That’s why I asked. Yes, it sounds like your carbs are spot on, other than deducting fiber.
Many people will say fiber carbs don’t count Fiber, in it’s pure form, won’t be digested - like whole grains - in theory. Processed fiber does affect blood glucose. I guarantee yogurt contains nothing but processed fiber. So it depends, and all people digest food differently.
I recently read a study from Joslin that said whole wheat pasta will not raise glucose levels, but white pasta will. However, it will, almost as much as white pasta.
Most endocrinologists I work with advise to just count the carbs, and that the fiber isn’t worth writing about, considering the food labels are +/- a good percentage (I don’t have the exact percentage at hand).
I say this only because you have one of two things going on (based on prior carb counting:
Your carb count is higher than you think.
Your insulin to carb ratios are off.
But it is my opinion. You can take it or leave it.
One terrific benefit of the pump, I have learned, is how much being able to adjust basal insulin rates helps reduce exercise-related lows (given, as others emphasized above, that your insulin-carb ratios and other settings are appropriate). @Eric is our exercise guru, btw.
@kmichel I’m seeing a new dietitian on Monday and will be asking about this. I only do it because my endocrinologist and all 3 CDE’s I’ve seen said the same thing, deduct carbs.
I’m sure my ratios are way off because my Dr moved me to 1:10 at breakfast and lunch and 1:15/20 for dinner. If I did 1:10 for breakfast even with just yogurt and fruit I’d spike over 400 and stay there until the afternoon sometime.
Do you subtract all the fiber, or just when it’s more than 5 g, which is what I’ve been instructed to do? Or maybe, given all the other variables, the difference is ultimately negligible.
I subtract any fiber since that’s what I was told to do.
I just got a call from one of the nurses over at Joclins and I’m not going to be going on Omni pods Monday. she’s claiming that I still have to take a multitude of classes before I am cleared to go on the pump, which I already had the conversation with my doctor. I’m getting so confused and frustrated and Insulet already sent me the PDM and pods and now I’m just probably going to have to wind up returning them and staying on MDI for the foreseeable future.
John,
As a side note, for what it may be worth, I have been very successful managing the disease because I have done it my way. I haven’t let anyone else determine what I do. I listened and learned and paid attention, but then made my own choices.
So, from what I am reading, this doesn’t sound right. Insulet does not require training. Your doctor may say you need training before they will prescribe it, but the pump company doesn’t require it.
You have the stuff. You can read the manual and try it. Or you can get a different endo. Insulet will arrange the training through your endo. so if you get a different endo, they will do training through that endo instead of your current one.
Insulet gives you a 30 day money back guarantee that starts from the day of training. So you don’t need to send the stuff back yet.
All of that aside - what is included in the multitude of classes? It would probably be useful for you regardless of doing a pump or not. Learning as much as you can is a good idea.
John, fwiw, it may be nice to have a head start on your pod prescription. If you start with a stock pile of pods, that will give you the needed extra pods from random pod failures or placement issues that you might encounter. You might feel better starting out knowing that you have extra supplies. It will make each pod placement less stressful, in my experience. Having a cushion might be nice!!
I agree with @Eric. I set up POD/pump training directly with the Insulet rep. She cane to my office a few days after I got my pump supplies, went through a 2 hours discussion and that was it. I was off and pumping. She texted me a few times to check and see how things were going but that was it.
Joslin might also want more control than run-of-the-mill endo offices want. I have encountered tighter controlled doctors offices. You might humor them at first just to see how it goes…but use your best judgment. The nurse at my endo office is so rude, but being nice to her and humoring her is worth it bc all my paperwork gets done faster in the end.
The first class is introduction to pumping, which I already took but she said I didn’t, then an assessment class where they can actually tell me “you’re not a good candidate” and if that happens I’m changing endocrinologists, then another class to start a week of saline in the pod then finally the class where you go live with insulin on board.
I understand that I’m not going to be using Basal insulin anymore but there has to be a way to get a number by saying, on MDI I was 18un a day which equals X % perhour.
@John_T1D
Absolutely. Not gonna step on @Eric’s toes. So no actual answer to your question from me. lol
If it was me, I would have zero concerns switching to the Omnipod with Eric as a guide. Guarantee you will get much much higher quality advice (than your trainer who doesn’t seem to keep good records on the classes you actually did attend).
BTW - With a functioning Dexcom, this should (IMHO) make the transition to the pump even easier. The Dex can give you advance warning when you are going out of your intended range. Which can be extremely useful particularly when starting on new technology.
When we started with the Animas Ping and then switched to the Tandem t:slim X2, we were presented with the option to start with saline. We just didn’t feel it was necessary. Whatever mistakes we make - we can correct.
I am a HUGE fan of reading documentation. I read the pump User Guide three times over when we started using it. On the first reading, lots of things don’t quite make sense but I just kept reading and didn’t worry about it. It kind of all pulled together so on the second readings it all made total sense. Then we started using the pump. After using the pump for a few weeks, I read the User Guide again and some of the sections had greater meaning after actual use with the pump.
That makes absolute sense Thomas, I’ll make some time over the weekend for research and my plan is to go Monday and see how it goes, then make an educated decision.
I just finished working, its 9:45pm already. One dinner but oh well
For what it is worth, my 13 year old, was given the intro to pumping class 1:1, then given a set to practice with, then hooked the pump up, the instructor programmed starting settings and off we went.
of course they started out conservatively with the basal, think like basal times 0.8 or 0.75, then let us ramp the basal up as needed over the next two weeks.
They offered the saline thing, but my 13 year old, said “just give me the pump” the way only 13 year olds can manage. And while we had issues adjusting to the pump, I don’t think the saline would have added anything. In the end, you have to be in control of your disease and treatment.
Yeah, not sure the saline does much except get you comfortable with pushing the buttons and changing settings and so forth.
We would probably have a hard time with threads saying, “Are my saline basals correct?” Or, “I can’t tell if I am bolusing too much saline for this meal!”
Good for Cody diving right in. How long after DX did he start?
