But is it? Based on what I’m reading here, I don’t think being that far off from 50/50 split is a problem at all. It’s a means to estimating, not an end goal. So unless my goal is to reduce the amount of insulin I take (and why would it be?), I think this is more of an observation, but not necessarily an indication that something needs fixing.
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This is the truth for me, @YogaO. Being successful everyday means enjoying all of it–including eating. I balance several conditions along with T1–Hashimoto’s thyroiditis (end stage…so no production of thyroxine), Adrenal Insufficiency, and intestinal permeability and dysbiosis…so I multiple considerations. My cortisol levels and digestive tract are assisted by skipping breakfast altogether, for example. It turns out to be good for me to fast from dinner to lunch. I know that’s not true for many, but for me it works really well.
I find that, if I hold steady on gluten-free and no sucrose of any kind in my diet, I am on the best track possible to achieve my daily effort to feel successful with myself. So, my daily regimen looks like: no carbs (or calories) at breakfast. For lunch I have a medium sized apple with a quarter cup of yogurt and a handful of macadamia nuts and pistachios. Dinner will often times look like either a bowl of bone broth soup and a piece of gluten free toast or a big salad with some chicken a small baked potato. Some nights, for a treat, I will eat berries with whipped cream and some cheese for dinner. And I do bake gluten free, apple sauce and stevia sweetened goodies on occasion–maybe once a month.
I started this thread because my naturopath wanted to me reduce carbs further, and I couldn’t see how that would work for me without sacrificing the pleasure component of eating. I’ve learned so much from everyone, and I have a much better understanding now of why she suggested it. For me, small modifications are the key.
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If you are happy with your control, I guess I’d say nothing needs “fixing”! 
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I keep it between 20-30g per day. I hate bolusing for carbs! 
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I’d like to go to bed with a “reasonable” BG, 100-140. To do that, I can eat a lower carb dinner, maybe about 20 or less and bolus correctly, or if I eat more carbs, take more insulin and hope that there was no mistake in matching I:C. The strategy of having more carbs in the morning, lunch, afternoon and the least at night seem to make sense. Has anyone else had success with this strategy?
Does the type of carb make a difference to some people? I find that with fruits, my I: C match are usually pretty good. With other foods, such as rice/pasta/bread for quantities such as 30g to 45g, even if measured accurately cannot be matched well by bolus insulin. This is frustrating! Has anyone else had similar experiences?
I eat about 200 a day. I don’t limit my diet mainly because I was never told I had to. I was always told growing up that I can eat everything a non diabetic eats. And with the exception of regular soda and pancake syrup, I do just that. My a1c is usually in the low 6s as well, so I don’t see a reason to change anything
For me it does. I do about 95% of carbs from fruit and vegetables. I read a few article on resistant starches that go very slowly through the system and, in fact, are great sources of food for the microbiome in the gut. One of those is potatoes that are boiled, then refrigerated before eating. I find that micro-waving works, too…and they have the least impact on bg spikes for me.
I also use resistant starch to feed my gut microbiome. I mix potato starch with warm water every night. Food is the best way to feed the gut but my supplement is better than leaving it out altogether. It moderates the symptoms from gastroparesis for me.
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Like you, I have my lowest carb meal for dinner.
I generally find that certain foods like rice/pasta/sourdough breads create a problem if I bolus strictly for the listed carbs. I like to multiply the listed carbs by 1.5 and then I do a dual-wave bolus with approx. 50% of the bolus delivered immediately and the remaining 50% delivered over 2-3 hours. I also do a fingerstick @ the end of the 2-3 hours and see how well things are going. If I am sky-high beyond what the remaining insulin will correct for, I take a correction bolus.
Wow, TimmyMac, that’s terrific for you that your a1c is in the low 6s.
I guess I’m still pretty bad at the matching the insulin to carb game. If I stay at around less than 30 g of carb for any given meal, I usually don’t approach 200, where I have my high alarm; but it’s not always less than 140 either. Bummer.
This is a general question for everyone: When fine tuning I:C raito between something like 1:15 or 1:13…are you able to measure your carbohydrate that precisely? I’ve read that for many the I :C ratio changes from meal to meal. If I’m having 3 strawberries, how precisely do you measure the carbs in the strawberry?
Thanks! I’ve been a type 1 since I was 5 years old so I’ve learned how to deal with it pretty well.
If you want to be really precise, you could always weigh your food. I know a lot of parents do that with very young kids. It’s the most accurate method I know of.
I’m personally on MDI so the difference between 1:15 and 1:13 wouldn’t be dosable for me unless I ate a pretty large meal. So unfortunately I cant help you there.
When I was on MDI, I was super wild with it but would use the “meniscus” on the shot (over or under the line…) for fine tuning! @TimmyMac has also hung around Tu for a while now ,maybe since I started here? I would like to see a scientist analyze whether participation in an online community like this might have helped him kick as much diabetes ■■■ as he has?
I agree that a scale is super useful for carb counting. I am not currently in a group but have done some fitness groups w/ several of my buddies who are BeachBody coaches and have found that when I weigh stuff, it’s easier to “nail it”, both fitnes and D-wise…
I do use a scale and weigh as often as practical.
If I’m unsure that my I:C is 1:18, 1:15 or 1:13 is precise measuring very important? If I’m unsure of my I:C ratio, I think that if my meal were only 18 g carbs, I could dose 1 unit or 1.5 insulin if my pre meal were BG 100. If my pre meal BG were 80 and I were uncertain of my I:C, the 1.5 insulin could make me low, yes? Could you guys weigh in with strategies and the thinking process you use? Thanks!
I eat between 100-120 grams of carbohydrate on a 1400 calorie diet. I am currently a student (so lots of sitting) and am trying to lose weight. Carbs are important for brains functioning (by extension breathing, muscle movement, etc). So I do try and have a good amount, however 200-250 grams is recommended for a 1400 calorie diet so I am a bit below. To counter act high bg’s I try to take a bolus anywhere from 10-30minutes before I eat (depending on time of day, how active I am, and how many grams of carbs I’m having per meal)
There is way more to insulin dosing that just counting carbs. You have to understand how activity (or a lack thereof) will effect you after you bolus and eat. I hardly bolus at all when active if I have just a tiny bit carbs in a meal as my basal will often be all I need. IF a meal has no carbs, and it’s not morning time, I won’t bolus. If I’m inactive and eat a fair amount of carbs, the insulin dose per gram of carbs may need to be increased above the normal amount for when I am not utterly inactive. It’s a balancing act of: 1) timing, 2) current and recent bg readings 3) carbs 4) fat, 5) activity level and duration. Anyone who is T1 and says they always get it right with ONE I:C setting must be eating the SAME thing and DOING the SAME thing over and over. For the rest of us, you have to “fly by the seat of your pants” when dosing. Good luck!!
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Thanks…it’d be great if the activity were planned. For example, when there is scheduled time at the gym, for example. Other times, I guess, always be prepared with snacks if unexpectedly active? FYI, I am on MDI, not a pump.
This worries me a bit: When I have a late dinner, 7 pm, for example, 15 g carb, I dose 1 unit insulin. I eat a little more, 8 pm, maybe for dessert 15 g, dose 1 more unit insulin. Some bolus insulin may still be working at midnight. I am concerned about going low at night while sleeping. Sometimes in the past I’ve only dosed 1/2 unit to cover the extra 15g because of fear of going low.
I have a fear of low because lows can be fatal short term, whereas highs have longterm health implications.
How do the folks who manage such nice Dexcom lines between 80’s and 100’s do it?
Most pumps allow multiple carb ratios. I have a lot of different ones based on time of day and if it’s a work day or off day. No real way to figure them out. Just a lot of trial and error. And yes it is a lot of error. I range from 1:8 all the way to 1:15. But as we all say YDMV (your diabetes may vary).
Let me first say that that tracing lines in a good BG range is not an every hour, every day thing. Just like anyone with diabetes, I struggle with the seemingly endless factors that work against painting normal lines.
With that disclaimer aside, the largest factors that help me is a low carb diet (I shoot for 30 grams per day limit, but often eat 30-50 grams/day.), daily walking averaging 3-5 miles, pre-bolusing 30-60 minutes, use of an extended pump bolus with every meal to cover protein and fat, and working to keep a good attitude that permits mistakes, errors, and less than perfect BG performance.
I also test a lot, about 10-14 times per day. That’s in addition to wearing a CGM and a watch that displays my BG on its default screen. Some might criticize my vigilance as obsessive but I’ve discovered it’s less stressful and time-intensive to keep my BGs in range. I know it’s paradoxical but more vigilance leads to less effort. More is less is more!
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I eat very low carb. I drink bulletproof coffee for breakfast (black coffee with coconut oil and butter), have a mid-morning snack of nuts and eat a hardboiled egg, cheese and lots of raw veggies with blue cheese dip and berries for lunch. I only bolus for lunch and dinner and pretty much float with my basal. I have a small portion of fish, chicken, egg or steak over salad for dinner and do my workout right before to avoid needing to bolus much for it. I should note, I am a T1 and take about 12 units basal and 2-3 units bolus a day. I keep my calories quite low too (around 1200). I also take Invokana, which has helped me immensely. At my next appointment, I’m going to ask my Endo about incorporating Metformin as well. I’m far from perfect, and if I eat “normal” like when I’m camping with friends or something, I can’t maintain any type of control. For me, I need to eat impeccably (low carb and calorie) and workout daily to maintain a lower weight and good control.
@ Terry4 - wow, pre bolusing 30-60 minutes? I did not know that. I’ve tried 15 minutes, 20 minutes; the CDE mentioned trying those. I sometimes am not sure that I would eat “that many carbs”, therefore, most often do not pre bolus. I think it happend once, where the pre bolus was 60 minutes by accident (there was no carb food), and my BG dropped to 75 (Dexcom alarm) and I suggested to my host that I would help prepare the watermelon “in record time” and sampled it as I prepared it. LOL.
If I bolus at the meal, does this mean that the post meal BG would tend to be high? So there would always be a mismatch?