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Re: [IPk] carbo counting

Hi kathryn -

Carbohydrate counting (or carbohydrate assessment) enables you to exactly 
match your insulin dose to the total carbohydrate in a meal. Matching your 
insulin does to your total carbohydrate enables you to maintain more even, 
normative blood sugars.

In order to effectively carbohydrate count, you need to know your 
insulin/carb ratio, which is the number of grams of carbohydrate covered by 
one unit of insulin. For example, my insulin/carb ratio is one unit covers 
16 grams of carbohydrate. Everyone has a different insulin/carb ratio. Some 
people have different ratios at different times of the day; for example, 
someone might need one unit for every 12g of carb at breakfast but one unit 
for every 15g of carb the rest of the day.

You can find out your insulin/carb ratio by asking your clinic to tell you, 
by trial and error (many people know, for example, how many units to take 
for a slice of toast. A standard slice of bread has 15 -17g of carb, so you 
can work out the ratio from there), or by referring to tables that suggest a 
starting rate based on weight or total insulin useage.

You should check your ratio occasionally by eating a meal in which you know 
the total carbohydrate and which is low in fat and protein. Begin by testing 
and taking your insulin. Eat the meal, and test at two hours and then again 
when your insulin is finished (3-4 hours for humalog, 4-5 hours for 
novorapid, 5-7 hours for actrapid). At two hours, your BG should be less 
than 10 mmol; at the end of your insulin, it should be within a few points 
of your starting blood sugar. For example, say you started at 5.5 mmol and 
you finished at 5.9. You are using the correct insulin/carb ratio. But if 
you started at 5.5 mmol but finished at 7 mmol, something is not correct.

Once you know your carb ratio, you can use food labels, books, info others 
pass to you, to determine the total carbohydrate in a meal. For example, 
I've just eaten a bar called a Nine Bar (yum!), which has 38.5g carb per 
100g, which is 19.25g per bar. I get 16g of carb per unit, so 19.25/16 is 
1.2 units.  I have a calculator handy because I'm at work, but if I had been 
doing the maths in my head, I would have said, '20g, hmm, that's about 1.3 
units' and had 1.3 units.

I hope this helps. Ask more, because I need the practice! Everyone, if there 
are any factual errors in any of the above, let me know ASAP because I need 
to be word perfect by the 17th Nov!


p.s. IP admins, when I finish my insulin/carb ratio chart, would you like it 
for the website? With a disclaimer, of course.


Grain is the enemy of the sedentary classes.

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