon and I am just wondering if this is the way you count carbs say if something has 19.3 carbohydrates in do you round that to 20 and then divide by 10? and then you get the carbohydrate portion and then thats how many units you take

[tanyatype1]

I take one unit of insulin for 15 carbs. If I'm eating something that has 45 carbs, like a small muffin, then I'll take 3 units of insulin.

[Alice]

Yes, I round up or down depending on what's going on any given day...any given moment! (I'm at a ratio of about 1:15 but personally find a fixed ratio not always realistic.)

But, 1:15 is a good ball park for me with the fewest corrections. Just know that corrections are part of the game and not something horribly wrong.

I split boluses on large starchy meals usually.

[Richard157]

Some doctors recommend starting with a 1:15 ratio. Then you use trial and error to determine whether to increase/decrease that to best fit your own particular needs. The appropriate ratio can vary throughout the day. I am not very insulin sensative. I use 1:4 in the morning, 1:6 at lunch and the afternood and 1:5 in the evening. Those changes need to be adjusted in the winter when I am not getting much exercise. There many factors involved here. We are all different.

[xMenace]

I hear good things about DAFNE. Give us a review when you're done.

Yes you have the math right. We take x units for every y grams of carbs, If you take one uniter per 10 grams then 19/10 * 1 = 1.9 units. Would I be so exact? Not likely. But some are very sensitive and pay close attention to these measurements.

[Gary_W]

Hi Jodie,

The DAFNE course does it a little differently to most of the folks on here in that it only deals in 10's of carbs and calls them carb units... To me, that's adding an extra layer of complexity whilst trying to make out that it is simpler.

Add to that the fact that DAFNE (at least around these parts) says that a patient's carb ratio is EITHER 1:5, 1:10 or 1:15 and you have a recipe for a system that doesn't quite work. If you insist of doing the above, you will forever be correcting with either food or insulin unless you happen to be one of the above numbers! If you are 1:12 then so be it. The maths is a little trickier but better tricky maths than feeling rotten.

To do it simply, do the following:

1. Work out your ratio. 1:15 is a good starting point, but if this doesn't work out for you then change it. Expect different ratios at different times of the day as you are naturally more insulin resistant in the mornings. To give you an example, my current ratios are 1:11 in the morning, 1:14 for lunch and 1:15 for my evening meal.

2. Count the number of carbs in something as exactly as you can. The only rounding is to the nearest whole number.

3. Do the maths with your ratio.

4. Decide to over inject a little or under inject a little, as the chances of coming up with a whole number are slim...

For example, for breakfast I'm eating 57g of carbs. My ratio is 1:11. I need 57 / 11 = 5.18 units of insulin. On a pen, you would reasonably put in 5u and expect to run just a tad higher than you'd like

Get to know your insulin profile (i.e. how long it is active for in you). Doing so makes testing at the 2 hour point work better as you'll get to know whether or not you need to do anything.

Good luck

Gary

[Alice]

In the US, I believe (could be wrong) that "they" use 15 carbs as a "carb exchange" which is a step between counting carbs and the old exchange diet program.

So, a banana (30 grams) would be two carb exchanges...or two fruit exchanges to some people.

I really like the carb counting as it takes the "sugar" out of the formula and just concentrates on the greater super set of carbs...sugars being only a sub set.

[Chappo]

That also depends on the makeup of sugars in your food.

With a pump, i know many people if having 50carbs (of which 25 are sugar), they will often bolus immediately 50% of the dose for 50 carbs, then allow the rest of the bolus over one hour. It seems pretty smart to me

[Gembo]

Originally Posted by Jodie

I am doing the DAFNE course soon and I am just wondering if this is the way you count carbs say if something has 19.3 carbohydrates in do you round that to 20 and then divide by 10? and then you get the carbohydrate portion and then thats how many units you take

I did the DAFNE course last November and you are pretty spot on with the procedures it uses. Your above example assumes that your ratio is 1 unit of insulin per CP though. However I agree with some of the other posters that converting to carb units is just making things more awkward than they need to be. My current ratio is 1:10 and I don't bother converting the carb grams into CPs.

Another thing I would say (and it's probably obvious) is that if you are going to eat a few different items I probably wouldn't do any rounding until the end when you've calculated the total amount of carbs. It may not make a huge amound of difference because for some items you will be rounding up and other items you will be rounding down but I prefer to have a completely accurate total and then round.

[ant hill]

I am going to do the same course in Oz and I am very interested in counting the carbs to match the short acting insulin. Also this is a good thing that I can count carbs and that would be a good "Safe" way to loose some weight without having the fear of going low as all of us are so scared of.

Would I be correct in saying that if I were to have a bike ride and stop for lunch, Would I have to alter my ratio?

[Subby]

Yep, the exchange or CHO or CPs were the old generalised way of "classifying" a very rough amount of carbs foods had. I also think that exchanges are inadequate for modern carb counting/dosage ratios, and just add complexity and "backward compatibility" for no good reason. (I suppose some may find them familiar or intuitive, I never did, and a resolution of 15 grams is just not useful at all). They should just go grams all the way. If you get the choice to bypass bothering with exchanges, do it!