Learning to count carbs

Mr M was diagnosed with Type 1 Diabetes in 2012, initially he was under the consultant at the hospital but after a couple of years he was discharged back to his GP

Since his diagnosis he has spent the total of 10 minutes with a dietician. That was when he was first diagnosed. He was repeatedly told he would be sent on a DAFNE (Dose Adjustment for Normal Eating) course, this never happened

Mr M has just got on, but has never been shown how to work out his insulin, meaning he has just given himself the same for pretty much every meal

His blood sugars have been high, between 12-20+ mmol, which if you know anything about diabetes is not good. At his last eye screening this noticed small changes in his eyes so he decided enough was enough as asked to be referred to the dietician

Last week he had his first appointment. I went with him so that I also had an understanding of what he needs to do but also as an extra pair of ears

We both learnt a lot. I have a medical background but no specialist diabetes knowledge, just what I’ve learnt since Mr M’s diagnosis

We learnt about carb counting. Basically Mr M needs to know the carbohydrates in every meal so that he knows how much insulin to give himself. He then has a carb to insulin ratio – for breakfast his ratio is 1:8 & for lunch & tea 1:10 – so if he has 42g of carbohydrates for breakfast he he gives himself 5 units of insulin, if he has 78g of carbs at tea he gives himself 8 units.

We are paying a lot more attention to food labels

He was also taught how to adjust, so if his blood sugars are between 7-10 mmol he gives himself an extra unit of insulin on top of what he is giving for his meal, if he is 10.1-13 mmol he gives 2 units extra, 13.1-16 mmol he gives 3 extra units and over 16.1 mmol he gives 4 units extra

He has also downloaded the Carbs & Cals app on his phone which helps you work out how many carbs are in your portion size

At his next appointment he will learn about snacks & exercise as he wants to lose weight.

Since his appointment is blood sugars have been much much better, I think the highest he has had is 9 mmol, still a little high but better than it was. He has noticed that he feels much better, he was feeling tired & ill all the time. He has had hypo like symptoms at 5.7 mmol however his body needs to get used to a more normal level

He is finding it a little time consuming working out the carbohydrates but his meter has a carbohydrate programme in it & the Carbs & Cals app has been a great help. The more he does it the more he will get used to it. It will become second nature. It’s just a shame he didn’t get this help & advice when he was diagnosed. I am here to support him throughout this journey

If you want to read more about carb counting check out Diabetes UK guide (which probably explains it better than I did!).

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