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When deciding how much to bolus for a meal, do you factor the amount of fiber into your calculation?
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I used to occasionally inject through clothing when I was on MDI but now I donāt because I only do occasional injections to supplement my pump if I need a faster correction. I find injections create a faster correction time than corrections through the pump.
Yes, anything over 5 grams I subtract 1/2 the amount of grams of fiber from the total carb count. I pay attention to it but don’t make a big deal about it. I happen to like fiber rich foods and the fiber content has a beneficial effect on the physical body systems of digestion, metabolism, assimilation and elimination.
Exact formulas? Right. Treatment and remedies are often presented as if they contained the precision and exactness of an IRS tax audit, but reality renders itself much more in the realm of biological uncertainty if not outright Heissenberg uncertainty.
Love your comment. So youāre saying if you check your BG it will have an influence on what it really is? (Ala Heisenberg)š
I used to use the math the diabetes instructor gave us. If you use that, raspberries have negative carbs. I tested that theory once. Raspberries definitely have carbs and raise BG. After that, I pretty much ignore fiber. The most consideration I give it now is to use the extended bolus.
Fiber can only be subtracted from bolus amount only when fiber grams are above 5 per serving, then it’s only what is over the 5.
It only matters for certain foods, so it depends. All foods affect my BG differently, so I use the calculated amount my pump produces and manually increase or decrease the bolus manually depending on what I’m eating. It also affects the timing. For instance I know eating nuts will raise my BG, but much more slowly and much later. I usually don’t bolus for nuts until after I’ve eaten them, but I ALWAYS pre-bolus for “carby” foods.
When dxād T2, the CDE class I took advocated counting carbs minus fiber minus 1/2 the protein (if 5g+). I correct dx of T1 in discussion with Endo, Endo said sheād never heard of that formula and said, āJust count all the carbs.ā i.e. no subtractions for fiber or protein. Iāve since learned fiber is complicated to determine what is/isnāt digested and both fat and protein CAN contribute to BG rise depending on their amount and the amount of carbs in a meal.
When eating or cooking with packaged foods, I subtract the “fiber” from the “carbohydrates”. The remainder is the carbs that I use to calculate how much insulin to take. For fresh foods, I guesstimate vegetables, fruits, etc.
Sometimes I discount fiber > 5g per serving but only for those foods that I have felt affected me in the past. I liked Sasha Wooldridge’s answer āĀ it is also the way I approach it.
P.S. for me, just very old habit ā way before USDA Nutrition labels were around to make it easier (not only for diabetic carb counters but for every other condition where we know enough to use those data on the label).
A more accurate answer would be that when checking the CARBS I also notice the amount of fiber. This information is unconsciously added or subtracted to the bolus configuration along with related factors such as time of day, past or future exercise, my happiness levels, wellbeing, clarity of mind and timing of delivery of insulin in relationship to the Carb/fiber intake. All is math and magic.
We subtract the fiber from the total carbs. As others have pointed out, it’s not an exact science but that seems to work best because we tend to eat a lot of high fiber foods.
I used to. I stopped when I didn’t see any change in my numbers.
If my blood sugar is over target range I do not factor fiber. If my blood sugar is in or is on the lower side of my target range I do factor in the fiber, as well as extend the bolus, as it takes longer for my digestive system with fiber to make the carbohydrates available to my system. If pumps had an if/then programming option, I would not have to do this in my head. We really need our pumps to be more programmable, even with basal iq options.
Itās really interestingā¦ when on liquid mealtime Insulins, I used to factor for fiber. Now after 3yrs being on Inhaled meal time insulin, I no longer account for it. JUST REALIZED that due to todays question! WOW!š. This stuff is really amazing. I actually think less about my BGās and Iāve had better control than when on a pump. Never thought Iād see the day!
I’ve always felt my control was better on MDI than it has been since going on a pump!
Insoluble = no, otherwise yes.
why would I?
I used to deduct anything over 5, but everything has become so unpredictable from day to day (how much insulin am I producing, how sensitive am I to the insulin I inject) and I have also realized that even if one’s carb calculations are taken from packaging, there is an element of error, never mind if it’s a casserole or soup.
I think I read somewhere that those labels only have to be +/- 10%.
Not usually except in rare instances where the product’s nutrition label shows a large percentage of fiber per carbohydrate content. For instance a product may have 20 grams of carbs per serving but may also have 16 grams of fiber per serving. I have heard some diabetes educators say just subtract 1/2 of the fiber when calculating the carbohydrate count, so I would count the carbs as (20 minus 8 grams of fiber= 12 grams of carbs.) Most of the time however, I am not that precise.
I include it in the carb totals
Unless I’m eating a LOT of fiber in one meal I don’t bother.
I chose “other” because I do subtract 1/2 of the fiber content from the total carbs, if I have the information. Unfortunately, I don’t always know the amount of carbs or the amount of fiber in my meals so I have to guesstimate how much to bolus for.
I always use Total Carbs (my opinion is that Net carbs are a marketing stat used to make food look ‘healthy’). I have never factored in Fiber nor Protein as some do. Bodies age and change though…..
oops…. Total carbs include Fiber! So my answer should have been “Yes’ I do factor in Fiber in my calculations. Sorry to skew the data!
I chose other. Most often the answer is no, but if my BG is being a diver and wanting to stay low I will decrease the amount of insulin for foods that take longer to digest.
Generally not unless I am eating a very fiber-rich meal (e.g. chili with beans).