I have seen some comments and posts that are confusing to me as a new T1, and I think my questions may be related. If not, I apologize for a confusing post!
What does "eat to your meter" mean? When someone says my bg is high and I am hungry, but can't eat, what does that mean?
How about, "I woke up high so couldn't eat breakfast and it was midmorning until I got it under control?"
How high is high? For example, if you are 180 going into a meal and your target is 100, do you correct and wait? Do you correct + bolus and go about your meal?
I think eat to your meter means you eat & dose according what your bg is before a meal and after what the results are etc.
For me personally, if I'm hungry and it's time to eat I just dose more and eat. If I correct I almost always go too low later when I have to take more to eat, stacking is bad.
I would rather stay the same and just exercise after eating if I'm on the high side. And I have found not eating can actually keep me there longer sometimes too.
You can also sort of progress to the point where you make food choices to anticipate the food's impact on your BG. Theoretically, with ratios, it shouldn't matter as any amount of carbs can be covered but many of us have learned that if you have a choice between say a burrito and a taco, the taco might have less impact on your BG. I'm not a huge fan of saying "I can't eat _______ (anything, except bananas, I loathe bananas...)" but make a lot of choices that might be labeled "healthy" or "conservative" by observers but my BG is pretty tightly controlled and, to me, it's worth it. As Kris Jenner said, "vodka is less calories than that wine..." after one of her daughters razzed her about being a lush.
No, actually what you are describing is a sliding scale, an outdated way to dose for meals.
"Eat to your meter" is an approach that involves trying various foods in various serving sizes and seeing what the results are two hours after eating. Then if you consistently see highs from this food you need to either use more insulin, eat a smaller serving or put that food on the "rare" or "never" list. What works for me may not work for you, we are all different. "Eating to my meter" has taught me that I can't tolerate many carbs at breakfast, that cereal never works for me at all in any serving size, ditto rice. Pasta is pretty iffy but can be managed on an occasional basis but I always do a combo bolus. Testing and seeing how you do is the best way to determine what you eat as well as to fine tune your I:C ratios for mealtime bolus dosing.
It's important to work out your ISF which is the amount of points that one unit of insulin lowers your blood sugar. This is also called "correction factor". Many people do correct and then wait to eat. I will do this sometimes depending on how hungry I am and how high.If I wake up high I'll bolus a correction and dawdle over my capp since I don't have to be anywhere first thing. Then I'll test again and add in a correction if still needed.(always taking into account the IOB or insulin on board). But generally I just add in my correction to my bolus. If I'm very high (in the 200s) I might alter my plans and eat less carbs. If I'm planning on eating something fairly carby I may test an hour before a meal to see where I'm at. I would prefer to not be much above 120 before a meal but ■■■■ happens!
Eat to your meter- Let your meter guide you as to what you can and can not eat. Example: Let's say that you like to eat pancakes for breakfast and your insulin to carb ratio (I:C) is 1:10. You eat pancakes that total 100 grams of carbohydrates and therefore dose 10 units (100/10) of insulin. You test your blood glucose (BG) before you eat at it's at 100 mg/dl. You take 10 units of insulin and then eat the pancakes. You use your meter to measure your blood glucose 2 hours after you eat and it's 290 mg/dl. You measure at 4 hours post-meal and it's 190 mg/dl.
Using the "eat to your meter" philosophy, you may decide that pancakes are not worth the high blood glucose or you could try eating the same 100 grams of carbs/pancakes the next morning and change your I:C to 1:9 and therefore give yourself 11.1 units of insulin (100/9). Repeat the post meal blood glucose checks on your meter. If the 2 and 4 hour checks are at your target (many people use 140 @ 2 hours and 100 @ 4 hours, but your targets may differ), then change your I:C to 1:9 instead of 1:10. If your BGs are still too high then you could change your I:C for the third morning of pancakes or abandon pancakes all together.
The basic formula is to eat, test, adjust.
When someone says my bg is high and I am hungry, but can't eat, what does that mean?
I don't usually eat if my BG is over 165 mg/dl. That's just me, not everyone does this. I make exceptions and accept the consequences. So, if I measure and I'm at 200, I will usually delay or skip that meal. But I may complain to whoever will listen, "I'm hungry and can't eat because my BG is high!"
If I'm at 180 and it's time to eat, I will usually take a correction and delay or skip my meal. I find that it's harder to pull down a high BG than it is to prevent one. I will make excpetions to this policy but know I will have to live with the consequences.
I've never figured out my ISF because if I take insulin, I'm going to eat something and my data gets thrown off. I just use whatever "Rule of 1450" number the doc plugged into my pump and it's worked ok. I just adjust the ratio and leave the ISF fixed.
My pump figures it out. The correction factor is in my pump, probably calculated by dividing 1450 by my TDD or however they figure that out. I suspect that if that number is off a bit (sometimes I wonder, not much though, or not enough to rummage around my pump and play around with it...) I would probably see the "off" but I would just adjust a ratio. I generally don't run that high except after larger meals and will correct by taking a second look at the meal and bolusing to cover the carbs I overlooked. I dunno that changing ISF from 41 to say 38 or 45 would make a huge difference in the bolus size for a particular BG reading. I don't even think about this stuff though, I just roll with the pump and if something is off regularly, I spend 1/2 hour reprogramming 20/ 24 1/2 hour increments for my basal rate, LOL...
I have basically been doing all those things too.. but after several bad lows from trying to correct a mild high, I no longer do that.
I do know all of this, and I have done it all, but to be honest none of it really works for me most of the time, isf changes all the time and I never react the same each time. I must have the difficult form of D, lol. I know how sensitive to carbs I am but that also varies according to a gazillion things, but I'm low carb- around 50g per day.
I can eat at 140 or higher and end up at 80-90, so that is what I do now, if not I just go for a walk. I hate the feeling of taking insulin when I'm already hungry and feeling even hungrier.
At above 180 I will correct first but then I have be very cautious about bolusing more and eating after that, especially if have also added water and exercise.
Am I the only one here whose insulin/carb ratio changes throughout the day and from day to day? I can't be the only one... also because of being low carb I have to also add some more for protein and fat.
I understand now. I forgot how lucky you are not to have too many highs that can't be accounted for by undercounting carbs!
I actually found that most of those formulas are pretty off for me, so I've never really used them. I just checked Using Insulin and it's "The 1800 Rule"or 1800 divided by TDD. That would give me a ISF of about 1:80 when I actually use 1:28 during the day and 1:48 at night! But, Walsh does say that formulas need to be confirmed by testing!
Everyone is different in how they interpret these, but I take them as follows.
"Eat to your meter" means don't eat foods that seem to consistently cause highs. For me, I go high (and low) for things other than food. So sometimes I'll be high after eating one time, but not the next, even though it's the same food. So I interpret this to mean that I don't eat foods if they cause highs most of the time, even if I happen to be fine one some occasions. For me, anything that puts me into the teens (above about 250) is too high. I find it hard not to spike over 11 (200) when I eat any food, if I test at say one hour, so I don't really consider that high, even though others definitely would.
Many here refrain from eating if they are high, which is why they might say they "can't eat" if they're high. For me, I will try to delay a meal if I'm in the double digits (over about 180) until I've come down a bit, but this isn't always possible, and I'm not that strict about it. For breakfast, especially, I find if I eat I actually come down much faster than if I don't eat.
Until recently, I considered anything under 180 to be pretty fine. My control has recently improved a lot, so now any time I am over about 8-9 (150-160) I'll go, "Hmmm, that's not normal, what happened there." There are some that have much stricter guidelines than this. It all depends on how consistent your BGs are (and some people have more swings than others, for various reasons). Someone who is just getting their diabetes under control will have very different guidelines than someone who is aiming for non-diabetic blood sugars.
Targets are also a good topic for your endocrinologist. I switched doctors last year and have not asked my new one what his suggested targets are, which I plan on bringing up at my next appointment in November. Of course, this will also depend on whether you trust and agree with your endocrinologist, as some fine their endocrinologist recommendations unsatisfactory and just come up with their own that works for them.
Sounds frustrating. I'd hate not to be able to rely on my ISF! Maybe that will even out for you in time. Mine definitely varies during the day and I have 1:27 programmed for 5AM to 8PM, and 1:48 for 8PM to 5AM. I can't say that it always works perfectly, compared to people like AR I have "the difficult form" compared to some, it's steady. Usually if it's off it's off in not being enough insulin, only very occasionally being too much (crashing me).
Unfortunately it seems I can't rely on anything... one minute I drink a sip of juice and I go up 50 points, another I drink the whole thing and I'm fine! I hate it! I think crashing scares me more though for sure, so I will do anything to avoid that now. I can be steady for a few days and then bounce all over with no warning too.. I don't even take a guess at what mine is number wise anymore because the bg reading and my activity level seems to work better for me.. I guess D is just difficult for us in different ways.. I hope it will settle out a bit but that could mean higher insulin needs for me too. That is good you don't crash at least.
I know this is an old thread, but I found it by googling "eat to your meter" in an effort to learn what that meant. In fact, it is what brought me to join the forum.
A couple people said that they delay or skip a meal if they test high, but most of the time when I try that I just end up going higher before it starts to drop. On another forum they said to eat as soon as you get up to stop the dumping of glucose. I prefer to eat when I feel hungry, which might not be for a few hours after I get up.
Welcome to tuD. This is a great place to interact with people who "get it" about diabetes. I have picked up valuable information here that I never heard from a doctor or any other health care professional.
Yes, I'm aware of people that say that their BG steadily rises once they get up in the morning and the only thing to stop it is an insulin dose and breakfast. You could, of course, test that hypothesis and see what's true for you. I would test three times before drawing any conclusion.
It's my understanding that in a glucose-normal person, the release of insulin in response to a meal signals the liver to stop releasing liver sugar or glycogen. I use an aggressive basal profile in the early morning hours to counteract liver glucose release, something referred to as "dawn phenomena." You'll need to carefully observe and monitor you morning glucose to identify your body's typical action.
Like you, I don't like eating when I first get up in the morning. I usually delay my breakfast until 11 a.m. or later. I only eat two meals a day. If my basal rates are well calibrated on my pump, I do not see my morning BGs rise. I take some small insulin doses to cover the cream in my coffee, however.
