Replies to This Discussion

Permalink Reply by Ann on March 27, 2012 at 5:37pm

This is a great question, awg. I wish I had a consistent answer! For myself, I base my insulin dosage on the Net Carbs of the food the first time or two that I eat it. If it turns out that it wasn't enough to cover the food, I'll try using the total carbs the third time I eat the thing.

But the other thing that makes a difference for me is the time of day that I eat whatever it is. I can only eat a small number of carbs in the morning or I can't keep my BG within range. By mid-afternoon, I can eat more carb. Dinnertime and until bedtime are the easiest for me to eat carbohydrates without spiking unexpectedly. I'm less insulin resistant after about 2:00 p.m. most days.

In the end, I think you'll need to test and see what happens for you. You'll be fine!

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Permalink Reply by Cora on March 27, 2012 at 5:52pm

I only count the net carbs. That is what works for me. Some folks bolus for the total carbs and that is what works for them. You will have to test to see what works best for you. Good luck.

Cora

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Permalink Reply by Molly on March 27, 2012 at 5:53pm

I read somewhere that you subtract the fiber from the amount of carbs then add half of the amount of sugar alcohols as carbs. They still can cause your BG to go up. I think it was from "Think like a Pancreas." I don't usually eat those anymore though because I haven't found any that taste very good. I'd rather just eat less of the real thing. Let me know if there's something I'm missing!

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Permalink Reply by Shawnmarie on March 27, 2012 at 5:59pm

I subtract fiber and generally don't eat anything with sugar alcohols. I tried some things with them when I was first diagnosed and it seemed to impact my BG, so I figured it wasn't worth it.

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Permalink Reply by Shawnmarie on March 28, 2012 at 10:16am

Replying to myself because this actually raised an interesting issue for me. I eat similar foods every day and all the foods with carbs generally have similar amounts of fiber, so I probably don't know if counting net carbs is working for me or whether my I:C ratio is different than I think it is. I might have to experiment with some non-fiber meals just to satisfy my curiousity.

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Permalink Reply by Leo2 on March 27, 2012 at 6:48pm

I don't get away with subtracting the sugar alcohols. To adequately figure it, I have to take the total carbs less the fiber only. Sugar alcohols spike my BG. I think everyone is different.

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Permalink Reply by Zoe on March 27, 2012 at 7:45pm

I go with the rule of subtracting fiber only if it is 5 or more grams. But I think whatever rule you go with, you will end up adjusting your I:C ratio accordingly.

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Permalink Reply by Kim on March 28, 2012 at 4:26am

I have to bolus for the total amount of carbs. Subtracting the fiber has never worked for me.

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Permalink Reply by Brian (bsc) on March 28, 2012 at 5:18am

I think there is a lot of different opinions about how to "count" carbs. In then end, all that really matters is estimating the total amount your blood sugar will rise from a given meal. Clearly, if you eat glucose (dextrose), your blood sugar will rise proportionally from the sugar. But other foods are more complicated. We have been told that fiber does not raise your blood sugar and can be subtracted. In fact, the definition of fiber is that it is indigestible. But on closer examination, that definition is totally bogus, in fact you do digest fiber in various ways. In particular, your gut flora ferments fiber and you can absorb part of it. It is well known that much of this fiber is absorbed as short chain fatty acids (SCFAs). I beleive that some non-trivial part of fiber is also absorbed as nutrients that raise blood sugar. At the very least, one would think that fiber should at least be considered as partly fat since it is absorbed as SCFAs.

And then when we look at things like sugar alcohol and glycerin, these are all things that raise your blood sugar. Not as much as dextrose or wheat flour, but in ways that are significant. David Mendosa wrote (years ago) about how to deal with sugar alcohols and carb counting. His view is that you must account for the proportion of sugar alcohols which will lead to a blood sugar rise and that you can subtract the total grams of sugar alcohol, but you must add back in the proportion that contributes to a glycemic load. And while I don't agree with Mendosas assessment of fiber and glycerin, I think he really has a good view on sugar alcohols.

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Permalink Reply by acidrock23 on March 28, 2012 at 7:44am

I don't bother subtracting carbs for fiber.

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Permalink Reply by KatiebirdMN on March 28, 2012 at 8:10am

I haven't heard of many people being able to bolus off of the "net carbs amount." I have always used the total amount, personally. Depending on how you metabolize, the "net effect" may be that the food is either processed slower or faster by your system and that may be telling on how you dose.

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Permalink Reply by suezq1949 on March 28, 2012 at 8:13am

Hi:

When I was diagnosed 3+ years ago, my CDE told me if the fiber was 5 grams or over, to subtract 1/2 from the total carbs. Tried it a few times, but always went high. Now I use total carbs for my calculations.

Sue

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