Posts filed under ‘carb counting’
Doesn’t it always happen this way: as soon as I mentally give up on something, things take a sudden turn for the better. After my terrible highs’n’lows weekend when ended with me going to bed in the 200s Sunday night, I woke up Monday morning with a normal fasting and have been sailing smoothly in the sweet 80s to 120s ever since. What changed? Counting 20 carbs per ounce of bread instead of 15. This did the trick on both my 1/2 whole wheat hamburger bun at dinner last night and for my 1/2 a bagel this morning. Insulin (and small amounts of whole-grain bread!) and I are friends again. 🙂
Looking forward to my body re-adjusting – right now I feel a bit hypoglycemic in the 80-90 range. It’s amazing and a bit scary how fast your body gets used to higher blood sugars.
Nothing much to report on the insulin front. Some days I feel like a lab rat with all these charts, graphs and needles, but I do like labs and some rats are pretty cute, so that’s OK.
The first few days of high blood sugar readings were tiring, both physically and mentally, but I think I’m starting to get a better feel for dosages and timing. It’s tempting to draw conclusions about carb intake right now based on the fact that the only good numbers I’ve seen this week have been after lower-carb meals, but I will hold my tongue and give it some time.
For my diet and blood sugar tracking, I’ve gone low-tech and started using some photocopied worksheets that the dietitian gave me. The upper third of the page is an area to plot my BG on,the middle third is a chart with a column for each hour of the day and rows for blood glucose, carbohydrates, exercise, insulin doses, stress, ketones, etc. The bottom third is for food and other notes. This format will be the easiest to fax back to my PA at the end of each week, plus I really enjoy connecting the dots on the glucose plot at the end of the day. I’m thinking of enlisting my husband to makes some improvements, notably a place to record where I injected. Right now I just randomly pick an injection site and hope I don’t hit the same place twice.
I’ve returned to FitDay for my diet tracking. Combined with the occasional quick lookup on CalorieKing.com and the handy recipe analyzer on Calorie-count.com, I have a decent system for carb counting and making sure I’m getting enough calories each day. I would still like to get some sort of pocket-sized nutrition handbook to carry with me and to keep in the kitchen so I don’t need a computer when I’m planning meals and doses – any recommendations?
These How-To articles on Dsolve.com have been quite helpful in helping me understand that only time, patience and diligent testing and documentation will lead the way to normal blood sugars with insulin. Even though I have a newfound appreciation for the ease, simplicity and efficiency of Starlix, I haven’t resorted back to it – I’m just too determined to get the insulin to work.
Friday night I injected my very first dose of insulin. Before dinner I decided to check the Lilly and Humalog sites one last time for some updated Luxura information and found a video tutorial on how to use the Luxura. Fabulous – the video was excellent – clear, easy to follow, and almost as good as having someone in the house showing me what to do.
After carefully (or so I thought) calculating the carbs in the meal, I rewound the tutorial, had my husband put the pizza in the oven, then went for it.
Closeup of the dose dial
My instructor for the evening
Spread of equipment
Priming the pen
Injecting and counting to five
Success (and a little red dot)!
Since I knew my food was cooking and the clock was ticking, I had no problems pushing the needle in. Once it was over I did have that kind of post-adrenalin rush shakey/cold-sweat feeling, but otherwise was A-OK. Simple as pie and didn’t hurt one bit.
I only wish that calculating the dose was as easy as administering it. After five pre-meal injections, I have still not been able to replicate the excellent one-hour post-prandial BGs that Starlix gave me. I just have to be patient and remind myself that it takes time to figure out insulin/carb ratios. I don’t like spending the day with post-meals in the 150s-200s and resting BGs in the 110-120s instead of my usual constant 80s and 90s though – it makes me anxious and physically tired. One thing I’m noticing is that whatever my BG is at the 1 hour mark, it will be at the 2 hour mark, which is discouraging – is the Humalog even doing anything? Edit: I’m also seeing my BG hit a good target at one hour, then rise up to 130-150 at the two-hour mark. 😦
I’m not sure if the error is in my a) timing b) carbohydrate counting or c) insulin to carb ratio. Right now I’m using 1 unit per 20 carbohydrates, which so far doesn’t seem to be enough. I’m also unclear on whether I’m supposed to cover proteins – my PA didn’t mention it, but Dr. Bernstein does.
I had one low on Saturday one hour after dinner (65), which I treated with three dex-4 glucose tablets per the dietician’s “rule of 15” instructions. I waited 15 minutes and tested again to find it had doubled my BG – yikes! Next time I try ONE tablet and wait 15 minutes.
So far I really like the pen. It has a nice weight and feels like it is built to last. The only thing I dislike about it for now is having to waste two units of insulin to prime the pen before every dose. Squirting 2 units into the air is also a bit messy – what happens if insulin gets on your furniture? Clothes? Floors?
Wish me luck (and patience) getting this whole dosing thing down straight.
Back from a morning spent at the hospital visiting the dietician and my PA. I’m having a hard time capturing my current state of annoyance, confusion and disappointment into words, but I will try.
My one-on-one carbohydrate counting and meal planning session with the dietician was quite helpful. I don’t think meeting the amount of carbs that she wants me to eat at each meal is going to be as hard as I anticipated, and I’m certainly looking forward to being able to eat things like fruit again on a regular basis. I now have an idea of how many calories, carbohydrates, proteins and fats I should be aiming for every day, and I’ll see her again in a month for a follow-up and to see how the meal plan works with my insulin. I’d say it was a productive visit, and I wish I could say the same about the visit to my endocrinologist’s office that followed.
Just got off the phone with my doctor’s office: one week and 4 days until my diabetes resource center visit and introduction to insulin! Still approaching the “big I” with enthusiasm and not fear, although an unsuccessful attempt to eat right while dining out for lunch yesterday did leave me a little nervous about the task of precisely calculating doses for meals consisting of food I don’t control. But hey, people do it all the time, right? This week I will try not to drive my insulin-dependent co-worker crazy with questions and will aim keep my mind occupied with non-diabetes-related things. I bet I don’t sleep a wink the night before!
P.S.: I removed my last post complaining about health insurance not covering all of my testing strips because I realized how whiny and ungrateful it must sound to those who are not lucky enough to have help paying for their supplies. I still don’t have strips and I feel “blind” not knowing what my sugars look like, even though I’m eating the same things I always eat! Will be going to pick some up at full price later today.
I finally got around to installing Health Engage on my laptop. It shows promise, but a few major issues:
- The user interface is awkward. The food input mechanism would probably get easier as time goes on, assuming you eat the same things frequently.
- It’s a memory hog. If I leave it running on my laptop for more than 12 hours, even if its just sitting there idle, it starts gobbling up virtual memory. 512MB for 2 days worth of data?
- My biggest complaint: the teeny-tiny, non-resizable viewing window. It’s fine for inputting data, but not for viewing reports.
Overall I’m not impressed. I’d be willing to give it a chance if and only if I can import data into it directly from my meter (Freestyle Flash), but I don’t have high hopes that this will be possible since I am still on a Power PC-based Powerbook. I’d be interested to know if any diabetic Mac users out there with Intel-based macs have had luck using PC-only software and data management products with either Boot Camp or Parallels.
Another online tool I took a look at this week was MyCalorieCounter.com. It showed promise, but I never returned to use it because the features that I really needed (nutritional totals per-meal and per-day) are only offered to paid users. How am I supposed to decide if I want to buy your product if I can’t at least have a trial of the features I’m paying for?
So for now I’m sticking with iCal and the occasional FitDay for looking up carbohydrate content. I have a few more tools and websites to try, but I’m losing steam already and will probably just stick with what works, with the exception of giving CalorieKing.com a try for carbohydrate look-ups, and possibly trying the (gasp!) analog Glucograf data sheets recommended by Dr. Bernstein.