Misleading Information

Type 1 and LADA Parents of Children with Type 1 Diabetes
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So, tonight, we had spaghetti for dinner…my family loves spaghetti (especially the way I make it). What we have changed up since our son was diagnosed is that we no longer use regular spaghetti noodles; instead, we use whole grain noodles.

So, I was a little shocked when I saw the carb count tonight…check out the below image:

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So, looking that this I was like…wow…a measly 2 ounces (1/4 cup) is 39 grams! So then I remember Think Like a Pancreas where it said you should “subtract the fiber” from the Carbs…so that means that each 1/4 cup is worth 33 grams.

So, he ate 1/4 of a cup (with a tiny amount of sauce on top just to wet the noodles), and wanted more so I got him another 1/4 of a cup…he only ate a small portion of that amount. So my wife and I figured he ate 1/3 of a cup total.

This means he ate roughly 44 grams JUST for the noodles…then he had 1/2 cup of milk which is another 6 grams of carbs and a popsicle for 4 grams. So, this put his TOTAL carb count at around 54 grams…meaning, if we give him .5 for every 15 grams, we should have (according to the numbers) given him 1.5 units with some left over.

I had actually at first not even remembered to subtract out the fiber from the carbs, so in my mind, he was due about 2.5 - 3 units of insulin!

Well, fortunately, I decided…I’m not going to give him that much insulin!! At least not all at once. So I started him off with 1 whole unit. I told myself, and my wife that I’d give him 1 unit now, and give him the remainder (extended bolus) at the 1 hour mark and the 2 hour mark.

So all was well and fine. His numbers were awesome, floating around 130 for the first hour…and I’m asking myself…why are his numbers not rising?? 1 hour passed and he’s still level at 135 (straight arrow across.) 1.5 hours passes and he’s still at 135. Then at the 2 hour mark, he starts dropping. He ends up starting to head 45 degree arrow down.

This is when my wife begins to research the carbs in wholegrain noodles and finds out that this is DRY NOODLE carb counts. The box does not indicate this! Are we to just guess? Since dry takes up less room than cooked noodles, we’re already cutting carbs there (and insulin requirement). Then she further found out that 1/4 cup of whole grain noodles equates to 1 cup of regular noodles. Meaning, for the 1/3 cup of whole grain noodles that he had he only realy had 11 carbs. Adding this to the 6 milk carbs and the 4 popcicle carbs, he only had 21 carbs. This is just .5 unit + 6 additional carbs.

Here I was about to give my son double, or even triple the dose of insulin he really needed because of the…what I consider…misleading information on the box.

I could have killed my son tonight…lucky we caught it and decided against giving too much insulin all at once because it just didn’t make much sense. My thoughts from the very beginning was to give it in increments (extended bolus), and if more was needed to give it as needed. Had I not been of that mind set, no telling how low he would have fallen.

Anyway, thanks for listening…any info, or advise on not having this happen again would be nice. Not used to not being able to trust information the box. We found out tonight that a carb isn’t necessarily a carb…

We had to give him additional carbs because he was at 84 with an arrow straight down when we realized what had happened.

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Sorry you had an issue with a low for your son. Those measurements are in weight/mass not in cups. 2oz is only equivalent to 1/4 cup if you are measuring a liquid. I weigh all my food that doesn’t fit in a measuring cup well. For example, if I’m eating tortilla chips, and the bag says 20g carbs in 32g of food: I weigh my chips (tare the scale to take out the weight of the plate- all weights are done dry), say I get 30g of chips. I take 20/32 gives me g(carbs) per g(food). Then multiply that by the g of food I want. This would give me 18.75g of carbs, and I would dose for 19g (whatever that means based on my I:C ratio). You can get a decent food scale off Amazon easily. I recommend one that can measure oz and grams.

Hope this helps! Good Luck!

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A food scale is your friend. It’s a lot more accurate when combined with an app like Calorie King.

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This the problem with carb counting. At best, it’s an estimate. And to make matters even more complicated, how long the pasta is cooked also affects carb absorption.

ETA: I agree with Terry. Calorie King (paperback, website or app) is a must!

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A few years ago when visiting my parents, they asked if there’s anything that I want as they were moving to a smaller place.

“You guys have a scale?”

“We still have Jeff’s (my brother) scale from when HE was diagnosed in '71.”

A physical scale (not electronic) with a 500g capacity. I have had horrible luck with electronic scales. Plus, I don’t have to worry about batteries. If grams are good enough for Walter White, they’re good enough for me!:wink:

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I weigh my dog food servings in grams, too. My dog has no extra weight, unlike me!

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We have a Salter scale that was recommended when my daughter was dxd. It has a huge database of foods (2500 IIRC) with complete nutrition info, & allows me to enter carb counts for my own recipes (by ingredient), a huge help since I cook from scratch with low carb ingredients. The model was discontinued a year or so after her dx, so I bought 2 more for backups plus 2 of the smaller travel sized. We only use the scale for new recipes & weighing fruit now, but she won’t have to worry about finding an accurate scale for a long time.

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Like others have said, I also use a scale, combined with Carbohydrate Factors, combined with Calorie King or Google (you can type in “carbs in X” and it will give you the carbohydrate count for 100 grams) to precisely measure carbs. I’m eating a low-carb diet right now, but I do have occasions when I eat high-carb food (for example, next week my office will be having pizza, including going through a ton of effort to order pizza I can eat with my allergies, so I can’t turn that down). I often put my plate on the scale and use it as I’m serving myself a meal: it lets me calculate exact carb counts while feeling “normal” because I’m able to serve whatever I want rather than using measuring cups (which doesn’t feel at all normal to me!). I even have a little portable scale that I keep in my bag to weigh things like fruit or nuts that I might bring in my lunch or purchase along the way.

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I like to eat mezze rigatoni from Barilla, each rigatoni is 1 gram.

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So what I do is weigh out the dry noodles, and then once cooked I usually portion them out into bowls equally, calculating the fraction of the total wet weight he has. So if he ate, say 1/8 of the wet noodles, I take that fraction and multiply it by the carb count of the whole box (or of the serving I actually cooked). Does that make sense? It’s tricky, you’ll get used to it though. It does require a scale.

Another thing we’ve found is that whole grain pasta takes a ton of tine to be processed and requires more over a 4-6 hour period than you’d expect, so we don’t typically bolus for the entire meal upfront. Instead we bolus for say, 50% or 70% and then the remainder as a combo bolus over many hours as needed.

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Plenty of good advice here. If it sounds like everyone is recommending using a scale, it’s because they are. :wink: I’ll add my voice to that chorus. I would not want to get by without mine. Tim, I’m sorry you’ve had such bad experiences with electronic scales. I’ve never had a whisper of trouble with mine. Sounds like you lost the scale lottery. :wink:

The only other caution I would (gently) suggest is, make sure that the difference between ordinary and whole grain pasta is significant for your son—never mind how it behaves for anyone else. For many people the difference is substantial. For others, it isn’t. As always, YDMV and you need to determine what works in the individual case.

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Manny’s video didn’t open up. I’d love to watch it, though!

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I checked some of the boxes of pasta in my cupboard and most of them specified “Dry.” Because pasta absorbs more water the longer it cooks, cooked weight would never be consistent. It’s really the same with all foods that are cooked in water.

Like others, I often use a scale and always for things like cereal. CalorieKing is good for carbs, but you can also just Google the food followed by “carbs”.

Like others, I definitely recommend becoming comfortable with Carb Factors. After a while the important ones will be ingrained in your brain. Also you will learn some of the “portion” estimates as talked about in Think Like a Pancreas. This will be very helpful when you are out and about. Other parents are experts in things like this and will help you find your way.

Remember that nothing about T1 is perfect, especially for a child. Perfection is not attainable and no number of worksheets will guarantee the expected result every time. You are smart. You know your child. You will get better at this. Your child is more than diabetes and you want him to grow up healthy both physically and mentally.

Remember that many of us were diagnosed before home BG testing. Even your mistakes will probably give your child better BG results than we had 90% of the time.

You’re doing great. :grinning:

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