# Re: [IPk] Carb counting

```Hi Jackie,

I had the good fortune to be diagnosed in 1969.  At first there was a
very regimented diet, which drove my mother spare, because there was a
lot of potatoes in it, and I refused to eat potatoes.  So the dietician
explained that 10g CHO in potatoes could be replaced with 10g CHO in

Shortly after (early 1970s), 'carbohydrate exchanges' were the rage.
Here, because it was assumed that people are stupid and can't deal with
real numbers, we were taught to count in blocks of 10g (others in 12, 15
or 20, depending on what number was thought good by the clinic).  We
were not taught to match insulin to CHO, but to inject the same amount
of insulin each day, and eat the same number of 'exchanges' at the same
time each day.

Then at some point we moved to real numbers.  The last time I saw a
dietician, prior to the post-pumping visit, was in 1983.  At that point
I was on 210g CHO a day. 50g of it at breakfast, but I didn't eat it!

I had by that point worked out my own carb-to-insulin ratio, and was
bolusing for what I actually ate.  But not telling the doctors that this
was what I did.

The dietician at Guy's was absolutely astonished that someone can read
off the back of the bread packet that a slice has 13g CHO in it, and
read off the beans tin that 100g has 4.5g in it, work out that there are
400g in a tin, and half a tin is therefore 9g, with two slices of bread
that makes a total of 35g in two slices of beans-on-toast!

Yes, there are people who can't add 13+13+9, and there are people who
cant work out 4.5*4/2 - either the mathematics, or work out that that is
the sum they need to do, but really, shouldn't those people be referred
to a Basic Skills remedial class?  Not told 'eat healthily'!

Illiteracy is a big problem for diabetics too, and I think the NHS is
criminal in that it is failing the illiterate and innumerate by ignoring
this aspect of diabetes management.  A reading and numeracy test should
be part of the instal diagnosis, as treatment will depend on it.

Best wishes,

Pat

In message <email @ redacted>,
Jackie Jacombs <email @ redacted> writes
>I am just wondering how all of you pumping learnt about carb counting if you
>were  not taught to do this.  Do the pump companies help you to do this?  If
>not, how did you teach yourselves.   I sort of do it now but I do not count
>fats and things.  If you are a parent of a child has any help/guidance been
>given?
>
>Jackie Jacombs
>email @ redacted
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--
Pat Reynolds
email @ redacted
"It might look a bit messy now, but just you come back in 500 years time"
(T. Pratchett)
----------------------------------------------------------
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```