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Re: [IPk] Carb Book


Thanks for the info. on the book, I shall get my daughter to go and buy it
for me - I'm sure I won't be able to buy it here in the US.

My apologies in advance for the length of this posting, earlier replies have
touched upon a subject that I am passionate about.

Re. your earlier posting, I agree with you John, it's easy to carb count and
then bolus accordingly, but like you I don't live out of a box either. 

It's strange that the BDA do not advocate carb. counting, here in the US it
is advocated very strongly, it makes you wonder if the two organisations
communicate!  I do believe though, that the ADA also still support the
older, 'exchange method' - I tried this when I was on MDI and found it to be
grossly inaccurate, so I have been carb. counting for about 4 months now. 

Since I have been pumping, and this is now my sixth week, my BG's numbers
are much better and more stable, 75 - 140, [4.1 - 7.7] for the most part. Of
course I still have the occasion when I stray way, way below or above these
numbers, but generally that's due to me doing something stupid. 

With the above in mind, I think it's very important to know the reason
behind our highs and lows. Many others I have spoken with don't, they just
say, "It's because I've got DM" and wait for their doctor to work it out for
them. Without this intuitive knowledge, it must be very difficult to bolus
correctly - thus making self propagating and therefore problematic

So how do I do it? The simple answer is to keep records of what is eaten and
learn by experience, but that's a bit too simplistic - I eat in restaurants
daily for lunch,  so when I started counting, I went to the same place
frequently and adjusted the bolus until it was correct. I have now found
that I can make a very reasonable estimate of the carbs. I eat, of course
every day maybe a new learning experience as I may eat something new - so I
take a guess - on the low side generally and then do a high BG bolus later.
I then add the high BG bolus to the meal bolus and use the result as the
basis for the next similar meal. Of course, it's lots of hassle writing
everything down and carrying a carb. value book around, but I am finding it
is getting easier daily as carb. values are being committed to memory - I'm
sure one day I won't need the carb value book soon, except for exceptional
things I may eat.

So John, from my experience I have found that meticulous record keeping is a
'must'. I can respect Euan's reluctance not to do this, but I cannot agree
with it, after all the fundamental reason we need insulin is because our
bodies cannot deal with the carbo naturally, and how can the insulin doses
be calculated accurately, if we don't know our carbo intake? Without carbo
values, basals and bolus's can be no better than a 'shot in the dark' - and
therefore result in a considerable number of 'roller coaster days'. 

Hope this is of help John, and once again an apology for its length.

Happy pumping.


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