Still have a few questions after all these yrs!


(CJ1230) #1

I've been T1 for 12 yrs now and have been on a minimed pump for the past 6yrs, and lately I've been lacking the control that I've always wanted. I guess for me it's keeping up the moviation of doing well(espically since I've been through a pretty deep depression, but coming out of it now HOPEFULLY!!)

My main problem I guess is getting the insulin dosage as correct as possible. And I guess an example is tonight for supper(dinner) I had sweet potatoes- about half of the bag probably 1 cup to 11/2 cups and probably 1 cup of veggies(brooccli, caulifour and carrots) and 2 very and I mean VERY small chicken breasts cut up into stir fry with a fajita spice.

So when I sat down to eat I found the chicken with the spice to salty and couldn't eat it so all I really had was the sweet potatoes and veggies. And this happens quite often with me that when I sit down to eat I don't eat everything on my plate and I may have given already or I just wait to correct. But I have no idea what to give for the portions. And I find when I make other amounts than what is suggested on the package I don't know how much to give until after I've eaten and I just give a correction bolus.

And no I don't use the measuring cup or scales anymore because when I was trained on the pump 6 yrs ago the nurse just told me to count carbs and I really didn't have to worry about much else.

Just wondering if anyone has some tips for adjusting to what your eating in situations like this.

CJ


(therese) #2

We also had many situations like that - giving a dose of insulin based on what my son intended to eat.  Then having to correct afterwards. 

One suggestion that worked well for him being on the pump was to give a smaller bolus right before eating then another bolus right after to bring the amount of insulin as close as possible to cover his carbs.  If was unsure, he could give a correction after 2 hours when all previous insulin should have been working already. 

Hope that helps!

~ Therese 


(stilledlife) #3

Great idea Therese! I'm going to try this from now on! I have just been taking my insulin after the fact- it causes problems because I want the have insulin the moment my food touches my mouth- just like a non-d body does.

Keep having question CJ1230, you have very good ones!


(paulg765) #4

You know, CJ, all diabetics face the issue of when to administer a bolus and how much.  It was even worse when diabetics were only on a long or medium acting insulin like NPH only.  Sometimes a meal was delayed or it didn't consit of what you anticipated.  When I go to a restaurant I never take my bolus until the food hits the table.  I've had experiences when a restaurant kitchen was slow and we had to ask the waitress if we could please have a glass of juice until the meal comes.  Especially in a restaurant you've never been to before you might have no idea of the size of the portions.

I find with my metabolism that taking my bolus right when I begin to eat works fine.  If you've eaten alot of frozen prepared meals like Lean Cuisines, you start to get an idea of what 45 grams of carbs looks like.  If you sit down to eat a meal and it looks like two Lean Cuisines you can estimate 90 grams.  There is one quite remarkable website which allows you to look up the complete nutritional information for just about everything in the world.  You can even enter i the size of the portion and it will calculate everything for you.  It is USDA FOOD LOOKUP WEBSITE .  Try it... it's amazing!  The more you do it, the better you'll get at estimating without looking up.  You can amaze your friends with your knowledge of nutrition.

 

Paul


(Kristi1967) #5

When I was first put on the pump, the diabetes educator told me you can bolus immediately after eating, that way you know the exact carb amount you ate.  You just can't wait too long after eating... immediately is the key word.

Hope it helps, Kristi


(poodlebone) #6

[quote user="CJ1230"]And no I don't use the measuring cup or scales anymore because when I was trained on the pump 6 yrs ago the nurse just told me to count carbs and I really didn't have to worry about much else. [/quote]

 

But how can you count carbs correctly if you don't use measuring cups or scales?!  My measuring cups and especially my digital food scale are used every day.  At first it was a chore to weigh everything but I'm so used to it now.  Get a book of carb counts and you'll be able to accurately count carbs to figure the correct dose. 

 

I often don't eat exactly one serving of something.  If the bag or box says a servings is 1/2 cup (90g) I always weigh rather than use a measuring cup.  If my scale shows I've weighed out 120 grams, that means it's 1.33 servings and I can adjust the carbs based on the nutrition label.

Actually, I use Calorie King to log my food and it means I don't have to do all of the math because numbers don't always come out as nicely as in my example above.  If I weighed out 154g, I'd just enter it in Calorie King and it would list the info for me.  There are free sites online that you can use to look up different foods and log them to figure out carbs.

 

 


(Doug D) #7

Hi CJ -

I have been told like some of the others that you can bolus right after a meal so you know how many carbs you actually ate although I rarely do that.  On another note, sometimes we just have to get back to the basics.  A lot of us 'eyeball' our portions but our bodies change and our insulin requirements will change with it.  Every year I'll take a few weeks and literally measure and write down everything I eat.  It really helps me in terms of eyeballing portions and knowing how I will react to certain foods.  For example, I'll have different insulin requirements for natural carbs like fruits and veggies vs. the same amount of carbs for wild rice or bread.  Not sure if others have the same response but it couldn't hurt going back to the drawing board for a bit as it will help you in the long run.  Be well,

Doug


(CJ1230) #8

Hi Paul,

Thank you for the advice and for the website. I'm going to have to check that out. And I've had similar experiences at resturants to and now a days I really don't eat out any more, but when I do I will have to keep your advice in my head to remember.

About impressing my friends with my knowledge of nutrition, well some of them are already amazed on how I know certain things about what I'm eating and then some of them can't believe what I have to go through just to be able to sit down and have something to eat.

Again thanks for the website and the advice, hope we talk soon and that your having a good one.

CJ


(CJ1230) #9

Hi Everyone,

I wanted to say thankyou for the ideas about this and I wanted to answer Liz's concerns about not using a measuring cup or scales. When I'm dishing up supper(dinner) I know for a fact that my ladle that I use is excatly 1/2 cup and I've measured out things like 1 cup of spegitti(sorry have never been able to spell it right) so I have an idea what it looks like, and I think someone else said that alot of use "eyeball" our portions.

And when I was 1st diagnosed I did use the scales and measuring cups but over the yrs have gotten away from that and like I said the trainer on my 1st pump said "you don't have to worry about what you are eating just count the carbs". So when I did get onto the 1st pump I did use the measuring cups again and I tried to stick with portions that were as close as to what was measured out on food labels.

And Doug D, the endo did change my insulin about a yr ago from Humulog to NovoRapid and I'm finding the NovoRapid is doing well for now. From your post it seems like you have a good metabolism and I would love to have it as mine has really slowed down, so I am trying to get it going again by being more active but we all know that somedays you just don't feel like doing anything and with the recent dealings with the depression I starting to back into the swing of things.

I just wanted to reply to you to let you know that I am trying to get a handle on this again, but I would have never known that so many of us wait until just after we have eaten to get a better idea of what carbs you have just eaten. So I've learned my something new today!!LOL

So I think it's time for back to basics and not giving insulin until I've finished what is on my plate...

Thanks again

CJ


(paulg765) #10

Hi CJ,

I was having a "good one" until I just went low an hour after eating a peach!

At my last appointment my endocrinologist had changed the carb ration on my MiniMed 722 from one unit for 12 grams to one unit for 9 grams.  Since that time I've had a few lows after eating. This time  I programmed the 14 grams of carbs for the peach as listed on the website.  Before eating it my blood sugar was 105 (yes!), but an hour later it had fallen to 46 (ouch).

Diabetes management is always full of surprises!  Just think of all the "fun" non-diabetics are missing out of :)

 

Paul