Just like @Eric says you should be able to guess what your bg is, before looking at your Dex or meter, in order to be successful you also need to be able to carb count well. No, you don’t have to guess everything exactly right, but you do have to be in the right range.
So today, my diabetic grabs the box of cereal and pours himself a bowl of Life. I absentmindedly ask how many carbs that is? He responds with a definitive 36.
I take the bowl, tare a new bowl on the scale and weigh it, damn little diabetic was within 0.85 of a carb. Even better he overestimated so his insulin amount was perfect… so much for this helicopter parenting…
That’s really impressive! I would say we’re not so great at carb counting but pretty good at what I would call “Similar bolus estimation.” So for instance, I know about how much mac n’ cheese is in a bowl and how it compares to a typical bowl – and then I will ramp up his insulin bolus based on that.
I guess for us the carb count is really not a great predictor of how we should bolus for most foods, and so we still haven’t developed that skill set yet. (Things like rice or milk can get a straight upfront bolus but almost everything else needs at least a dual-wave bolus).
This is my life. Every day. I try to count carbs on new foods, but often I can determine the amount of carbs by experience or taste (to a certain degree… no flat lining is going to occur from this methodology). More recently, I’ve found chickpeas/falafel to be deceptively low carb. From the taste, I would’ve expected many more carbs.
Sometimes it works… sometimes it doesn’t. As long as you’re in the general range though, it doesn’t turn out too bad!
I have to admit, I’m horrible at carb counting, and have not set my pump bolus using a carb count (wizard) in over 20 years.
I look at my plate of food and take an educated guess every time. For my standard meals I prepare, I’m pretty accurate and usually stay in range.
For less known meals out or prepared by others, I try to compare it to one of my known meals, and bolus based on that. Primarily I gauge quantity/percentage of carbs, fats, proteins to make my estimate. Then I watch dexcom and adjust as needed (bolus, lower basal or more food!).
I started pumping after YEARS of using the exchange system with Reg, NPH. So even though I was taught carb counting when starting pump, I found I still thought of my meals in terms of portions/exchanges. But it works for me, no matter what my endo says.
Watching the CGM is my main approach too. When I can, I use a gram scale and nutrition labels to help me get a good estimate, but often I find that I just guess a reasonable insulin dose and correct as I see the response on the CGM.
I am probably the exception, as I am a very organized and structured person (read ‘anal’ ). When I am at home I weigh and measure everything I eat. I enter it into an app to calculate the total carbs for my meal and then I dose using that. When I am at a restaurant I also enter everything into the app to get the best guesstimate of my carbs. If I don’t know the carbs of something at all, I probably wouldn’t eat it.
Even though I can look at a plate and guess the carbs, I often under estimate to be on the safe side, as I am pretty insulin sensitive. This would always cause high BGs after meals. So I stick with my app and that works for me!
Though I practise, I find this really hard to do. I’m the guy who pulls out the 1-cup Tupperware container for 2 cups of leftovers. (I’ve been like this forever, but now being mostly blind in one eye makes it worse.) I cannot tell 1/3 cup mashed potatoes from 1/2 cup from 2/3 cup. I can see one is bigger than the others, but don’t ask me to guess the amount. With my IC ratios, those small differences in measure make a big difference to dose, but maybe with the thousands of other known and unknown variables, it doesn’t make any difference in the long run.
Nevertheless, at home, I measure religiously. I weigh the ingredients of the meal; I weigh my portion of the finished meal or calculate what, say, 1/6 will be equal to. Though I have toast for breakfast most mornings, I weigh my bread each time, because I make different kinds of loaves, and slice them differently, and so two slices can weigh anywhere from (using last week as an example) 30 to 54 g, or 15 to 27 carbs. I could take an average and just slice my bread and not weigh it and bolus for 21 g carb every morning, but again, I prefer to limit the variables, and measuring is scarcely a chore so why not.
When I’m out, obviously I guess. I accept it’s not going to be accurate, and accept that I’m likely to end up too high or too low, but so what, it’s easily corrected and it’s not every night. (Yes, I know, I could take the same approach to that morning toast: just guess, it’s easily corrected …)
I write down everything I put in my mouth, and add the carbs. It takes time and dedication and sometimes my friends make fun because I’m always looking things up and often late to start eating. I have used many online sites for this and am currently using “Fatsecret.com”. This lists most of the foods I eat. There is the ability to add a new food. There is the ability to change the amount eaten. It totals for each meal and grand total at end of day. Trying to judge carbs by taste can be dangerous. My favorite surprise was ReddiWip. Want something sweet that tastes like you’re cheating when you’re not? Look it up.
Thank you for your concern. I’ve had diabetes for a long time, and I’ve had a lot of different kinds of foods. I’m comfortable with my diabetes management at this point in time. My A1c is excellent, and my average and standard deviation are within good ranges.
I don’t even “count” per say anymore. I know what I eat, I know how I’ve dosed for it hundreds of times, each time it’s been too much or not enough I’ve made a mental note of the experience. I look at a plate and see “that looks like 6u with a 2u follow up 2.5 hours later” instead of “that looks like X carbs”
I was totally surprised on the ReddiWip - that is a funny one. My daughter told me it was “free” (carb/insulin perspective) and I was like - no way. So I read the label and WOW - yup. Who would of guessed? (Well not me at least.)
I could get used to this relaxed approach if (a) my country sold Afrezza or (b) I was comfortable with doing IM injections. As it is, if the CGM goes way, way up, I’m stuck with that for 4 to 6 hours, which is angry-making, and so I try to avoid it by doing all that darn measuring.