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RE: [IPk] Carb counting training

thanks or your help - everyone is so wonderful!!
I have experience with type 1 patients but ths is definitely new.
Unfortuniately most people are really into GI here, particularly up
north and see it a bit backward to carb count again. I plan to bring in
food and the equations i know so it should run smoothly. I have taken a
previous/injection only group to a canteen - i don't know if this will
be a as valuable to this group as we are meeting after dinner.... Any
other suggestions would be greatfully received. I will let you all know
how i get on. julette :)

> -----Original Message-----
> From:	John Neale [SMTP:email @ redacted]
> Sent:	20 September 1999 15:14
> To:	email @ redacted
> Subject:	[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:)
> 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
> them...
> Crazy!
> 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 :-)
> John
> --
> mailto:email @ redacted
> http://www.webshowcase.net/johnneale
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