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    • 11 hours, 9 minutes ago
      Amanda Barras likes your comment at
      If you or your spouse live with T1D and are thinking about having a baby, how concerned are you about them carrying T1D autoantibodies?
      I had two healthy pregnancies. The only issues were low blood sugars and my babies being born early other than that they are 38 and 35 years old, healthy children.
    • 15 hours, 28 minutes ago
      Lawrence S. likes your comment at
      When you bolus for a meal, do you usually estimate carbs, use an app, or the nutrition label? Please share your habits in the comments.
      I use them all. I use an app when I’m eating out. I use labels when at home. If not on the app I estimate.
    • 15 hours, 28 minutes ago
      Lawrence S. likes your comment at
      When you bolus for a meal, do you usually estimate carbs, use an app, or the nutrition label? Please share your habits in the comments.
      If there is a label, I always read it. I can estimate pretty well, too, after 40 years. It helps to eat similar foods daily. Not computer savvy enough to use an app. It seems a lot of work..
    • 15 hours, 28 minutes ago
      Lawrence S. likes your comment at
      When you bolus for a meal, do you usually estimate carbs, use an app, or the nutrition label? Please share your habits in the comments.
      I generally do a very rough guess of carbs and correct if needed by adding more insulin for an also rough guess for effect of fat and protein later. My alert is set at 130 to remind me so I don’t get too high. I watch arrows a lot. I have had individual sensors lately that are not accurate. This can throw me off, where the sensor reading will be going up fast at say 180 and I will test my blood and it is 130. Sometimes I will have already corrected for the 180. This can cause a very rough day having to feed the insulin. I am hoping sensors will continue to get more accurate. So much depends on it especially with the algorithm. I usually don’t wait for my algorithm to correct because it will let my bg get too high. I know I’m supposed to let the algorithm do its thing but my goals are more strict. I am on G7 and Omnipod 5. I would like to be able to set my target at 100.
    • 15 hours, 29 minutes ago
      Lawrence S. likes your comment at
      When you bolus for a meal, do you usually estimate carbs, use an app, or the nutrition label? Please share your habits in the comments.
      I should have clicked the fourth option. I use the labels if available. If not, I estimate.
    • 15 hours, 52 minutes ago
      atr likes your comment at
      If you or your spouse live with T1D and are thinking about having a baby, how concerned are you about them carrying T1D autoantibodies?
      We knew the risk was 50%. My wife miscarried 4x. We ended up with three great sons, only 1 has T1D. His eldest daughter (of 2) also has T1D.
    • 15 hours, 53 minutes ago
      atr likes your comment at
      If you or your spouse live with T1D and are thinking about having a baby, how concerned are you about them carrying T1D autoantibodies?
      47 years ago i had my pregnancies and didnt hear about her carrying T1D antibodies but i did have concerns about my child having diabetes. When she was about 12 there was a study to see her chance of developing diabetes ,this blood test was negative. 2 of my grandchildren have been tested and were negative . At the time of my pregnancies i had diabetes for 10 years
    • 15 hours, 54 minutes ago
      atr likes your comment at
      If you or your spouse live with T1D and are thinking about having a baby, how concerned are you about them carrying T1D autoantibodies?
      If you have T1D, there is an 80% chance that no one else in your family has or will have it. If someone else in my family had it, I'd be much more concerned about passing it on than I am knowing that I am the one and only.
    • 1 day, 5 hours ago
      Watertail likes your comment at
      When people talk about diabetes, are there trigger words that bother you? Please share what they are in the comments.
      oh and this one...... when I see a new doctor they say... "let's get some blood work to see if you have diabetes" and I ask them... did you even read my intake forms that say I have had T1 D for over 40 years? ughhhhhh
    • 1 day, 5 hours ago
      Janis Senungetuk likes your comment at
      When you bolus for a meal, do you usually estimate carbs, use an app, or the nutrition label? Please share your habits in the comments.
      I use the nutrition labels as a starting point. For home made foods or for restaurant meals, my wife who was a nutritionist, helps come up with a carb estimate. Then there are times that I just have to take a wild ass guess. I have collected a list of over a hundred common foods that I eat and I keep that keep that list in a notes app on my phone right next to my T-slim app. I often check the nutrition labels for things on my list to see if the recommended carb levels for that item have changed. Then I adjust my list as needed. I also check my BG response to listed carbs I eat. I have adjusted some items over time. So, I would call this approach a hybrid. As Daniel Bestvater notes above, we are only controlling one item out of 6. Your mileage may vary.
    • 1 day, 5 hours ago
      Watertail likes your comment at
      When people talk about diabetes, are there trigger words that bother you? Please share what they are in the comments.
      Not really trigger words as much as not understanding or even aware of the difference between Type 1 and Type 2.
    • 1 day, 5 hours ago
      Watertail likes your comment at
      When people talk about diabetes, are there trigger words that bother you? Please share what they are in the comments.
      And it's especially frustrating when HCP's ask about "checking your sugars? Be a professional dammit, ask about my "blood glucose"
    • 1 day, 5 hours ago
      Janis Senungetuk likes your comment at
      When you bolus for a meal, do you usually estimate carbs, use an app, or the nutrition label? Please share your habits in the comments.
      I count carbs, acc. To Mabel if I have, look up nutrition for items, and estimate if needed. Used to always cook myself till this yr, now in apt where food is provided, so now looking up a lot to estimate. Going pretty well
    • 1 day, 5 hours ago
      Janis Senungetuk likes your comment at
      When you bolus for a meal, do you usually estimate carbs, use an app, or the nutrition label? Please share your habits in the comments.
      Years ago I used to calculate out carbs with a scale & book. Then I realized it didn’t seem to make a huge difference. I had many discussions with an endocrinologist friend about this topic and we both found that highly accurate carb counting didn’t seem to make much difference. As long as you are in the ballpark. I think we need to realize the pancreas produces at least 6 BG regulator hormones and we are only injecting one, insulin. So we need to do our best but not stress over it. This is at least why 2 identical meals can result in two different BG levels.
    • 1 day, 5 hours ago
      Janis Senungetuk likes your comment at
      When you bolus for a meal, do you usually estimate carbs, use an app, or the nutrition label? Please share your habits in the comments.
      It depends on the situation. At home I calculate carbohydrate with my scale. At restaurants it depends on if they have nutritional information available. If they don't have it, I estimate. The same with eating with other people's houses even while using my scale.
    • 1 day, 7 hours ago
      AmyM likes your comment at
      When you bolus for a meal, do you usually estimate carbs, use an app, or the nutrition label? Please share your habits in the comments.
      If I have a label I use it. Mostly I guesstimate then use the info the next time I eat the same meal. I am a big eater with no weight problem. When I go out, usually 2-3 times per week, I have to put in 90 grams of carbs, then add if not enough because I will go low before I go high. The other times, when eating at home, I eat less. Exercise is key. I just got back from 3 trips in 6 weeks. To Sicily, Boothbay Harbor, Maine, and to visit family in Baltimore. Only in Baltimore did I have issues with BG, because I wasn’t walking as much, although I did walk 1.5 miles most days. A1C when got home was 6.3. Time in range about 75%, down from usual 85%. I’ll take that. Not traveling for another year probably and will get back on track.
    • 1 day, 10 hours ago
      KarenM6 likes your comment at
      When you bolus for a meal, do you usually estimate carbs, use an app, or the nutrition label? Please share your habits in the comments.
      I should have clicked the fourth option. I use the labels if available. If not, I estimate.
    • 1 day, 10 hours ago
      KarenM6 likes your comment at
      When you bolus for a meal, do you usually estimate carbs, use an app, or the nutrition label? Please share your habits in the comments.
      Years ago I used to calculate out carbs with a scale & book. Then I realized it didn’t seem to make a huge difference. I had many discussions with an endocrinologist friend about this topic and we both found that highly accurate carb counting didn’t seem to make much difference. As long as you are in the ballpark. I think we need to realize the pancreas produces at least 6 BG regulator hormones and we are only injecting one, insulin. So we need to do our best but not stress over it. This is at least why 2 identical meals can result in two different BG levels.
    • 1 day, 12 hours ago
      lis be likes your comment at
      When you bolus for a meal, do you usually estimate carbs, use an app, or the nutrition label? Please share your habits in the comments.
      Years ago I used to calculate out carbs with a scale & book. Then I realized it didn’t seem to make a huge difference. I had many discussions with an endocrinologist friend about this topic and we both found that highly accurate carb counting didn’t seem to make much difference. As long as you are in the ballpark. I think we need to realize the pancreas produces at least 6 BG regulator hormones and we are only injecting one, insulin. So we need to do our best but not stress over it. This is at least why 2 identical meals can result in two different BG levels.
    • 1 day, 12 hours ago
      lis be likes your comment at
      When you bolus for a meal, do you usually estimate carbs, use an app, or the nutrition label? Please share your habits in the comments.
      Cronometer
    • 1 day, 13 hours ago
      Trina Blake likes your comment at
      When you bolus for a meal, do you usually estimate carbs, use an app, or the nutrition label? Please share your habits in the comments.
      Years ago I used to calculate out carbs with a scale & book. Then I realized it didn’t seem to make a huge difference. I had many discussions with an endocrinologist friend about this topic and we both found that highly accurate carb counting didn’t seem to make much difference. As long as you are in the ballpark. I think we need to realize the pancreas produces at least 6 BG regulator hormones and we are only injecting one, insulin. So we need to do our best but not stress over it. This is at least why 2 identical meals can result in two different BG levels.
    • 1 day, 14 hours ago
      TEH likes your comment at
      When you bolus for a meal, do you usually estimate carbs, use an app, or the nutrition label? Please share your habits in the comments.
      Years ago I used to calculate out carbs with a scale & book. Then I realized it didn’t seem to make a huge difference. I had many discussions with an endocrinologist friend about this topic and we both found that highly accurate carb counting didn’t seem to make much difference. As long as you are in the ballpark. I think we need to realize the pancreas produces at least 6 BG regulator hormones and we are only injecting one, insulin. So we need to do our best but not stress over it. This is at least why 2 identical meals can result in two different BG levels.
    • 1 day, 15 hours ago
      Bob Durstenfeld likes your comment at
      When you bolus for a meal, do you usually estimate carbs, use an app, or the nutrition label? Please share your habits in the comments.
      Years ago I used to calculate out carbs with a scale & book. Then I realized it didn’t seem to make a huge difference. I had many discussions with an endocrinologist friend about this topic and we both found that highly accurate carb counting didn’t seem to make much difference. As long as you are in the ballpark. I think we need to realize the pancreas produces at least 6 BG regulator hormones and we are only injecting one, insulin. So we need to do our best but not stress over it. This is at least why 2 identical meals can result in two different BG levels.
    • 1 day, 16 hours ago
      Marty likes your comment at
      When you bolus for a meal, do you usually estimate carbs, use an app, or the nutrition label? Please share your habits in the comments.
      Years ago I used to calculate out carbs with a scale & book. Then I realized it didn’t seem to make a huge difference. I had many discussions with an endocrinologist friend about this topic and we both found that highly accurate carb counting didn’t seem to make much difference. As long as you are in the ballpark. I think we need to realize the pancreas produces at least 6 BG regulator hormones and we are only injecting one, insulin. So we need to do our best but not stress over it. This is at least why 2 identical meals can result in two different BG levels.
    • 1 day, 16 hours ago
      atr likes your comment at
      When you bolus for a meal, do you usually estimate carbs, use an app, or the nutrition label? Please share your habits in the comments.
      Years ago I used to calculate out carbs with a scale & book. Then I realized it didn’t seem to make a huge difference. I had many discussions with an endocrinologist friend about this topic and we both found that highly accurate carb counting didn’t seem to make much difference. As long as you are in the ballpark. I think we need to realize the pancreas produces at least 6 BG regulator hormones and we are only injecting one, insulin. So we need to do our best but not stress over it. This is at least why 2 identical meals can result in two different BG levels.
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    When counting your carbs before bolusing, do you factor the amount of fat into your calculation at all?

    Home > LC Polls > When counting your carbs before bolusing, do you factor the amount of fat into your calculation at all?
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    When you are traveling away from home for a few days, do you typically take glucagon with you?

    Sarah Howard

    Sarah Howard has worked in the diabetes research field ever since she was diagnosed with T1D while in college in May 2013. Since then, she has worked for various diabetes organizations, focusing on research, advocacy, and community-building efforts for people with T1D and their loved ones. Sarah is currently the Senior Marketing Manager at T1D Exchange.

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    29 Comments

    1. AimmcG

      Since I use a closed loop system my accuracy in carb counting has gotten less accurate. I don’t have to be as precise

      3 years ago Log in to Reply
    2. Ms Cris

      Yes.
      Higher fat meal, longer extended bolus.
      Lower fat meal, shorter extender bolus.

      3 years ago Log in to Reply
    3. Lawrence S.

      Generally, I eat a low-fat diet. However, there may be occasions when I eat a high fat meal, and use an extended bolus. But, I don’t calculate for fats.

      3 years ago Log in to Reply
    4. Amanda Barras

      Not so much actually counting it, but being aware it’s there and is going to delay absorption. Changing a regular bolus to an extended bolus to cover high carb and fat food like pizza and Chinese food.

      4
      3 years ago Log in to Reply
      1. mojoseje

        I wish CGM paired with my pump allowed for dual and square-wave boluses.

        2
        3 years ago Log in to Reply
    5. Ahh Life

      In the good old days it would take 90 minutes for digestion on my low-fat diet. I would add 2-3 hours for pizza and high-fat food digestion with extended boluses.

      Then gastroparesis reared its ugly head. All bets were off. I now use the best artful artifice to finesse and approximate the equations diabetic educators recommend. Biology and faulty nerves often work at wicked purposes. 🙈

      6
      3 years ago Log in to Reply
      1. Lawrence S.

        Ditto

        3 years ago Log in to Reply
      2. Joan Fray

        Yes, delayed stomach emptying can be another monkey in the wrench!

        3 years ago Log in to Reply
    6. Sherolyn Newell

      I read that fat also inhibits the action of insulin. It also said how much is different for everyone, some need 10% more insulin, some need double. Seems risky to experiment much, but I usually increase the carb count by 10% and do the usual extended bolus.

      3 years ago Log in to Reply
    7. mbulzomi@optonline.net

      I have travelled extensively around the world. I never have taken my Gvoke HypoPen with me. Do you think everybody can read English to administer the glucagon injection?

      A never leave home without my Glucose tablets PERIOD!

      3 years ago Log in to Reply
      1. mbulzomi@optonline.net

        Answered in error.

        1
        3 years ago Log in to Reply
    8. mojoseje

      I only bolus for carbs and when my bg starts to rise later (after a couple of hours) I look at the upward trend and “correct” for the fats. I think I’m pretty successful at it since my endocrinologist says being in-range at 93% is really good.

      3
      3 years ago Log in to Reply
    9. Jane Cerullo

      For me fat usually requires a bolus a few hours after a meal. Tried keto but was not for me. BS all over the place. I’ll stick to low carb moderate fat.

      1
      3 years ago Log in to Reply
    10. Mick Martin

      I do factor in the amount of fat in a meal in order to administer a dual-wave bolus of insulin.

      With meals such as pizza or chips (French fries) I tend to give two thirds of my bolus immediately and the remaining third over a period of about 1.5 hours.

      2
      3 years ago Log in to Reply
    11. Bob Durstenfeld

      Pizza!
      It gets a delayed bolus.
      Other than that, not often. I stay away from fatty meals.

      1
      3 years ago Log in to Reply
    12. Sheldon Schwartz

      . Fat slows digestion so it will determine extended bolus or not.

      3 years ago Log in to Reply
    13. Janis Senungetuk

      I only consider the amount of fat if my meal is pizza or another meal with lots of cheese. If that’s the case then I extend the bolus delivery but I don’t increase the carb count.

      1
      3 years ago Log in to Reply
    14. Jeff Balbirnie

      If the food has a greater amount of fat/protein if may factor in the dosage, but there is no specific math for that I know of….

      Likely being attentive at the back end of that dosage ( I.e. 3-4 hours later.)

      1
      3 years ago Log in to Reply
    15. Becky Hertz

      I rarely eat high fat meals. I use extended bonus when I do

      3 years ago Log in to Reply
    16. Bonnie Lundblom

      Pizza is the meal that requires me to extend the bolus dose but doesn’t affect the amount of insulin bolus I use to cover the carbohydrate amount.

      3 years ago Log in to Reply
    17. Pauline M Reynolds

      I only take the fat into consideration if it is a high fat meal, like pizza. Then I use extended bolus.

      4
      3 years ago Log in to Reply
    18. Mitchell Ehrlich

      I consider the amount of fat to determine if, and how long, to set up an extended or dual-wave bolus. I do this to account for the effect of the fat slowing absorption of the carbs, and thus slowing of the rise of BG. For me, if I don’t do this I will end up with high BG much later than usual after the meal.

      1
      3 years ago Log in to Reply
    19. kflying1@yahoo.com

      Through experimentation for different foods, and limiting the varieties I’ve come to involuntarily account for fats, like with pizza or various meats.

      1
      3 years ago Log in to Reply
    20. Eve Rabbiner

      I try to avoid fat rich meals in the evening but when I don’t I increase my basal rate.

      3 years ago Log in to Reply
    21. KarenM6

      Just as an “extended” bolus.

      3 years ago Log in to Reply
    22. Nicholas Argento

      Fat clearly increases the need for insulin by making the person more insulin resistant for 6-12 or more hours, and also by a more direct mechanism. There really is no concensus on how to cover, and it does vary from person to person. As a rule of thumb, if there are carbs and fat, I increase carb counts by 30-50% and give the extra as a 2 hr delayed bolus w pump, or a second bolus at 1-2 hours for pizza. If fat alone like nuts, I don’t cover unless a large amount. I do cover cheese if a larger amount but no set way to do it. One suggestion is consider as 1 gram fat = 1/2 to 1/3 gram carb. Coverage for fat is needed, but it is highly varied based on individual experience.

      2
      3 years ago Log in to Reply
    23. Wanacure

      I try to eliminate variables by trying to maintain same doses of MDI at same times. I try for each breakfast to have same grams of fat, protein, and net carbs. Each lunch has the same food values as preceding day’s lunch. Each dinner has same value as preceding day’s dinner. If I deviate, I try to anticipate what effect it will have and lower or increase fast acting lispro, and/or plan on a snack. I try to be aware of and correct for unusual exercise, or poor sleep or unusual menu item if eat at a restaurant or taco truck.

      3 years ago Log in to Reply
    24. Katie King

      Pizza is the one food that I have to consider the fat with my calculations

      3 years ago Log in to Reply
    25. Cheryl Seibert

      In 22 years of pumping, I never counted Fat or protein. However, I do count fat and protein now. Recently, as I am getting older, I’ve had issues with spiking BGs after eating even with adjusting carb ratios, etc. Protein tends to affect the BG more than fat, but since I’ve starting counting fat, my Time In Range is much beter.

      3 years ago Log in to Reply

    When counting your carbs before bolusing, do you factor the amount of fat into your calculation at all? Cancel reply

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