FUDiabetes

Ratio of Planned Carbs to Oops Carbs

Just curious for those who are happy with their control…or not…so everyone, really:

What is your proportion of planned carbs in a day compared to your unplanned carbs (oops carbs, low carbs) in a day?

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Most work days - 100% planned.
BUT lately (yes my basal is too high) I have ~10-15g unplanned every other day or so.

EDIT: I have this weird 4-5pm thing where some days I will just drop for no reason with no exercise. I can turn my basal off and still eat carbs. I may have that today :slight_smile:

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I don’t have a planned carb count!! Interesting concept. :grinning:

My meals are driven by what’s in the pantry, fridge or freezer when its time to eat.
Does that mean 100% oops?

My carb choices are also influenced by BG before meal, unless I use afrezza.

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I mean what you bolus for and how it pans out throughout the day. So I guess another way to ask it is how many unplanned lows people have? Or how often do you move more than anticipated and end up with an unanticipated low?

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We think differently, and I can’t answer that.

I EXPECT uncertainty in insulin action, food/carb counts, and now with CGMS, just wing it, then PLAN on adjusting if/when needed (surfing).

My question … do you think if you get good enough at it, the oops carbs would be reduced or eliminated?? I just don’t think that way.

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I don’t think about it in terms of “good enough”. I suppose I think of it in terms of results mirroring expectations…or not.

For the people with the super tight A1C’s (as I used to have), I’d tend to guess that they feed the backside of it to keep everything close to ideal. But maybe I’m wrong there.

I actually don’t set up my goal to match insulin to carbs. I match my insulin to other factors…with carbs being one of them.

I guess I’m also curious if the low carbers are low carb as far as meal planning…but then they eat more to nudge up lows?

Just spit balling here. Don’t infer too much from my question for how I operate. :slight_smile:

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~ 60/40 planned vs unplanned.

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Hmm, this is a good question. I’m still adjusting to Loop. On good absorption days with OmniPod, everything works exceltionally well as long as I record everything, pre bolus, carbs, and accurate settings. Lots of variables there but when right, I can achieve near normal bgs :slight_smile:

Pre loop, try as I might, I could never achieve near normal bgs.

So, if I take oops carbs now, I always record it in Loop, and Loop will either increase a temp basal, or I can do a bolus on the first uptick for faster action. Still requires a lot of attention, but now it actually works, whereas pre loop, I was just shooting in the dark.

Key for me though is accurate and working cgm, and good OmniPod absorption. If either fail, which could happen at each pod change, or randomly withe sensor failure, my bgs revert to the horrible pre loop values! I guess I’ve become dependent on the technology!

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Good question…believe it or not, that has been rattling around in the back of my mind for a while too. I’m glad you threw it out there !

For me, it varies a lot but seems to go in mini waves depending on my activity level or whatever else is happening to raise or lower my average BG. The past week I have not done much (so far) and have been running higher BG, bigger post meal spikes, than desired so I am probably about 90% planned (meals and bolussed snacks) to 10% unplanned (snacks or fast carbs when trending low). A few weeks ago I was more like 70/30 and not too happy about it. Felt like I was going to destroy my teeth with all that candy and powerade to catch or correct lows.

Still trying to figure out what the optimal ratio is. On one hand, at the BG ranges that put me at 90/10 I am guessing an A1c in the low 6 range. But at 70/30 I was probably close to 5.5 but correcting lows constantly. The lower average BG came with more time spent low, correcting lows, waiting for corrections to kick in, etc. The quandary is: at 70/30 I was battling lows but seldom had to knock down a high BG, now at 90/10 it’s the opposite…using more insulin to correct/catch highs. That’s why I appreciate your description of “unplanned carbs”.

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I’ve only gone back to low-carb for the past four or five days. But I would say a definite no to this. On low carb, I generally go low far less often than I do when eating more carbs. And, those lows tend to be much more responsive to fewer carbs because there isn’t a ton of insulin on board behind the low. And, I feel far more comfortable cruising at a low-normal level while low-carb than I do while eating more carbs, so more more apt to eat carbs to bump up a low-normal level in the latter situation. And bouts of exercise (planned or unplanned) don’t drop me rapidly on low-carb like it does when eating more carbs. All of which adds up to using way, way fewer glucose tablets (which is mostly what I use to treat or prevent lows) or apples or granola bars (which is what I eat before exercise on a high-carb diet) when eating low-carb than when not eating that way.

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Not so weird. I’ve been told it’s a natural drop, much like dawn phenomenon is natural. I plunge every day at that time. My basal drops from 0.7 to 0.2 for 90 minutes to accommodate it. Of course a mid-afternoon biscuit or two helps too.

Aren’t all lows unplanned? I don’t really think about it, because then I’d have to restrict my activity, and that’s no way to live. I would also have to be permanently aware of my diabetes, which I’m not. I am also very sensitive to activity – my control would be superior if I were bed-ridden – so if, say, I have to run down four flights of stairs to sign for a package, that’s unplanned activity, and rarely do I think, on the way back upstairs, that I should take some extra carbs to avoid the resulting low. On the downside, I go low. On the upside, I’m not exhausted by thinking about my diabetes every second of the day.

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This is so interesting! I mentioned this problem to my endo once (I often have to suspend my pump around 3 pm for an hour or an hour and a half to prevent a plummet at 4-5 pm) and he said that maybe it was my being relaxed after getting off work. :slight_smile: But I’ve seen others on TuD report the same thing, so I wasn’t so sure. Interesting to hear it may actually be fairly common…

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I’m one of those low carb’ers (usually < 10 grams a day), so carbs I eat are incidental. For me it’s all about protein and fat, which is what I bolus for.

I generally don’t eat for lows, unless below 3.0 (54 mg/dl), when I might have a Dex4 tab or 2. Otherwise I adjust with temporary basal.

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I guess it seems your answer is, “I haven’t thought of this question before, I don’t think about this stuff, and I don’t know the answer.”

In my opinion, this is an interesting question…and observation of the trends can be helpful for big picture troubleshooting.

But if the prospect of the question stresses people out, that’s cool, too.

Wow! That is super low-carb. Do you eat any veggies on that diet?

I don’t understand how your Dexcom data is showing a “low” risk of lows (versus “minimal”) when you have 100% TIR. What Dexcom app is that? I sometimes wonder if its numbers are off. I had a few hours of a mild low BG (in the 3s) overnight the other night and suddenly Clarity is saying 21% of my readings are low…

That looks to be straight from a Clarity report. I agree that the %'s sometimes seem off when looking at different time periods.

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Jen - That’s from Clarity.

Your Clarity report saying “21% of my readings are low” are likely for the past 7 or 14 days. If you know the day(s) you were low (or high), start changing the calendar range from “7 days” to 6, then 8, 9, 10, 11, and see how your % low readings vary dramatically.

Also keep in mind I rarely go out of range (excursions on the low side are usually compression lows, and high side readings most often are bad infusion sites). And above all, I don’t consume many carbs.

As far as veggies, usually 2 or 3 times a week, but only those with low NET carbs. It’s not to say I don’t ever eat carbs - I broke down and ate pizza for the 1st time in a year this past weekend (did eat over 60 grams of carbs) but kept everything in range (barely :stuck_out_tongue:). And yes, it was delicious!!

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I’m really curious what you eat on a daily basis that only totals 10 g of carbs. I’m back to eating low-carb but that is one meal for me. :slight_smile:

In Clarity, I haven’t figured out how to adjust by single days. I’m looking at teh 2 day data, but you’re right, if I change it to 7 days that percentage drops dramatically.

I ate some non-low-carb coconut ice cream yesterday and it was tasty. But that was more of an accident (I bought it because I’ve had it before and thought it was low-carb!). I threw a bunch of insulin at it and barely stayed in range. I am pretty happy with that if I can eat low-carb 99% of the time and do that on occasion. :slight_smile:

@Jen Yesterday I ate a 11 oz strip loin steak. Nothing else (I only eat once a day). BTW it was delicious:

649 Calories
0 grams carbs
30 grams fat
89 grams protein

Monday I ate 2 slices of vegetarian pizza :pizza:

579 calories
66 grams carbs :flushed:
22.5 grams fat
30 grams protein

Are you trying to lose weight, because 649 calories seems like a terribly low amount to exist on day to day. Having done keto I understand the desire to eat goes away, but wow, that is a low number of calories.