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Re: [IP] carb counting

> She said that I am not counting carbs right.
>  That I have to measure my milk in a measuring cup
> (not pour it in an 8oz glass, because it may be 9 oz.
> or 7 oz.) and that I have to have a diet scale.  I
> have been using a carb reference book to get carb
> values of food - she said that is not acceptable.
> I would just like some input from other people - how
> do you count carbs - very, very accurately, or
> educated estimates, or another way.  This lady will
> make my life miserable.  She said I will not be able
> to start pumping for at least 3 months - have to
> practice carb counting until then!!!!  Even my endo
> thinks she is crazy, but he leaves everything up to
> the CDE who is not saying anything much - she let the
> dietician run on and on.  
> So...what do ya'll think.  Do I need a scale?

There is a middle ground here. Carb counting needs to be accurate to 
be effective. The CDE sounds like nurse Rachet though. When you begin 
carb counting it is not easy to accurately estimate carbs, even when 
pouring milk into a 9 oz glass :-). The other side of that is after a 
while, you become very good at estimating and you will be able to 
tell by looking at a glass if it is 8 oz or 9oz or 7 oz, and 
adjusting accordingly. I am continually amazed by my daughter's 
ability to go out to a resturant for dinner and "inspect" the plate 
and do a bolus that will keep her bg's within acceptable range -- it 
doesn't always work, but usually it does. The ability comes from 
months of studiously measuring every morsel of food by volume or 
weight and carrying around a book full of carb conversions. Now she 
can draw on all of that from memory and it is automatic. No, it is 
not as easy as counting exchanges, but it's a heck of a lot more 
accurate and will become as easy for you with time.

The three things you need for measurement are
1) a good scale
2) a one cup measure
3) a tablespoon measure

For a long time after Lily started pumping, we toted a portable scale 
into resturants when we dined out and always asked for a "water 
glass" (standard 8 oz) to measure stuff like rice and potatoes when 
we forgot to bring a measuring cup. Like I said, now she just looks 
at the plate. Practice makes perfect.

All of that said, I see no reason whatsoever why you should wait 3 
months to go on the pump because the CDE is some kind of control 
freak. Practicing carb counting while using a pump is the absolute 
best way that I can think of to see the results and get immediate 
feedback about how you are doing. I sure won't work nearly as well 
with MDI and the unpredictable long terms insulins.

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