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07-16-2008, 07:52 PM
|  | Junior Member | | Join Date: Apr 2008
Posts: 50
| |  Had 1st Endo visit, Now MDI
I've been on a slowly increasing dose of Lantus (every night at bedtime) since mid April. Started at 10 units for a week then increased every 3 days till I'm now at 40 units.
Still not at goal, but a lot closer... Yesterday I had my first visit with the Endo and she cut my Lantus back to 20 units and put me on Humalog - 5 units with every meal for the next 3 weeks then I go back and we figure out a starting ratio for my bolus shots...
In the meantime, I have to get a lot better with actually counting carbs...
My question is this...
For those of you on a basal/bolus insulin therapy, do you subtract the fiber grams from the total carbs to calculate your bolus, or do you bolus for total carbs? 
I'm trying to set an appointment with a nutritionist (approved by my ins) but those people keep bankers   hours, and I've not had any luck so far. |
07-16-2008, 07:57 PM
|  | Senior Member
I am a: Type 2 | | Join Date: Mar 2008 Location: Alabama
Posts: 704
| | Good luck with your MDI therapy! I don't use insulin, but certainly appreciate the intricacies in getting it right. 
__________________
Glycemic impact diet
exercise
Metformin 2000 mg
Byetta 5 mcg/2x daily
Enalapril 40 mg
A1C, 8-7-08: 6.3
A1C, 5-1-08: 5.6!! 
A1C, 2-5-08: 7.4  |
07-16-2008, 08:10 PM
|  | Senior Member
I am a: Type 1 | | Join Date: Aug 2007 Location: North Texas
Posts: 1,797
| | | Poppa,
My practice regarding fiber, is to only subtract fiber if it's at least 5 grams. Some people ignore the fiber, and others subtract every bit of it.
5 units of humalog for me would mean I'd need a meal with 75 carbs! It would mean 50 carbs for others, etc.. I think you do understand that though. Just be careful and keep glucose tablets or OJ, or similar around in case 5 units is too much.
Good luck with getting the appt with the nutritionist!
__________________  Type 1 since 1979
Pumping with MM 522 since Feb '08
HbA1c 6.1 - April '08 |
07-16-2008, 08:17 PM
|  | Senior Member
I am a: Type 1 | | Join Date: Jun 2006 Location: Rothesay, New Brunswick Canada, eh
Posts: 6,454
| | I subtract it, but frankly it's all an estimate anyway: 15 total - 3 fibre still equals 15g in my math
__________________ Michael Pollan on CBC
In Defense of Food with Michael Pollan T1 1975, MM 722 pump
A1C 7/08 5.9%
HDL - 1.55 (59.9)
LDL - 1.76 (68.1)
Triglicerides - 0.44 (40.0)
Called John, plus many other things
1 - - - - - - - - - - - - - - - - - - - - - - - - - - 3 - - - - - - - - - - - - - - - - - - - - - - - - - - 5 > > > > > > >  > > > > > > > > > > > > > > > > > > > > > > > > > > >
John's Troll Meter - current level: Iffy |
07-16-2008, 10:35 PM
|  | Senior Member
I am a: Type 1 | | Join Date: Jul 2006 Location: Kent, WA USA
Posts: 2,592
| | I don't subtract it. I so subtract half of any sugar alcohols, but I so rarely eat anything that's "sugar free", that I normally don't have to do any subtraction.
To each their own, YMMV. |
07-17-2008, 02:58 AM
|  | Member
I am a: Type 1 | | Join Date: Apr 2008 Location: Oswego, NY
Posts: 254
| | | I ignore it, but I have looked and almost everything I eat has few in it.
__________________
The Przepiora Clan  Theresa Maria Jonny Bridget(kate) David Lily Jimmy Danny(holding the bear) Margaret isn't in the picture |
07-17-2008, 05:04 AM
|  | Senior Member
I am a: Type 2 | | Join Date: Mar 2008 Location: Nova Scotia, Canada
Posts: 1,724
| | Quote:
Originally Posted by Jan B  My practice regarding fiber, is to only subtract fiber if it's at least 5 grams. Some people ignore the fiber, and others subtract every bit of it. | I had been told to subtract fibre from the total but I think the most important thing is that you are consistent with your approach... in time you will build up a better feel for your Insulin to Carbohydrate ratio (I:C). Mine is currently around 1:7... so 5 units is good for 35g Quote:
Originally Posted by Jan B 5 units of humalog for me would mean I'd need a meal with 75 carbs! It would mean 50 carbs for others, etc.. I think you do understand that though. Just be careful and keep glucose tablets or OJ, or similar around in case 5 units is too much. | I suspect that Poppa is in the Type 2 category and we need a lot more exogenous Insulin to combat the Insulin Resistance. 5 units seems very reasonable to me as a starting point BUT Jan's advice is still sound... keep a ready supply of fast-acting carbs with you at all times and best luck. I think MDI (or Pump) is the way to go... so much more control than you ever had before
__________________ ~ Frank Metabolic Syndrome Dx'd March 2003. Started MM 712 Pump April 2004. MM 722 + Contour Link April 2008. "...type 2 diabetes is associated with obesity... [so] most people assume that the excess weight causes the diabetes. But... it's possible that diabetes causes obesity" "One of the causes of your diabetes is a poor choice of ancestors." - Gretchen Becker - The First Year: Type 2 Diabetes: An Essential Guide for the Newly Diagnosed |
07-18-2008, 08:25 PM
| | Junior Member | | Join Date: Apr 2008
Posts: 50
| |
Thanks for the input everyone!
It seems like All, Some, None... doesn't really matter as long as I'm consistant about it.... |
07-19-2008, 09:37 AM
| | Member
I am a: Type 2 | | Join Date: Dec 2006 Location: Ft. Worth, Tx.
Posts: 115
| | | I tried subtracting the fiber from the total carbs before and found my insulin didn't cover it so I don't bother.
But that is just me.
Nita |
07-19-2008, 10:45 AM
| | Junior Member | | Join Date: Jul 2008
Posts: 9
| | | Fiber does not convert to glucose so,technically speaking,
subtraction should be performed.
Cheers/good luck
Eddie |
07-19-2008, 10:42 PM
|  | Senior Member
I am a: Type 1.5 | | Join Date: May 2007 Location: Federal Way, Wa
Posts: 787
| | | One thing to remember is YMMV = Your Mileage May Vary. What works for one is not necessarily going to work for another. Best info I can give you is to try and test 2 hours after and see where you are. |
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