[poppa]

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.

[Scrabblechick]

Good luck with your MDI therapy! I don't use insulin, but certainly appreciate the intricacies in getting it right.

[Jan B]

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!

[xMenace]

I subtract it, but frankly it's all an estimate anyway: 15 total - 3 fibre still equals 15g in my math

[Keezheekoni]

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.

[sprzepiora]

I ignore it, but I have looked and almost everything I eat has few in it.

[fgummett]

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

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

[poppa]

Thanks for the input everyone!

It seems like All, Some, None... doesn't really matter as long as I'm consistant about it....

[Nita]

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

[rededmcm]

Fiber does not convert to glucose so,technically speaking,
subtraction should be performed.
Cheers/good luck
Eddie

[mortis505]

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.