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Re: [IPk] Carb counting training



Hi John

I think Carbohydrate Assesment is an excellent term to use. Although it is 
not an exact science, I have always felt that it is useful tool or guide to 
judging how much insulin is needed to cover what you are going to eat.

Steven

At 18:44 23/09/99 , you wrote:
>Julette
>
>Most clinics I travel to in the UK regard the need for calorie counting as a
>retrograde step as this was done in the exchanges system.  The reason given
>is that the emphasis is now on healthy eating.  I fail to see how healthy
>eating and assessing the carbohydrate content of a meal to (gauge the
>correct amount of insulin required), are mutually exclusive.
>
>I suggest we use a different term such as carbohydrate assessment - this
>denotes a less regimented approach that does not imply the use of scales.
>People going on to the pump for the first time feel that assessing their
>carbohydrates and matching up their insulin dose is logical and helps them
>to understand insulin adjustment
>
>Best wishes
>
>John H (Disetronic)
>-----Original Message-----
>From: Julette Kentish <email @ redacted>
>To: 'email @ redacted' <email @ redacted>
>Date: 20 September 1999 16:36
>Subject: 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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