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Re: [IP] Re: Counting carbs



Hey, thanks for this post.  A lot of good information here. I think it
will qualify to print out and study :)  Oh, and don't worry Buddy, I
printed out yours too..:) you seem to have such a down home "down to
earth" way of saying things, keep up those posts.. ;)

You mentioned info on the "fast food" stuff. I got a really cool guide
from my CDE, it's a book from Eli Lilly called "Nutrition in the Fast
Lane" A guide to Nutrition and Dietary Exchange Values for Fast Food. 
It lists some of the most famous restaurants and their menus.  And when
I have a Subway across the street from where I live it comes in awful
handy.
I'm not sure where my CDE got it but you can call 1-800-634-1993 and get
a copy. 

Forrest

email @ redacted wrote:
> 
> Scott:
> 
> One of the dilemmas with carb counting is how to estimate the carbs in
> foods which have no labels attached to them (such as when dining out, or
> trying "strange" foods). Naturally, labelled foods make life easier ...
> 
> You are correct in saying that the skill develops with experience and
> through trial and error. Even after 19+ months on the pump, I still get
> stymied on occasion. There are others who have a great deal of experience
> with carb counting, but here's my .02:
> 
> Some tricks to try:
> 
> 1)  Is the food similar to another food you have successfully managed
> before? If so, estimate based on this past experience.
> 2)  If uncertain, it is generally safer to *under bolus* rather than *over
> bolus*. I would rather deal with a high BG resulting from a meal, than deal
> with a low BG resulting from too large a bolus.
> 3)  What has been your overall activity levels prior to the meal? If very
> active, such as you might be when at a picnic with volleyball, etc,. it may
> be *safe* to nibble or snack on familiar foods without the bolus. If
> relatively inactive, you will probably need a higher bolus, or choose to
> eat smaller portions (or forego some of the meal altogether).
> 4)  Someone mentioned to me that a *conservative* estimate for many carb
> based foods is 10 grams of CHO for each *portion*. Obviously, this is an
> estimate based on *normal size portions*, food not heavily sauced or
> sweetened, etc. Initially, I was a bit skeptical of this approach, but have
> been able to adopt it to my needs. It generally works well for me.
> 
> Of course, as Buddy mentioned, checking BGs frequently after eating new
> foods will allow you to make adjustments if your BG is too high. Add the
> results to your *database*, and your next experience should be a little
> easier ;-)
> 
> I don't agree with the statement that "Something else you will find is that
> EVERY meal you normally eat will require between 5 and 12 units of
> insulin". I have never bolused 15 units for a meal at any time during my
> pumping experience. Each of us requires a different insulin to carbohydrate
> ratio, which is the basis for determining the amount to bolus for a given
> amount of carbs. There are some users who only bolus a set amount for each
> meal, with little variation in the meal content (probably not *true* carb
> counting).
> 
> Personally, I use a ratio of 1 unit of Humalog to 20 grams CHO for
> breakfast, and a ratio of 1 unit of Humalog to 15 grams of CHO for lunch
> and dinner. For me, that means a typical breakfast bolus of 2 units,
> anywhere from 5 to 8 units for lunch, and 4 to 7 units for dinner (actual
> amounts vary, of course).
> 
> I think books do help. Corrine Netzer's is one I have looked at, but do not
> own. Sometimes I will sneak into the bookstore when I am out, look up some
> info, then jot some notes for later on. I can't recall the name of the book
> I own (I think one of the author's names is Pennington), but it is a very
> valuable resource, even with all the food labels that are available. It
> also has references to *fast foods* which are useful. My wife is a very
> inventive, wonderful cook, and this book has allowed us to really enjoy the
> flexibility of the pump.
> 
> Your mileage may vary (YMMV) and this should get easier as you progress.
> 
> Best of luck to you.
> 
> Bob Burnett
> 
> mailto:email @ redacted