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[IPk] Carb counting training

>Thanks for your input. I have an education session first one for pump
>ptients here on wednesday and i like equating carbs to food as you
>suggested. I generally relate most things to one piece of bread equals
>15g and compare foods from there. I am thinking of bringing in some food
>samples and illustrating how much carb there is in each plate sample. I
>know it is trial and error against personal BGL with regard to insulin
>sensitivity and how long digestion takes etc.. but what do you think of
>the pracical? Any other examples you found useful? thanks for your help

Julette - Hi :)

I've had diabetes for 22 years, and have used a pump for the last 2 years...

>From my experience, it seems that different clinics have different
attitudes to carb counting. Some feel it unnecessary, others believe
patients don't do it even if you tell them to, so they don't bother to tell


For me, with a pump, carb counting is absolutely essential in order to reap
the benefits a pump offers: to be able to actively control your bg
throughout the day and night.

I'm not sure how much you know about pumping, but to recap: each patient
must establish how much carbohydrate is metabolised by one unit of insulin.
There are procedures for doing this which your clinic will be familiar with
if they support insulin pumps. Once you have this ratio, the door to the
kitchen is unlocked, since you can meet any reasonable amount of food with
the correct amount of insulin.

I don't know what others feel, but I believe there are 3 stages to becoming
a professional carb counter:

First you must be able to accurately calculate the carb content of any food
within the home. This means being able to interpret the nutrional panel on
most prepackaged food, and doing the associated maths, and knowing the carb
content (g per 100g) of most food ingredients. General lists are good, and
I also find the Collins Gem Calorie Counter a very good resource -
everything is listed (apart from Magnum Classics! ;-) Add it all up on a
calculator, divide by your carb ratio, adjust it for your existing bg, and
you have your required insulin dose. And it works! That's what is amazing.

The second stage is being able to accurately guess the carb content of a
plate of food, just by eyeballing it. This takes practice and experience,
but eventually you can get there. Pick up a piece of cake, feel it, take a
bite to see how fatty or starchy it is, and say I reckon that's 65g of
carb... If necessary, guess the content, then calculate it, and see how
close you were, and work out where you went wrong, and how you can improve
your guess next time. Obviously, you need this skill to eat in canteens and
restaurants where you may not have seen the food being prepared - and it's
not practical to be piling food onto a set of portable scales :-)

The third stage is being able to guess directly the insulin you require:
look at a pile of pasta, and say that looks like it needs 4.5 units of
insulin... again, it's a skill that you build up with experience.

As Di says, bring real food in. Do a shop at the supermarket, buy light
bread, heavy bread, cakey things, big orangess, little oranges... and let
us know how you get on :-)


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