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Counting Carbs For Insulin

Insulin And Carb Counting

Insulin And Carb Counting

Matching Insulin to Carbs Matching insulin doses to the amount of carbohydrates consumed helps control blood sugar levels. This advanced carb counting method also can allow those with diabetes to be able to make more food choices. Used with 3-4 daily shots of insulin or an insulin pump, matching insulin doses to carb count mimics the action of a pancreas. To do this, each individual has to figure out his or her insulin-to-carb ratio. For example, 1 unit of insulin may be needed for every 15 carbs eaten. Ratios vary between individuals and can change over time. A healthcare provider can help determine your insulin-to-carb ratio. Be sure to test blood sugar before and 2 hours after a meal How to Use Your Insulin-to-Carb Ratio: Add up the total number of carbohydrate grams in a meal. Divide the total number of carbohydrate grams by your insulin-to-carb ratio. Inject the insulin needed to match your carbohydrate intake. Example: Your meal has a total of 45 carbohydrate grams. Your insulin-to-carb ratio is 1 unit per 15 carbohydrate grams. So, 45 grams divided by 15 equals 3 units of insulin needed for this meal. Insulin Correction Factor An insulin correction factor (ICF) is how many points blood sugar drops with 1 unit of insulin. ICF varies among individuals and corrects high or low pre-meal blood sugar levels. An ICF dose is either added or subtracted to the dose given before the meal. How to Use Your ICF: Subtract your target blood sugar level from current blood sugar level. Divide by your ICF. Adjust pre-meal insulin dosage accordingly. (Current Blood Sugar - Target Blood Sugar) ÷ Insuling Correction Factor = Correction Insulin Dose Example: Your current blood sugar level is 200 and your target blood sugar level is 120. This is a difference of 80, which is divided by Continue reading >>

Calculating Insulin Dose

Calculating Insulin Dose

You'll need to calculate some of your insulin doses. You'll also need to know some basic things about insulin. For example, 40-50% of the total daily insulin dose is to replace insulin overnight. Your provider will prescribe an insulin dose regimen for you; however, you still need to calculate some of your insulin doses. Your insulin dose regimen provides formulas that allow you to calculate how much bolus insulin to take at meals and snacks, or to correct high blood sugars. In this section, you will find: First, some basic things to know about insulin: Approximately 40-50% of the total daily insulin dose is to replace insulin overnight, when you are fasting and between meals. This is called background or basal insulin replacement. The basal or background insulin dose usually is constant from day to day. The other 50-60% of the total daily insulin dose is for carbohydrate coverage (food) and high blood sugar correction. This is called the bolus insulin replacement. Bolus – Carbohydrate coverage The bolus dose for food coverage is prescribed as an insulin to carbohydrate ratio. The insulin to carbohydrate ratio represents how many grams of carbohydrate are covered or disposed of by 1 unit of insulin. Generally, one unit of rapid-acting insulin will dispose of 12-15 grams of carbohydrate. This range can vary from 6-30 grams or more of carbohydrate depending on an individual’s sensitivity to insulin. Insulin sensitivity can vary according to the time of day, from person to person, and is affected by physical activity and stress. Bolus – High blood sugar correction (also known as insulin sensitivity factor) The bolus dose for high blood sugar correction is defined as how much one unit of rapid-acting insulin will drop the blood sugar. Generally, to correct a high bloo Continue reading >>

Understanding Advanced Carbohydrate Counting — A Useful Tool For Some Patients To Improve Blood Glucose Control

Understanding Advanced Carbohydrate Counting — A Useful Tool For Some Patients To Improve Blood Glucose Control

Today’s Dietitian Vol. 15 No. 12 P. 40 Suggested CDR Learning Codes: 2070, 3020, 5190, 5460; Level 3 Take this course and earn 2 CEUs on our Continuing Education Learning Library Click here for patient handout Carbohydrate, whether from sugars or starches, has the greatest impact on postprandial blood sugar levels compared with protein and fat. For this reason, carbohydrate counting has become a mainstay in diabetes management and education. Patients with type 1 or 2 diabetes benefit from carbohydrate counting in terms of improvements in average glucose levels,1,2 quality of life,2,3 and treatment satisfaction.3 Basic carbohydrate counting is used to keep blood glucose levels consistent, while advanced carbohydrate counting helps with calculating insulin dose. Both basic and advanced carbohydrate counting give people with diabetes the freedom to choose the foods they enjoy while keeping their postprandial blood glucose under control. This continuing education course introduces advanced carbohydrate counting as a tool for improving blood glucose management, evaluates basic and advanced carbohydrate counting, describes good candidates for advanced carbohydrate counting, and discusses strategies for counseling patients as well as precautions when using advanced carbohydrate counting. Basic Carb Counting Basic carbohydrate counting is a structured approach that emphasizes consistency in the timing and amount of carbohydrate consumed. Dietitians teach patients about the relationship among food, diabetes medications, physical activity, and blood glucose levels.4 Basic carbohydrate counting assigns a fixed amount of carbohydrate to be consumed at each meal and, if desired, snacks. Among the skills RDs teach patients are how to identify carbohydrate foods, recognize serving s Continue reading >>

Net Carbs Vs. Total Carbs: What Counts?

Net Carbs Vs. Total Carbs: What Counts?

People often wonder if they should count their net carbohydrates or total carbohydrates, which appear on some food labels. Medtronic Diabetes Clinical Manager for Cape Cod, Massachusetts, Katie Crupi-Sullivan, RD, CDE, tackles net carbs, and the advice she gives her patients with diabetes. Net Carbs or Total Carbs: “I’m confused” One of my patients recently asked me about a low carb bar her Mom had purchased for her to use as a quick snack. She wanted to know, “What is the deal with net carbs?” Net carbs was a phrase coined by the food industry when low carb diets became popular about a decade ago, and doesn’t have a formal definition. It’s not a term recognized by the Food and Drug Administration (FDA) or American Diabetes Association (ADA). Net carbs usually subtract fiber, sugar alcohols, and glycerin from the total carbohydrates. This can be misleading for anyone counting carbs and using insulin to carb ratio to bolus for food. When is it appropriate to subtract fiber or sugar alcohols from total carbs? Looking at my patient’s pump download on CareLink, I realized when she ate the low carb bar, her blood sugar dropped. She asked, “What do I do to prevent these lows?” If you notice a low after eating high fiber foods (beans, whole grains, fiber fortified products or foods rich in sugar alcohols, sugar-free desserts and candies), there are rules set forth by the ADA: If a meal has more than five grams of total fiber, you can subtract half the total fiber from the total carbohydrate If a food contains sugar alcohols, you can subtract half the total sugar alcohol from the total carbohydrate (Keep in mind that these are general guidelines and might vary for each individual so keep a close eye on your blood glucose.) What’s the deal with sugar alcoho Continue reading >>

What Is An Insulin-to-carb Ratio?

What Is An Insulin-to-carb Ratio?

If you use fast-acting insulin and count carbohydrates, you want to know your insulin-to-carbohydrate ratio. An insulin-to-carb ratio allows you to easily figure out how much of your fast-acting insulin is needed for the amount of carbohydrate you consume. You can talk to your health care provider or certified diabetes educator (CDE) to help you know where to start and then through trial and error you can figure out the right ratio for you. An example of an insulin-to-carb ratio is 1:15 meaning one unit of insulin is needed for every 15 grams of carbohydrate. Someone needing more insulin may have a ratio of 1:10 and someone needing less insulin may have a ratio of 1:20. When you are trying to figure out your correct ratio, it is helpful to write down your blood sugar levels and check more frequently to see how the insulin-to-carb ratio you used affected your blood sugar levels two hours after eating. Calculating the best insulin-to-carb ratio is a process of trial and error: Check your blood sugar before eating and write down your result. Count your carbs and give your insulin and write down the insulin-to-carb ratio you are using. Check your blood sugar 2 hours after eating and write down your result. Try this process out a for a few days before adjusting your ratio. When you do adjust your ratio, do so in small, safe increments. When an insulin-to-carb ratio works consistently well, keep it! But remember that factors like illness, skipping a meal, extra exercise, stress and other changes in routine may cause your insulin-to-carb ratio to change. In the book Using Insulin, the authors share the Rule of 500 to figure out a good starting ratio. This applies to people with type 1 diabetes who are taking multiple daily injections of insulin. They write: Your body is often Continue reading >>

Carb Counting

Carb Counting

Straight to the Point It’s important to keep in mind that there’s no such thing as a ‘diabetes diet’. With the help of your health care professionals, you can tailor your insulin treatments to suit your diet and lifestyle (you can still eat out and be spontaneous when you have type 1 diabetes!) and ensure that your blood glucose levels stay in control. A key component of managing your insulin regime is learning ‘carb-counting’. That’s because you need to match your insulin intake to your carb intake to ensure that you achieve the target range for blood glucose levels. Everyone’s insulin-to-carb ratio is different, and your health care professionals will help you figure out how many units of insulin you need for each ‘exchange’ of carbs. An ‘exchange’ is normally 10 or 15 grams of carbs, or a third of a cup of cooked pasta, two taco shells, 250ml of milk, or a slice of sandwich bread. Counting all the exchanges in a meal will help you decide how much insulin to take with each meal. Example: Jane’s health care professional recommends an insulin regime of one dose of long-acting insulin at night, and short-acting insulin for meals and corrections. She is recommended to have two units of insulin per exchange of carbs that she eats. For breakfast, Jane has two Weetbix (three exchanges) in 250ml of milk (one exchange) and a medium-sized banana (one and a half exchange). To cover this meal, Jane injects eleven units of insulin to match her insulin intake to her food intake. The important thing to remember is that carb-counting and insulin-to-carb ratios are different for everyone. Your health care professional can recommend the best insulin program for you. Want to learn more about carb counting and other type 1 diabetes topics? Continue reading >>

The Nuts And Bolts Of Carb Counting

The Nuts And Bolts Of Carb Counting

If you’re living with Type 1 diabetes, you might find that carbohydrate counting, or carb counting, is an effective way of managing your blood glucose levels – it means that your insulin dose can be individually matched to the amount of carbohydrate you eat and drink. Being aware of the amount of carbs in food and drinks is important for everyone with diabetes, but carb counting is particularly helpful for those on basal-bolus insulin regimen. This is when the person with diabetes (mostly Type 1 diabetes) injects insulin with each meal or uses an insulin pump. Although carb counting requires a great deal of time and effort, once mastered it can lead to better blood glucose control and greater flexibility in the times and amount of carbohydrate you eat. It doesn't mean total freedom to eat whatever you want in excess as this would be unhealthy for anyone, although special occasions and treats can be more easily incorporated and insulin adjusted to match. Carbohydrates can be counted in two ways, in grams or as carbohydrate portions (CP). One CP is usually equal to 10g of carbohydrate. It is important that you find the method that works best for you. Once you’ve got to grips with estimating the amount of carbohydrate you are going to eat and drink, the next key piece of information you need is your insulin-to-carbohydrate ratio. Insulin-to-carbohydrate ratios vary from person to person, so you will have your own personal ratio depending on your age, weight, activity levels and how sensitive you are to insulin. Your diabetes healthcare team will help you work it out and, eventually, you may even have a different insulin to carbohydrate ratio for each meal. They will usually estimate your starting insulin-to-carb ratio and subsequently fine-tune this based on your blo Continue reading >>

The 500 Rule | Diabetesnet.com

The 500 Rule | Diabetesnet.com

Wed, 12/15/2010 - 16:38 -- Richard Morris The 500 Rule (aka 450 Rule) from Using Insulin and the Pocket Pancreas is a great way to estimate how many grams of carbohydrate will be covered by one unit of Humalog or Novolog insulin. This is your insulin to carb ratio or your carb factor. Once you know this, you can count the grams of carb in the food you want to eat and divide by your carb factor to find how many units of bolus insulin are needed to cover the carbs. This allows flexibility in your food choices because any number of carbs can be covered with a matching dose of insulin. The 500 Rule used to determine your carb factor depends on accurately knowing your TDD. As with basal doses, an accurate carb factor can be determined only after you've calculated an accurate TDD for yourself. estimates grams of carb per unit of Humalog or Novolog insulins (the 450 Rule is used with Regular insulin) 500 divided by your TDD (Total Daily Dose of insulin) = grams of carb covered by one unit of Humalog or Novolog Lets you keep your post meal readings normal! Someone's TDD = 50 units (i.e., the total amount of say Humalog and Lente insulins they used per day). 500/50 = 10 grams of carbohydrate covered by each unit of Humalog insulin TDD = all fast insulin taken before meals, plus all long-acting insulin used in a day. If Humalog is used everyday to correct high readings, this may also need to be factored into the TDD. For instance, if someone's TDD is "30 units" (5 H before each meal, plus 15 Lantus at bedtime), but they need 8 to 12 units more almost every day to bring down highs, at least some of this 8 to 12 units will need to be factored into a new TDD. Caution: The 500 Rule will be most accurate for those who make no insulin of their own and receive 50% to 60% of their TDD a Continue reading >>

Carbohydrate Count In Insulin Dosing

Carbohydrate Count In Insulin Dosing

Aka: Carbohydrate Count in Insulin Dosing, Insulin Adjustment with Carbohydrate Counting II. Management: Step 1a - Determine Carbohydrate to Insulin ratio Option 1: Known dose from multiple daily doses or Insulin Pump Option 2: Calculate based on patient weight WtKg x 0.3 units/kg: Underweight, advance age, Dialysis WtKg x 0.6 units/kg: Obese, steroid use, high Insulin Resistance Option 3: Simple carbohydrate based-method (below in Step Ib) Plan to split the basal Insulin and Bolus Insulin evenly (50% to each) Uses 1 unit per carbohydrate PLUS 1 unit per 50 over 150 Blood Sugar of 200 at lunch and having prepared a 4 carbohydrate meal Takes a total of 6 units: 4 units (4 carbs) plus an additional 2 units (for Blood Sugar of 200) Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Carbohydrate Count in Insulin Dosing." Click on the image (or right click) to open the source website in a new browser window. Search Bing for all related images Related Studies (from Trip Database) Open in New Window Continue reading >>

45 Top Carb-counting Tips

45 Top Carb-counting Tips

Tried-and-true tactics for fine-tuning your techniques and attitudes Carb counting sounds simple. After all, anyone who's passed third grade knows the basics of adding numbers. Unfortunately, counting carbohydrate grams isn't as easy as one, two, three. That's why Diabetes Forecast went to the experts for help. Who better to give tips on carb counting than the people who do it day in and day out? Read on for 45 tried-and-true carb-counting how-tos. "It's really important to work with your doctor," says Tammy Walker, 36, who was diagnosed with type 1 diabetes four years ago. "If you're newly diagnosed and your doctor doesn't have the experience, have your doctor refer you to a dietitian to teach you how to eat." "It's getting past that initial 'I can't do it,' " says Daniele Hargenrader, 31, who's had type 1 diabetes since she was 8. "The first days and weeks are the hardest. Anyone can change." Count total carbohydrate grams, not just the sugar grams listed on the food label, says David Frank, 41, who was diagnosed with type 2 diabetes a year ago. A cereal may only have 1 gram of sugar, for instance, but 21 grams of carbohydrate. "You have to look at the carbohydrates because carbohydrates break down into sugar." "The only way you can really know what your blood sugar is doing is if you have a readout. You can't guess what your blood sugar is," says Hargenrader. "And you can't guess how many carbs you need if you don't check your blood sugar." Checking before a meal and about two hours after the first bite shows you how what you eat affects your blood glucose. Intensive insulin users may do this frequently; for others, it can be helpful to do so when starting new medication or making other treatment changes. "They start to remember things," says Gabrielle Brits, whose Continue reading >>

Carbohydrate Counting 101

Carbohydrate Counting 101

Carbohydrate Counting 101 There are several different ways people with diabetes can manage their food intake to keep their blood glucose (sugar) within their target range and one such method is 'carbohydrate counting'. Carbohydrate, or carb counting is a method of calculating grams of carbohydrate consumed at meals and snacks. Foods that contain carb have the greatest effect on blood glucose compared to foods that contain protein or fat. Before starting any new treatment or meal plan, you should always consult with your diabetes care professional. What are the benefits of counting carbs? ·Counting carbohydrates is a good solution for many people with diabetes. Once you learn how to count carbs, you’ll find it easier to fit a wide variety of foods into your meal plan, including combination foods such as those in frozen dinners. For example, by checking the grams of total carbohydrate on the Nutrition Facts label on a frozen dinner, you can figure out how to fit the dinner into your carb allotment for a particular meal. Many people find carb counting to be much easier than using a more traditional exchange meal plan. ·Another benefit of counting carbohydrates is that it can bring tighter control over your glucose readings. Being as precise as possible with your carb intake and medication will help you better manage your blood glucose after meals. ·Lastly, if you take mealtime insulin, counting carbohydrates allows you to decide how much carb you want to eat at a meal, rather than having to eat a certain amount of carbohydrates, even if you do not want to. Who can use carbohydrate counting? Carbohydrate counting can be used by anyone with diabetes, not just people taking insulin. This method is also useful for people who are using more intensive methods of adjusting i Continue reading >>

Carb Counting - What Is Carb Counting And How To Count Carbs

Carb Counting - What Is Carb Counting And How To Count Carbs

Tweet Carb counting is a way of better understanding how carbohydrates affect your blood sugar, medication requirement and insulin requirement. For people with type 1 diabetes and those with type 2 diabetes who require insulin, carbohydrate counting is a way of matching insulin requirements with the amount of carbohydrate that you eat or drink. For people with type 2 diabetes who don’t require insulin, carbohydrate counting is a way of regulating the amount of carbohydrate you consume and monitoring how this affects your blood glucose control, weight management and medication intake. Carbohydrate counting requires patience and diligence. Learning it successfully means understanding carbohydrates, learning how to adjust your insulin or medication accordingly, and measure yor blood glucose levels regularly for clarity. What are carbohydrates? Every carbohydrate we eat is converted into glucose and has an impact on blood sugar levels. Carbohydrates are commonly found within the following foods: Grains (breads, pasta, cereals) Fruits Vegetables Root crops (potatoes, sweet potatoes, and yams) Most alcoholic drinks (Beer, cider, lager, most cocktails) Desserts and sweets Most dairy products, except cheese, Sugars including sucrose, fructose, dextrose, maltose How should I count carbohydrates? Most people count carbohydrates using grams, with one serving equal to 15 grams of carbohydrate. Most foods are only partially carbohydrate (although some foods are entirely carbohydrate), but the effect of 15 grams carbohydrate will be the same whether it is from bread, biscuits or other foods. To ascertain the carbohydrate content of these foods, it is necessary to use food labels, reference books or computer programs, and a scale and list of carbohydrates. There are two methods of c Continue reading >>

Carbohydrate Counting & Diabetes

Carbohydrate Counting & Diabetes

What is carbohydrate counting? Carbohydrate counting, also called carb counting, is a meal planning tool for people with type 1 or type 2 diabetes. Carbohydrate counting involves keeping track of the amount of carbohydrate in the foods you eat each day. Carbohydrates are one of the main nutrients found in food and drinks. Protein and fat are the other main nutrients. Carbohydrates include sugars, starches, and fiber. Carbohydrate counting can help you control your blood glucose, also called blood sugar, levels because carbohydrates affect your blood glucose more than other nutrients. Healthy carbohydrates, such as whole grains, fruits, and vegetables, are an important part of a healthy eating plan because they can provide both energy and nutrients, such as vitamins and minerals, and fiber. Fiber can help you prevent constipation, lower your cholesterol levels, and control your weight. Unhealthy carbohydrates are often food and drinks with added sugars. Although unhealthy carbohydrates can also provide energy, they have little to no nutrients. More information about which carbohydrates provide nutrients for good health and which carbohydrates do not is provided in the NIDDK health topic, Diabetes Diet and Eating. The amount of carbohydrate in foods is measured in grams. To count grams of carbohydrate in foods you eat, you’ll need to know which foods contain carbohydrates learn to estimate the number of grams of carbohydrate in the foods you eat add up the number of grams of carbohydrate from each food you eat to get your total for the day Your doctor can refer you to a dietitian or diabetes educator who can help you develop a healthy eating plan based on carbohydrate counting. Which foods contain carbohydrates? Foods that contain carbohydrates include grains, such as b Continue reading >>

How To Count Carbs In 10 Common Foods

How To Count Carbs In 10 Common Foods

What are carbohydrates? Carbohydrates are sugar-based molecules found in many foods, from cookies to cantaloupes. If you have diabetes, planning your carb intake—and sticking to the plan—is critical to keep blood sugar on an even keel and to cut your risk of diabetes-related problems like heart disease and stroke. Whether or not you have diabetes, you should aim to get about half your calories from complex carbohydrates (which are high in fiber), 20-25% from protein, and no more than 30% from fat, says Lalita Kaul, PhD, RD, a spokesperson for the American Dietetic Association. How to read a food label The Nutrition Facts label lists the total amount of carbohydrates per serving, including carbs from fiber, sugar, and sugar alcohols. (If you're counting carbs in your diet, be aware that 15 grams of carbohydrates count as one serving.) Sugar alcohols are often used in sugar-free foods, although they still deliver calories and carbs. Sugar alcohols and fiber don't affect blood sugar as much as other carbs, because they're not completely absorbed. If food contains sugar alcohol or 5 or more grams of fiber, you can subtract half of the grams of these ingredients from the number of total carbs. (See more details at the American Diabetes Association and University of California, San Francisco.) How many carbs per day? If you eat 2,000 calories a day, you should consume about 250 grams of complex carbohydrates per day. A good starting place for people with diabetes is to have roughly 45 to 60 grams of carbs per meal and 15 to 30 grams for snacks. While snacks are key for people with diabetes who use insulin or pills that increase insulin production (otherwise, they run the risk of low blood sugar), they aren’t essential for non-insulin users. The goal for anyone with diab Continue reading >>

Carb Counting

Carb Counting

Last week we talked about two types of diabetes meal planning tools: the exchange system and the plate method. While both of these approaches can work well, today, more and more people with diabetes are turning to carbohydrate counting. Carbohydrate, or “carb”, counting, really isn’t all that new. In fact, Dr. Elliott Joslin taught carb counting to his patients back in the early part of the 20th Century: “In teaching patients their diet,” he said, “I lay emphasis first on carbohydrate values, and teach to a few only the values for protein and fat.” Patients who came to Joslin Clinic in those days were taught by Dr. Joslin himself, and today, the walls of Joslin Diabetes Center are lined with pictures of folks from that period sitting in a classroom with gram scales in front of them for the purpose of weighing their food. Since those days, many aspects of diabetes care have changed for the better, but carb counting has made a comeback as an effective yet simple approach to help people better manage their diabetes. There are actually two types of carb counting. The first type, often called basic or consistent carb counting (or, as one of the doctors at Joslin likes to say, “CC”), is usually what most people with diabetes learn about these days. Basic carb counting isn’t a diet, but rather a tool to help you better plan meals and learn how your food choices affect your blood glucose levels. As you may know, most of the carbohydrate we eat turns to glucose (sugar) during digestion. Our bodies then use this glucose for energy. Let’s review the types of foods that contain carbohydrate: Bread, pasta, cereals, rice Starchy vegetables (corn, peas, potatoes, lima beans) Fruit and fruit juices Milk and yogurt Sweets and desserts (Non-starchy vegetables, such Continue reading >>

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