Yep, I think you need to make your IC stronger!
The old Cozmo pump actually had this as a feature, you could program different correction ratios for different BG ranges. Then again, sometimes I’m high and a single standard correction does work the first time to bring me down…but sometimes I’m high and I spend the entire day doing correction after correction and temporary basals to get it down and it still takes allllll day…
I think it helps but, yes, it doesn’t work. Part of the reason is that the food labeling standards in the US require an under estimate of the carbs we T1Ds typically ingest, part of the reason is that most of the time we don’t eat stuff with a label on it and both vegetables and fruit have an amount of carbohydrate that varies enormously, part of the reason is that eyeballing a plate of spinach really isn’t very accurate.
On the other hand, I do actually have a 100% accurate carb counter. It is my own body. It doesn’t merely measure carbs, as recorded on that fake news FDA nutrition label, it also reveals, completely accurately, the rate of adsorption. It is wonderful, amazing, I just have to find out how to use it. Looping is one obvious answer.
The most accurate way to count carbohydrates, especially for foods without labels, is by using a kitchen scale and carbohydrate factors. I actually have a spare kitchen scale, if anyone wants it (just PM me). I just put the plate on the scale, zero out the weight of the plate, and then do the same as I add each type of food to the plate. I have a pocket scale that I bring travelling to measure things like fruit. I can’t say I measure things all the time, but there’s a noticeable improvement in my control when I do take the few extra seconds to calculate exactly how many carbohydrates I’m eating. (This is probably a bit easier for me because I almost never eat out, and the couple times a year I might eat out I tend to be limited to very simple custom-made meals due to my food allergies.)
I asked a friend who runs a commercial bakery about the process for nutrition labelling. He said everybody (at least in his circle) uses the same software to generate the labels based on the recipe for each item…and the federal rules allow +/- 20%. So not precise at all.
I like the picture apps like bitesnap, although I still estimate and often forget to take the pic prior to the bolus…but i use it for extremely high carb items like 97 gram muffins, etc
I am almost the same. If I were to have 50g of carbs the 1:10 would not work. I would also have a high BG level. I usually have 35g of carbs for each meal. I take 4U of Humalog before each meal. If my BG level is high before a meal I add one U for each 30 BG above 100 or subtract the same amount below 100. I try to keep my Postprandial less than 140 after each meal. This has been a very successful approach to keep my A1C less than 6.0, between 5.3 and 5.9. I have been a T1D for 46 years with no complications. I also exercise by running or doing other physical workouts. The workouts also help to reduce a high BG level. I do use a Dexcom CGM with a smartwatch as my primary collector using xDrip.
Yikes…you may be correct about making the IC stronger.
This morning pre breakfast BG 114, bolused 2 units instead of the usual 1.5 units for the usual yogurt/flaxseed/walnut breakfast. pre lunch number BG 113.
Perhaps you are correct. If I am increasing my bolus, do I need to tweak up slightly my basal? Previously, I was on 4 units Tresiba basal, about 5 units Novolog…I will see if 5 units of Tresiba and the slightly stronger IC units will lead to tighter BG numbers.
Most likely the other way round. I think most T1Ds have the basal set high to soak up carbs from proteins and fats and that probably covers some amount of underestimate. It’s a decision; I make my basal be such that I have to bolus for everything, other people have the fats and proteins covered. Your basal might be fine or it might be that it is correcting for under-bolus. If it is the latter you will find you have to decrease the basal.
There’s no magic here and no right numbers. The correct I/C is dependent on whether or not the C estimates are spot on, consistently high, or consistently low. I think some of the more innovative developers who have posted on fudiabetes since I have been reading it are acknowledging this and just trying to work out the right number for the individual, not taking some ivory tower viewpoint about it all being hard math.
My approach is to tweak the numbers until they work, for me.
I like my basal to be as accurate as possible without food in the mix so I do a basal fasting test every 2-4 months. My I/C ratio doesn’t change with the amount of carbs, so much as the time of day is significant to me and the amount of fat in whatever I am eating. Honestly pre bolusing is the most important thing for me in controlling my levels with exercise being next.
This sandwich would not bother me much at all if I was exercising or doing yard work. Exercise makes all the difference in the world for me and how I handle any type of carbs.
Sorry to vent, but why didn’t anyone tell me what an evil food onion rings are? Thought I’d treat myself to an occasional serving. I weighed them and used their carb content, and prebolused about 30 minutes. I got a peak of about 170 and then a drop down to 123, which I thought was pretty good. Yay, successful!
Then I went to bed and zoomed to the moon, and spent all night over 300.
Anyone else have trouble with onion rings? I don’t have them very often.
Not with those specifically, but yes with very high fat, high carb foods in general. As a fellow MDI-er, they usually require a second much later bolus to cover the major spike due to the fat. Also in my experience, those are foods where the carb estimates are likely to be too low and wrong anyway, which is often the case with restaurant food, so I tend to tack on a bunch of extra units to my estimate than I would with food prepped at home, but distribute the total between initial and later dose.
I’ve split it into two parts, at times, 1.5 hours apart. It seems like I may need a third or fourth bolus.
I had a blooming onion at outback steak house a few years ago… I think my results were a lot worse than that. I ended up snorting something like 30u of afrezza to beat that spike down! WTH I thought an onion was a vegetable or something like one!
The part you are eating is a bulb. If you want to google it try “allium”; “onion” gets you nowhere, fast.
The bit we eat is the bulb; the bit this plant uses to store energy over winter, so it’s got a whole load of sugar in it.
Yeah onions are full of sugars—that’s why they can be caramelized. Not quite as densely so as beets I think (I mean, if you want proof that vegetables can be high sugar, there you go), but still not a low carb food. Normally you’re probably not eating enough of an onion at once though for it have a huge impact.
I have to think all the breading/ seasoning etc that they saturated it in must have played a large role in the process as I frequently eat things with large amounts of onion in them and have never seen a reaction of anywhere near that level
Excellent point; it’s actually something chefs (cooks, in the parlance of my day) understand and it really does get to the point (“if you can caramelize it I’m not going to eat it”);
I didn’t know that could be done. Where is the emoji for down-to-the-feet-bow? I love beets. I hate beets.
Roasted golden beets…yum…