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:
(Non-starchy vegetables, such as broccoli, green beans, and carrots have a little carb, but not enough to affect blood glucose levels unless you eat large amounts.)
Many people “count” carbs using grams. One carb choice, or serving, is the amount of food that contains 15 grams of carbohydrate. Whether you eat 15 grams of carb from a piece of bread or 15 grams of carb from a cookie, the effect on your blood glucose level is about the same. (It’s a common misconception that eating sweet foods causes your blood glucose level to climb higher than if you eat a starchy food.) You can learn how much carbohydrate is in your foods by reading food labels for serving size and total carbohydrate, as well as using a carb counting book that you can buy in any bookstore.
The goal with basic carb counting is to aim to eat a consistent amount of carbohydrate at your meals on a day-to-day basis. If you eat more carbohydrate than usual at a meal, for example, you’ll probably have a high glucose level later on. Eating a certain amount of carbohydrate at meals, along with getting regular physical activity and taking your diabetes medicine as prescribed, is an effective way of controlling blood glucose levels.
How do you know how much carb you should aim for at your meals? A dietitian is the best person to help answer this. A dietitian takes into account your medication, food likes and dislikes, eating schedule, weight goals and overall diabetes control to come up with a carb amount that’s best for you. If you’re interested in trying carb counting, you might aim for about 45 to 60 grams of carbohydrate (or three to four carbohyrate choices) at each meal until you meet with a dietitian. On reviewing your individual needs, the dietitian may recommend eating more or less carbohydrate.
The next type of carb counting is really more like the next “level” of carb counting. Sometimes it’s called advanced carb counting, although it has nothing to do with how smart you are! Advanced carb counting is a very flexible way of meal planning that can be used by people who take fast-acting insulin (lispro, aspart, glulisine or Regular) before meals, whether by injection or via an insulin pump (you can’t do advanced carb counting if you take only diabetes pills or long-acting insulin). Here’s how it works: Right before you eat a meal, you figure out how much carbohydrate you’ll be eating. Then, using something called an insulin-to-carb ratio, you calculate how much insulin you need to take to “cover” the carbohydrate in your meal. Let’s say you have an insulin-to-carb ratio of 1:15. This means that you need to take 1 unit of your fast-acting insulin to cover every 15 grams of carb you eat. So, if you plan to eat 45 grams of carb at your meal, how much insulin would you need? If you guessed 3 units, you’re right! Pretty easy to do!
Of course, you need to keep a few things in mind. First, your health-care team (usually your dietitian) should help you figure out your own insulin-to-carb ratio. Ratios vary from person to person, and you may even need different ratios for different meals. Second, be prepared to keep food records and check your blood glucose levels after meals for a while to make sure your ratio is correct. Third, if your blood glucose level is too high before a meal, you need to take extra insulin, along with the insulin to cover your carbs. This extra insulin is called a correctional dose and also needs to be calculated with the help of your health-care team. Finally, while advanced carb counting really gives you the flexibility of eating as much or as little carb as you want while still maintaining good diabetes control, don’t forget that you still want to eat a variety of foods and not load up on empty calories found in desserts and snack foods. Also, it’s not uncommon for people to gain weight when they start adjusting their insulin for their food intake. If you’re trying to lose or maintain your weight, you still may want to aim for a certain amount of carb at your meals, along with keeping portions of protein and fat foods in control, too.
Carb counting is another meal planning tool that can help you manage your diabetes. Many people with diabetes find that carb counting helps them eat more like a person without diabetes because it’s more flexible than other meal planning methods. If you think you’d like to try this approach, make an appointment with a dietitian to learn more about how carb counting can work for you.
Background: Type 1 for 45 years on pump.
Posted by bpc | Aug 21, 2006 at 12:11 pmWhen traveling and eating out for breakfast especially, I think I’ve counted right, but sometimes I misjudge carbs - then my blood glucose snowballs for the next 4-5 hours. Testing post-eating is the answer, I know, but it’s not always possible. What causes the snowball effect? My blood glucose readings are so high prior to the next meal that it shocks me - I couldn’t have misjudged that much!
There could be several reasons why your blood glucose “snowballs” after eating out for breakfast. First, keep in mind that when you eat away from home, portions tend to be much larger than you might think - in other words, you might be getting more carb than you bargain for. Second, is your breakfast high in fat? Fat can delay digestion of carbs, causing high glucose levels several hours later. Third, it’s possible that the types of foods you’re eating at breakfast have a high glycemic index, which can raise blood glucose levels higher and faster. Finally, since you’re on a pump, you might need to use a different insulin-to-carb ratio on days when you eat breakfast out. It would be helpful if you could check a 3-hour post-meal blood glucose after eating breakfast out, just to get a sense of what’s happening with your glucose at that time.
Posted by acampbell | Aug 23, 2006 at 8:18 amAs a new diabetic and a new user to your site I would suggest a “print article” option to to your list of options.
Posted by LandSDistribu | Aug 26, 2006 at 10:19 amAny recommendations for helping a 10 year old getting control, She runs 250 - 350 at 11:30 am prior to lunch. She doesn’t keep records, I have to teach her everything, she’s not working with a nutritionist & Mom just tells her how much insulin to take prior to lunch!
Posted by Lifelong commitment | Feb 09, 2007 at 10:17 amHi Lifelong commitment,
Posted by acampbell | Feb 09, 2007 at 2:50 pmIt’s great that you’re so concerned about this child. I’m not sure how receptive or motivated the child is, but one of the real issues is getting her mom (and dad, if he’s around) on board with the importance of diabetes management. While she’s not too young to be doing some things herself for her diabetes care, she definitely needs the support of her mother. If you haven’t already, you might try talking to her mom, expressing your concerns, especially about her high blood glucose readings. Give her some literature to read, or recommend a local diabetes class or a dietitian appointment. You might also mention that her daughter will physically feel better and will do better in school if her glucose levels are better controlled. If you know another parent with a child who has diabetes, suggest the parent talk to this child’s mother, if both are willing. I hope all works out.
What is your preferred way of calculating insulin:carb ratios…from your practice do you find pattern mgmt or the 500 rule works better.
Thanks
Posted by New DM RD | Jun 17, 2007 at 10:07 pmHi New DM RD,
There are actually several ways to figure out an insulin-to-carb ratio for someone. I typically use the 500 rule, as I’ve found this tends to be a little more precise than basing the calculation on typical food intake and insulin doses. But, this is more of an art than a science, so either method can work. The most important part is to follow-up with the patient for fine-tuning of the ratio, as it almost always needs to be tweaked a little. And don’t forget that people can have different ratios for different meals. Hope this helps!
Posted by acampbell | Jun 18, 2007 at 12:20 pmhi,
Posted by dr gunpreet singh | Aug 08, 2007 at 11:41 ami am a pediatrician. i have an indian pt.in my office who happens to have type1 diabetes. can you please suggest a book or web site to calculate carb content of indian food.
thanks
gunpreet singh
dr gunpreet singh: go to http://www.mendosa.com/gilists.htm . scroll all the way to the bottom of the page. then slowly scroll up and the glycemic index and load for international foods, including Indian, will appear. it’s not carb counting, but should be of help.
Posted by barry | Sep 08, 2007 at 8:18 pmWhat is the amount of fiber where you can subtract from the carbs. Example Fiber One
1/2 cup 25 grams Carbohydrate
14 grams of Fiber
I heard you subtract from carb any amount greater than 5 carbs.
So for Carb counting of Fiber One
25-14=11. Is that how many carbs to bolus for?
thanks
Posted by glwfood | Apr 20, 2008 at 4:50 pmHi glwfood,
The “newer” guideline for subtracting fiber is this: if a food has more than 5 grams of fiber, subtract half those fiber grams from the total carb. Then, bolus for the resulting carbs. Therefore, in your example, you’d bolus for 18 grams of carb. Same applies to grams of sugar alcohols - subtract half those from the total carb, and then bolus for that amount. Confusing, isn’t it?!
Posted by acampbell | Apr 22, 2008 at 4:34 pmWhat the heck does “bolus” mean?
Posted by eileenmechler | Jul 17, 2008 at 7:49 amHi Eileen,
An insulin bolus refers to the dose, or amount, of rapid/short acting insulin that you’d give before you eat a meal, or when you’re correcting for a high glucose level. You can give a bolus with a syringe, insulin pen, or insulin pump.
Posted by acampbell | Jul 17, 2008 at 3:08 pmHi, I was wanting to know if you can help me. I am very newly diagnosed with type 1 diabetes and I do have an appt. scheduled with the dietetion for the end of August because they are pretty booked. I believe I got the insulin to carb ratio understood. My doctor wants me to take insulin to carb ratio of 1:10. Just an example-if I plan on eating 50g. carbs then I would take 5 units, correct? He also gave me a correction of 1:25. So what I am having trouble with is this part. Could you help me figure out on the above example how much extra I will need after the 5 units?
Posted by bmadams | Aug 01, 2008 at 10:39 pmThanks,
Bonnie
Hi Bonnie,
Posted by acampbell | Aug 04, 2008 at 1:46 pmGlad to hear you’ll be meeting with a dietitian. You’re correct about how to use your insulin to carb ratio. In order to use your correction factor, you need to know two things: what your current BG level is and what your target BG is. For example, let’s say your pre-meal BG is 200 and your target is 150. You know you need to come down 50 points. You then divide your correction factor, 25, into 50 and you get 2. That means you need 2 units of insulin to “correct” for your high BG. But be sure to add that to the insulin you need to cover your food. If you were taking 5 units to cover your carbs, you’d add 2 units to correct, for a total of 7 units. Of course, make sure you use your own BG and target levels! Hope this helps.
Hey Amy,
Thanks for the reply for the correction factor. So tonight before supper my Blood Glucose was 210, and my goal is 140. I ate 35 carbs for supper so I need 3.5 units for an insulin to carb ratio of 1:10, and for the correction of 1:25 I need 2.8 units. so I will needed 6.3 units total. Is this right? Just making sure. I don’t want to get too low or high and have problems. Any how it’s really hard to do the 6.3 so what do I do for the 10ths? Just go a little over or would 6 units be ok?
I really appreciate all your help and thank you again for the reply.
Bonnie
Posted by bmadams | Aug 04, 2008 at 9:18 pmHi Bonnie,
Yes, your calculations are right on! Unless you’re on an insulin pump, you really can’t bolus 6.3 units, so I would round down to 6 units. It’s also good to be on the conservative side when you first start carb counting. Be sure to check your blood glucose about 3 hours after your meal to see how things worked out. When you meet with the dietitian later this month, make sure he or she reviews how to check the accuracy of both your insulin to carb ratio and your correction factor. Also, keep in mind that you may have different ratios for different meals. Be patient, keep good records and don’t get too frustrated if you don’t always see the numbers that you want. All in all, this is a flexible and practical meal planning and insulin regime.
Posted by acampbell | Aug 05, 2008 at 12:52 pmHi Amy,
Posted by Bevin | Oct 04, 2008 at 3:09 amMy 9 year old was diagnosed last Christmas and we just got him on an insulin pump about 2 weeks ago. We are having a really hard time with his BG at recess now - which is about 2 1/4 hours after breakfast. We have always had him test before his snack at recess, but now he is really running high, close to 300. We have raised his basal rate from 7am-11am from .35 to .375 to .4 and also hid I:C ratio from 15 to 12. I think when he was on lantus his BG was about 80-100 and his BG target right now is 120. I am working with the endo and pump folks, but it is so frustrating. How do I know what we should change next his basal or IC? Any thoughts?
Thanks,
Bevin
Hi Bevin,
I can imagine how frustrating it is for you and your son to see these high glucose readings. What may be helpful is to focus initially on your son’s basal rates to be sure they’re correct. Most people focus first on the overnight basals (because they’re easier to start with!)and then move on to the morning basal(which means skipping breakfast and morning snack), and so forth. If the basals aren’t correct, it’s then hard to establish the insulin to carb ratio. Your son’s team may take a different approach, but I’d suggest you and your son focus on one thing at a time, starting with basal evaluations.
Posted by acampbell | Oct 06, 2008 at 2:08 pmI really like your site. I appreciate the fact that you seem to get back to the people in need of help very quickly. Good to see someone so interested in helping diabetics learn how to help manage their own disease (along with the help of their diabetes team). I have been diabetic for 26 years and have been on the pump for 10. For me all of the carb counting and dosing and options for improvement seem so natural, second nature almost. But I have a newly diagnosed brother in law (type 1) earlier this year. He has been to a family practice dr. a few times, and had an appt. for an endo for over 6 mos. But they tend to keep moving his appt. farther in the future. He is very out of control. He takes 70/30 2x per day (morning and dinner) and Lantus 40 u at bed. We will be having Thanksgiving dinner and he is worried because of the inablity to “stop” after just enough. So he asked that I help him with a dose of humalog to cover dinner. I am somewhat worried because of such a range of dosing he has already. But he typically runs 400+mg/dl and sometimes at night dips down to 40 mg/dl or so. I keep telling him to get to an endo…but they keep putting him off. I was wondering if 1:15 ratio would be safe with me there with a glucogen kit? and then retest 2-3 hrs post meal and correct 1:50 over 150 mg/dl. I will be there more than 24 hrs after the meal and humalog dosing. But still somewhat worried that I will make him go too low. (Because of the nph, regular/lantus mix flowing through his body already) Please, any advice would be so helpful. Sincerely, MrsBB
Posted by MrsBB | Nov 22, 2008 at 9:57 amHi MrsBB,
Posted by acampbell | Nov 24, 2008 at 2:14 pmYour brother is certainly lucky to have you help him! I wish he’d been able to see an endo a lot sooner. Unfortunately, I can’t give you advice on insulin dosing. However, one suggestion is to see if anyone else in the endo’s office (such as a nurse practitioner, nurse educator or dietitian) might be able to squeeze him in for a quick visit or even speak to him on the phone to discuss how he might handle his insulin on Thanksgiving. If not, I’d suggest that your brother aim to spread out his food intake over Thanksgiving day and, as hard as it can be, not eat too many carb foods at one time. Suggest he focus more on turkey and vegetables and a little less on stuffing and potatoes! Also, the more active he can be during the day, such as walking after the meal, the better. It’s a little risky to have him use Humalog (although a logical idea), given the 70/30 mix he’s already taking. Finally, is there another endo nearby who might be able to see him a little sooner? I wish I could help more. Please let me know how things work out.
Hi. Is there any damage done to the body by having hypos? (besides the risk of passing out, and by hypo, I mean in the 40’s range)
Posted by Henely | Nov 24, 2008 at 5:50 pmHi Henely,
Some studies have indicated that people who have repeated episodes of severe hypoglycemia are at a higher risk for cognitive impairment (memory loss, confusion, distractability). And people who have had diabetes for a long time, particularly those who also have neuropathy, are more likely to have cognitive impairment as a result of hypoglycemia. However, the good news is that a follow-up study to the Diabetes Control and Complication Trial (DCCT), a landmark diabetes clinical trial, found no link between hypoglycemia and cognitive impairment. The one catch is that people in this study didn’t have hypoglycemia unawareness, or inability to sense lows. So we’re not sure if there’s a link in those with hypo unawareness. For those who have hypo unawareness, symptoms of hypoglycemia can be restored.
Posted by acampbell | Nov 25, 2008 at 4:20 pmMy 4 year old stepdaughter was recently diagnosed with type 1. She lives with us full time. Her dad and I both work weekends, so my mother in law keeps her for us. This is all new to us, but we are established with an endocrinologist and they have done a fantastic job teaching us, answering questions, and being available 24/7 to answer any questions we have. Our daughter’s school has been fantastic also, in being very proactive on getting educated and trained to help take care of Jade. Now for the problem, mother in law is a type 2, but from the beginning daughter’s diagnosis, mother in law has had a know it all atitude. We cannot make her understand there is a difference between type 1 and type 2! She takes very good care of our daughter, but thinks we are being to overprotective and overeacting to this situation. Our deal is we are teaching Jade to be very compliant and she thinks we are to rigid. Here is an example: Mother in law was babysitting for us. When my husband got off work, he called to check on Jade and his mom told him they were at cafe in town eating, husband told her Jade had already eatin and it was not time for her to eat again. She told him Jade wasn’t eating very much. Husband asked her what blood sugar was before she let her eat and mother in law informed him that she had forgotten the bag (containing glucometer, insulin, glucose tabs, glucopen, and juice and crackers)at home. We could not believe it! She acted like it was no big deal. How do we convince her that this is to be taken seriously at ALL times? Right now, until we get more family members trained, we do not have an alternative means for babysitting. Jade was diagnose in Nov. 08. So we are still learning about this. Can you help?
Posted by pscifres | Dec 27, 2008 at 1:46 pmHi pscifres,
Posted by acampbell | Jan 06, 2009 at 8:00 amYou have a tricky situation on your hands. How much do you think your mother-in-law knows about type 1 diabetes? It might help to sit down with her and perhaps review some education materials that better explain the difference between type 1 and type 2 (she may not have a good understanding of her own diabetes, either). Another suggestion: invite her to come to one of your daughter’s appointments with her endocrinologist or diabetes educator. She might be more receptive to a healthcare professional’s advice.
HI LEIGH HERE CAN YOU TELL ME WHAT BOOK WOULD BE GOOD FOR CARB COUNTING.
Posted by leigh | May 03, 2009 at 7:48 amHi Leigh,
There are several good books on the market, but the one I tend to like the most is The Calorie King Calorie Fat & Carbohydrate Counter. This book is small so you can easily take it with you, and contains all sorts of info on food, including restaurant and fast food. Plus, you can also access the food database for free at .
Posted by acampbell | May 04, 2009 at 1:16 pmHi,
I’ve had diabetes for 28 years and just was introduced to Sensitivity Factor and Carb:Insulin Ratio. Curious about lowering a high sugar based upon this program. If a person has a level of say 250, and they take a certain amount of insulin to lower it….what is the time frame to have the level back to normal? Is it to lower it within a couple of hrs or is it to lower it enough prior to the next meal?
Thanks,
Posted by Howard | Jul 27, 2009 at 3:53 pmHoward
Hi Howard,
Good questions! But there’s not necessarily one right answer. Hopefully you’ve established your target blood glucose goals with your provider, meaning that you know the range for your fasting, 2–3 hour postmeal, and bedtime blood glucose targets. With that said, using your example: If your premeal blood glucose is 250, and you use your sensitivity factor to correct for the high blood glucose, your goal at 2 hours may be 180. At 3 hours, your goal may be 140–160. But by 4–5 hours (which is perhaps close to the time of your next meal), you should ideally be back within your premeal target range (for example, 100). Of course, various factors can affect this, such as what you eat for a meal. And rapid-acting insulins may “peak” anywhere from 30 minutes to 3 hours after injecting or bolusing. I’d suggest you discuss your premeal, 3 hour postmeal, and bedtime goals with your provider so you can gauge how well your sensitivity factor is doing.
Posted by acampbell | Jul 28, 2009 at 8:43 amHi my son is a diabetic and I am learning how to do the ratios. His lunch ratio is 1:10 but what i dont understand is the Correction Insulin for high blood sugar. The Dr has written down use the following correction formula BG-100/40 (for pre lunch blood sugar over 150). How do I calculate this? Also it says if BG is gretaer than 300 and its been two hours since last dose give half of the correction formula noted above Say his blood sugar at lunch is 200 and he had 30 grams of carbs. I know that he gets 3 units of insulin but how do I do the correction for him being over his target range of 150
Posted by Karen | Aug 04, 2009 at 6:10 pmHi Karen,
Your son’s correction factor is 1:40, meaning that one unit of insulin theoretically drops his BG 40 points. So, using your example, plug the numbers into the formula: 200 (current BG) minus 100 (goal BG) = 100 (how many points he needs to come down to reach his goal). Divide this by 40 and you get 2.5. This means he’d have to take 2.5 units of insulin, in addition to the 3 units for his carbs, for a total of 5.5 units. He may need to round up from 2.5 to 3, unless he’s using a pump. If his BG is greater than 300 two hours after the last dose, use the same formula and then take half of that dose. For example:
Posted by acampbell | Aug 05, 2009 at 3:04 pm320-100 = 220. Divide 220 by 40 which is 5.5 units. Then divide the 5.5 by 2, which is 2.75, or 3 units. You divide by 2 because it’s only been 2 hours since the last dose and the insulin from the earlier dose is still working. If you gave the full dose, your son could go too low. I hope this makes sense for you. It gets easier the more you do it!
Hi
Do you have any recommendations on what books for health care professionals to learn more about Advanced Carbohydrate Counting to help with their diabetic clients? Thank you
Posted by Esther | Aug 12, 2009 at 11:51 pmHi Esther,
While not necessarily a professional resource, you could try the Complete Guide to Carb Counting by Hope Warshaw and Karmeen Kulkarni. Also, Smart Pumping by Howard Wolpert. Hope Warshaw has also written a book called Practical Carbohydrate Counting: A How to Teach Guide for Health Professionals. All are published by the American Diabetes Association.
Posted by acampbell | Aug 13, 2009 at 1:43 pmHi, My dad has type 2 diabetes. He is 72 years old. He has had it now for about 30 years. The doctor who is attending my father now wants he’s blood sugar levels between 90 and 100 in the mornings (which I personally think unrealistic). My father has a problem with low blood sugar. He does not realize when he is low. Currently he is on Novolin 70/30 40 units a day. He takes his insulin before breakfast and before dinner. He needs to have better control of his diet. If he has high numbers for a week ( around 180) the doctor will increase his insulin the problem is he doesn’t eat like that all the time, this is the reason he’s blood sugar has a tendencacy to go low. My question is do you think carb counting will work when taking the 70/30 type of insulin twice a day.
Thank you
Posted by Russell Williams | Nov 10, 2009 at 1:34 pmRussell Williams
Hi Russell,
It certainly does seem like your father needs more lenient glucose goals. Have you talked with his doctor about this? Or might there be a diabetes educator that your father could meet with to help intervene on his behalf? Your father can do carbohydrate counting with 70/30, but the goal would be to aim for a consistent amount of carbohydrate at each meal and each snack. You really can’t adjust this type of insulin for the amount of carbohydrate because this insulin is a mixture of a fast-acting and longer-acting insulin; if you adjust this insulin, you not only affect the fast-acting part, you also adjust the longer-acting. However, eating a fixed amount of carbohydrate at meals can certainly help limit the lows. Perhaps your father would be willing to meet with a dietitian to discuss this further?
Posted by acampbell | Nov 11, 2009 at 8:49 amI see a lot of posts about correction factors (you are calling it correction ratios) and calculating doses and I must point out one problem, at least it is for me. When your blood sugar is high, you may not be thinking straight. I tried doing some dosage calculation to correct a high blood sugar while my blood sugar was high. I felt that I was thinking clearly. After my blood sugar came down I looked at my calculations again and boy was I wrong!!! Luckily I hadn’t overdosed. (My BS wasn’t normal but was better so that I obviously was thinking more clearly.)
It seems that we are less able to make math calculations with high blood sugar. This can make sense since, although all of that sugar is there, there may not be enough insulin for the sugar to get to our brain.
What I have done is to use a spread sheet to calculate my insulin dose for a range of blood sugar levels using my correction factor. (You can use a calculator, if you wish.) I printed it out and I keep it with my diabetic kit. No more calculating or the possibility of making a math error regardless of my state of mental confusion.
I didn’t see this article at first. Just today I made several posts about empirically deriving a custom sliding scale based on your own body’s resistant to insulin through lots of testing. I also posted on how to determine insulin dosage based on carb counting and your body’s resistance to insulin. This was a comment in reply to the article, “How much Lantus should you take?” You should first read my post on testing because these scales are developed empirically and can only be determined by lots and lots of testing. I describe how often and when you should test.
Posted by Dale | Dec 23, 2009 at 7:44 pmThanks, Dale. You make a very good point about how either too high or too low a blood glucose can sometimes impair the ability to think (and calculate) clearly. Preestablished insulin dosing scales can certainly be helpful for some, although, as you mention, it does require time and patience to customize.
Posted by acampbell | Jan 04, 2010 at 9:29 amI have had an upset stomach and running low. I am on a pump. I got some regular pop and it said total 28 grams carbs and sugars 25 granms so do I add the two together to figure how much sugar I am getting. thanks
Posted by james juks | Jan 30, 2010 at 8:03 amHi James,
No, the grams of sugar are included in the grams of total carbohydrate. So, when you read a food label, look at the serving size and the total carbohydrate, not the sugar.
Posted by acampbell | Feb 01, 2010 at 2:42 pm