Nutrition

10 Easy Steps to Carbohydrate Counting

1.Identify what foods have carbohydrate:
Starches, Fruits/Juices, Milk/Yogurt. Vegetables, Sweets

2.Determine portions of foods eaten:
For example, measure by volume (1 c) or weight (3 oz) or count (2 ea)

3. Determine grams of carbohydrate of food actually eaten:
Food Labels
Carbohydrate
Counting Books
Exchange Lists

4. Total the grams of carbohydrate eaten for each meal.

5.Start with the Food Factor 15 or use a factor according to your weight.
You can also determine your Food Factor by dividing *500 by your total daily insulin (long-acting + short-acting). Divide the total carbohydrate grams at each meal by your Food Factor. This is how much Novolog/Humalog insulin you will take before you eat. A Food Factor of 15 indicates that 1 unit of Novolog/Humalog insulin will cover 15 grams of carbohydrate.

6. Check your blood glucose before you eat.

7. If your blood glucose is over 150, you will need a Correction Factor ; consider 1 additional unit of Novolog/Humalog insulin for every 50 points over 150.
A more precise method is to add up your total daily insulin (long-acting + short-acting) and divide *1700 by this number. This is your Correction Factor.

8. Give enough insulin for the grams of carbohydrate at the meal plus extra insulin needed based on blood glucose.

9. Record your blood glucose 1-2 hours after eating.

10. Make any needed changes in the Food Factor based upon this blood glucose.

If blood glucose is too high, decrease the Food Factor by several points (more insulin).

If blood glucose is too low, increase the Food Factor by several points (less insulin).

A Food Factor of 10 indicates that 1 unit of Novolog/Humalog insulin will cover 10 grams of carbohydrate and a Food Factor of 20 indicates that 1 unit will cover 20 grams.

If this doesn't work you may need to change your Correction Factor.

EXAMPLES 1-4. You plan to eat:

1 sl bread (starch) 15 g carbohydrate ( carbs )
2 oz ham, cheese (meat) 0 g
1 small peach (fruit) 15 g
½ c pasta (starch) 15 g
1 c raw salad (vegetable) 5 g
1 c LF milk (milk) 12 g
Total 62 g carbs

EXAMPLE 5. 62 g carbs divided by 15 (your Food Factor) = 4 units Humalog insulin

(If the food label states 5 g of fiber or more, deduct that from the total carbs on the food label).

Or, if your total daily insulin is 34 (18 u Lantus + 16 u Humalog ), then *500 divided by 34 is ~15. You would need 1 unit of Humalog for every 15 g of carbs consumed. In this example, both methods give the same result. Even if you don't take insulin, being aware of how much carbs you eat at a meal can help control your blood glucose (BG).

EXAMPLES 6-7 . If your BG is 200 mg/ dL at this meal:

You may need 1 additional unit of Humalog to take care of the pre-meal elevated BG in addition to the insulin needed for the carbs you eat. If your Correction Factor is 50, 1 unit of Humalog is needed for every 50 points your BG is elevated over 150.

If you divide *1700 by 34 (your total daily insulin) you get 50: 1 unit of Humalog is needed for every 50 points your BG is elevated. In this example, both methods give the same result.

EXAMPLE 8. Give 4 units Humalog for the carbs you plan to eat + 1 unit for the elevated pre-meal BG...a total of 5 units.

EXAMPLE 9. Your BG should be < 160 1 hour after eating or < 140 mg/dl 2 hours after eating.

EXAMPLE 10 . Your Food Factor may vary from meal to meal. You may need more insulin at your noon meal. For example, if your BG is elevated after the noon meal, try a factor of 12 at the noon meal. So, 62 divided by 12 = 5 instead of 4 units of Humalog for the carbs at the noon meal.

If your BG is too low (<70) after the noon meal, you may need less insulin at the noon meal. You will need to increase your factor at the noon meal; try a factor of 18 or 20, eg , 62 divided by 20 = 3 instead of 4 units of Humalog for the carbs at the noon meal.

If this doesn't work, you may need to change your Correction Factor, eg , take 1 unit of Humalog for every 30 points (more insulin) or 1 unit for every 80 points (less insulin) your BG is elevated instead of 1 unit for every 50 points your BG is elevated over 150.

*500 and *1700 are often quoted formula numbers found in many scientific references.