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Location: Minneapolis, Minnesota, United States

Diagnosed with Type 1 diabetes in April of 1980. I recognize the incredible mental struggle of living with diabetes. I hope to share my struggles, my successes, and everything in between.

Sunday, February 19, 2006

To the 5? To the 10? Exact?

How exact do you get when entering carbs into your calculations?

Looking back on the last few weeks of my pump history, all of my carb values have been rounded numbers, either on the 10 mark, or the 5 mark.

I think this is due to a couple of different things.

1) Carry over from the old fashioned "exchange system" days, where a "carb (or starch) exchange" was 15 grams. So, to me, a slice of bread is always 15 grams. Even though many of the breads these days are more like 18 grams! It's like my brain is stuck in the old system. Or, maybe a slice of bread has always been 18 grams, and the "exchange system" rounded it down to 15 to simplify. I don't know.

2) I have been doing corrections independent of my meals. No special reason, just the way the day rolls out. For example, I test when I wake up. Not two seconds after my feet slide into their hard soled slippers am I reaching for my test kit. So I will correct depending on what that number is. Even if it's a respectable 120 or something, I'll dose to get closer to my target of 100. Then when I eat breakfast 15 - 20 minutes later, there's no sense in calculating in another correction, so I will use my touch bolus button (which counts up in 10g increments) to bolus for that. Or I'll not want to be bothered by pulling my pump out to bolus (how silly is that?!), so I'll guesstimate my way into convincing myself that what I'm eating is an even "10" number (40, 50, 60, etc.).

In many cases I may be miscalculating by a few carbs by using either of the above two scenarios. I had always thought that it didn't matter that much. I had also always thought that I did exact calculations for most of my meals & boluses - but the data shows otherwise!

Looking at my ratios, it can be gathered that being inaccurate by 1 gram of carbs will have an effect of about 4.7 BG points. That's not too much. However, being off by 10 grams changes that number quite a bit! Now we're talking 47 points! That is a very big difference when you're trying to "catch the trap" on the aircraft carrier!

So, my question to you - how anal do you get about your carb grams. Do you enter each and every gram? Do you round to even numbers only when SWAG bolusing? When you round off, is it just a matter of not wanting to do the math, or is it to take some other "shortcut"?

5 Comments:

Anonymous Caro said...

Hmmm... you've got me thinking!

I generally count carbs to the nearest 5g, unless it is something that I really know a value for, like a certain brand of choc chip cookies, say, but for those I usually just know a value in insulin units, and don't use the CarbSmart feature on my pump.

The question is, how accurate is is possible to be when counting carbs? Even if the package says a slice of bread has 18g of carb, where is the guarantee? It may actually fall anywhere between 15 and 21. So I guess no matter how hard we try, we can't be perfect.

I guess you have to go with what seems to give you the best control, without worrying too much why. If counting to the nearest 2g instead of the nearest 10g has very little impact on your overall control, it probably isn't worth the hassle.

2:42 PM  
Blogger Johnboy said...

Scott, really. Isn't this whole thing a matter of estimating?

Unless, you are doing the strictly pre-packaged or are weighing & measuring everything (i measure volume at home but not weight unless pre-packaged), you are not always going to be EXACTLY on the mark.

That said, I think about my SWAGs generally in 5g increments...at least I think I think I do...hmmmm

3:24 PM  
Anonymous Theresa said...

Counting carbs is not an exact science. I don't always find the carbs listed on a package to be all that helpful. For example, if I have a veggie patty (6g) with 2 bread (36g) that equals 42g. I would round up to 45g and should take 3 units of humalog. However, from experience I know that I actually need 4 units of humalog for this meal. If I ate that for breakfast I would need 7 units of humalog. I always need more insulin in the morning than at lunch and dinner to cover my meal. You need to keep a list of foods and how many units of insulin to take for that food item or meal. It's basically trial and error.

4:07 PM  
Blogger Shannon said...

At home we try to be precise. We weigh and measure food and use the Calorie King book to find out the carbs.

If it's packaged, I typically weigh the portion. On cereal they give the measured amount and the weight (1 cup and 40 grams for instance). But I found that 1 cup of cereal weighs a lot less than 40 grams weight wise. So I chose to weigh things like that.

We don't round up or down because Brendon is so young, so a dose for just a few extra carbs can be a bit much sometimes.

If we go out to a restaurant, we eyeball everything. I measure fries with my hand...a small grip is about 2 oz (I tested this at home first). Milk typically comes in 10 oz. cups, so that's pretty easy to figure out.

So I guess we're pretty anal about measuring his food. It doesn't always work out because the amount of fat comes into play like with pizza or the occasional fast food, and screws up his numbers.

6:32 PM  
Blogger Wil said...

I count by fives. Left over habit from the old days of shots pre-pump when you can't shoot up all that accurately to the carb.

I add up every element of a meal to the carb and then round the total up or down to the nearest 5.

At home I do weigh/measure everything.

When eating out...well that's always a problem, isn't it? I SWAG a lot when I'm out and about.

Sometimes it works better than other times...lucky for me I'm too poor to eat out much!

8:10 PM  

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