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    • 9 hours, 30 minutes ago
      KarenM6 likes your comment at
      In the past 12 months, have you experienced nausea and/or vomiting as a symptom of high blood glucose levels?
      "It's a forever learning curve" - so very true
    • 9 hours, 37 minutes ago
      KarenM6 likes your comment at
      For pump users: In the past 3 months, have you had issues with insulin delivery due to a bent cannula or occlusion?
      I hesitate to bring this up but I am quite sure this happens more than people realize. I use a tubed pump and small amounts of total daily insulin and have checked the tubing for YEARS for bubbles. YES, they are difficult to "notice" unless you have a good light behind the clear tubing because the insulin is also colorless. I detach and check the tubing in the morning and before bedtime if not before the evening meal...I'm talking about significant bubbles----8-10-or12 inches in length can appear and you would NOT notice them unless you were looking. I wonder how many people wonder why their blood sugar is occasionally high and it's being caused by a significant bubble...NO, not the champagne sized version that's often mentioned to "ignore." The pump company I deal with tried to get me to switch to injections instead but I am an EXPERT with the bubble situation. Also, comments over the years that I am probably not filling the reservoir correctly, etc....just plain silly. I am NOT new at this...LOL!!!
    • 10 hours, 2 minutes ago
      KarenM6 likes your comment at
      In the past 12 months, have you experienced nausea and/or vomiting as a symptom of high blood glucose levels?
      I said yes to nausea, occurred with a bad pump site insertion and rising BG over the next 4 hours. I picked it up early w CGM notification and realizing that it was very unusual for me to have rising BG at that time of the day (morning) when on Control IQ pump. The severity was delayed because I had given a breakfast meal bolus via the prior site before the change, so BG was rising after 3 hours, and I knew something was not right. I think this is an important clue for pumpers- when I see people get in trouble w bad sites or insertion failures, the thought process usually is- I just put a new site in, it must be ok- or maybe it does not occur to people that the pump site could have failed--when it should be- did the insertion fail? ----If in doubt, pull it out!----- I pulled the site and could see the cannula was bent, so I know what happened and injected w a syringe, put a new site in, and was better in a 3-4 hours.
    • 14 hours, 39 minutes ago
      Janis Senungetuk likes your comment at
      In the past 12 months, have you experienced nausea and/or vomiting as a symptom of high blood glucose levels?
      I said yes to nausea, occurred with a bad pump site insertion and rising BG over the next 4 hours. I picked it up early w CGM notification and realizing that it was very unusual for me to have rising BG at that time of the day (morning) when on Control IQ pump. The severity was delayed because I had given a breakfast meal bolus via the prior site before the change, so BG was rising after 3 hours, and I knew something was not right. I think this is an important clue for pumpers- when I see people get in trouble w bad sites or insertion failures, the thought process usually is- I just put a new site in, it must be ok- or maybe it does not occur to people that the pump site could have failed--when it should be- did the insertion fail? ----If in doubt, pull it out!----- I pulled the site and could see the cannula was bent, so I know what happened and injected w a syringe, put a new site in, and was better in a 3-4 hours.
    • 14 hours, 39 minutes ago
      Richard Wiener likes your comment at
      In the past 12 months, have you experienced nausea and/or vomiting as a symptom of high blood glucose levels?
      I said yes to nausea, occurred with a bad pump site insertion and rising BG over the next 4 hours. I picked it up early w CGM notification and realizing that it was very unusual for me to have rising BG at that time of the day (morning) when on Control IQ pump. The severity was delayed because I had given a breakfast meal bolus via the prior site before the change, so BG was rising after 3 hours, and I knew something was not right. I think this is an important clue for pumpers- when I see people get in trouble w bad sites or insertion failures, the thought process usually is- I just put a new site in, it must be ok- or maybe it does not occur to people that the pump site could have failed--when it should be- did the insertion fail? ----If in doubt, pull it out!----- I pulled the site and could see the cannula was bent, so I know what happened and injected w a syringe, put a new site in, and was better in a 3-4 hours.
    • 14 hours, 59 minutes ago
      Ahh Life likes your comment at
      In the past 12 months, have you experienced nausea and/or vomiting as a symptom of high blood glucose levels?
      I began playing Pickleball last year in March. When the temperatures started to rise the extra effort my body was experiencing because of the heat got my body hormones out of balance and I began experiencing nausea, higher heart rates and feeling very uncomfortable. I soon realized that I cannot play when is too hot or I’ll end up with ketones. Any new activity when on. Insulin requires adjustments. It’s a forever learning curve. Adding to the heat, last year I was having some absorption problems by the overuse of my abdomen. I have now move the infusion sites to my upper front side and it’s working much better.
    • 14 hours, 59 minutes ago
      Kristine Warmecke likes your comment at
      In the past 12 months, have you experienced nausea and/or vomiting as a symptom of high blood glucose levels?
      I said yes to nausea, occurred with a bad pump site insertion and rising BG over the next 4 hours. I picked it up early w CGM notification and realizing that it was very unusual for me to have rising BG at that time of the day (morning) when on Control IQ pump. The severity was delayed because I had given a breakfast meal bolus via the prior site before the change, so BG was rising after 3 hours, and I knew something was not right. I think this is an important clue for pumpers- when I see people get in trouble w bad sites or insertion failures, the thought process usually is- I just put a new site in, it must be ok- or maybe it does not occur to people that the pump site could have failed--when it should be- did the insertion fail? ----If in doubt, pull it out!----- I pulled the site and could see the cannula was bent, so I know what happened and injected w a syringe, put a new site in, and was better in a 3-4 hours.
    • 15 hours ago
      Ahh Life likes your comment at
      In the past 12 months, have you experienced nausea and/or vomiting as a symptom of high blood glucose levels?
      I answered no, but I do experience nausea and/or vomiting, usually on a daily basis, but this is because I have gastroparesis. I have rarely been able to eat breakfast over the last 20+ years as I end up vomiting it all back up ... try explaining that to ward staff in hospital(s). ;-)
    • 15 hours, 19 minutes ago
      Becky Hertz likes your comment at
      In the past 12 months, have you experienced nausea and/or vomiting as a symptom of high blood glucose levels?
      I said yes to nausea, occurred with a bad pump site insertion and rising BG over the next 4 hours. I picked it up early w CGM notification and realizing that it was very unusual for me to have rising BG at that time of the day (morning) when on Control IQ pump. The severity was delayed because I had given a breakfast meal bolus via the prior site before the change, so BG was rising after 3 hours, and I knew something was not right. I think this is an important clue for pumpers- when I see people get in trouble w bad sites or insertion failures, the thought process usually is- I just put a new site in, it must be ok- or maybe it does not occur to people that the pump site could have failed--when it should be- did the insertion fail? ----If in doubt, pull it out!----- I pulled the site and could see the cannula was bent, so I know what happened and injected w a syringe, put a new site in, and was better in a 3-4 hours.
    • 1 day, 7 hours ago
      Wanacure likes your comment at
      Have you developed lipohypertrophy due to repeated injections/infusions of insulin? Lipohypertrophy is a term to describe hardened lumps of body fat just under the skin that resulted from repeated insulin injections/infusion sites. If so, share how you’ve handled lipohypertrophy in the comments!
      After 62 years I have skin issues everywhere. I am an avid at rotating every time I change my infusion set. When I was on multiple daily injections, up to 9 per day, I had massive skin hardening. Since on the pump it’s not nearly as bad that’s been 33 years. I take very little insulin my daily basal comes out to 9 units over 24 hours I eat two meals that I count carbs for and try to keep at a minimum of 30-40 per day. Everything is going well. Rotation is key
    • 1 day, 7 hours ago
      Wanacure likes your comment at
      Have you developed lipohypertrophy due to repeated injections/infusions of insulin? Lipohypertrophy is a term to describe hardened lumps of body fat just under the skin that resulted from repeated insulin injections/infusion sites. If so, share how you’ve handled lipohypertrophy in the comments!
      I use a pump and have had issues with insulin absorbtion. It seems I have a lot of them on the side I primarily use for infusion sets. I recently switched to the other side of my abdomen and dropped more than one point on my a1c.
    • 1 day, 9 hours ago
      Wanacure likes your comment at
      Does your T1D healthcare provider suggest new medications or devices that they think would be beneficial to your T1D management during your appointments?
      When I first started with my current Endo we would discuss the released and upcoming products and I would tell her about the 'off-market' applications and devices, we both learned from each other. But she was so good with helping me transition to the Dexcom and then the Tandem after Animas was pulled from the Market. She followed my Dex and even finer tuned my Basals and early this year I got an "unbeleivable" 5.4 A1c and we are both extremely happy!
    • 1 day, 9 hours ago
      Wanacure likes your comment at
      Does your T1D healthcare provider suggest new medications or devices that they think would be beneficial to your T1D management during your appointments?
      Yes. But then I self-selected when choosing an endocrinology clinic that pursues cutting-edge advances 40 years ago. Cutting-edge is a phrase that is also often called bleeding-edge because it is often experimental, hit or miss on results, and very expensive. I am convinced the “bleeding” refers to $$$.
    • 1 day, 9 hours ago
      Wanacure likes your comment at
      Does your T1D healthcare provider suggest new medications or devices that they think would be beneficial to your T1D management during your appointments?
      not anymore, and I am happy about it! Most of the time they were recommending things that had been recently pitched to them by a pharmaceutical salesperson or a durable medical supplier. The doctors would give patients the "free samples" and it was often not the best fit, then after the "free" supply ran out, the prices were exorbitant. Maybe it still happens, but I haven't seen it for a while.
    • 1 day, 9 hours ago
      Wanacure likes your comment at
      If you have never used an insulin pump with automated insulin delivery (also known as a hybrid closed-loop pump), what are some of the reasons you’re reluctant, or obstacles you’ve encountered? Please select all that apply.
      The need for better CGM accuracy is a big consideration for me. Also my control is pretty good right now (a1c in the low 6 range). Although I am tempted by the sleep and exercise modes which would be very helpful since I’m getting back in to exercise. So…I keep sitting on the fence…
    • 1 day, 9 hours ago
      Wanacure likes your comment at
      If you have never used an insulin pump with automated insulin delivery (also known as a hybrid closed-loop pump), what are some of the reasons you’re reluctant, or obstacles you’ve encountered? Please select all that apply.
      I don’t want to change from the Omnipod Dash to Omnipod 5 because the minimum target blood glucose is level is higher than where I like to keep it. My A1C is currently 5.0.
    • 1 day, 9 hours ago
      Wanacure likes your comment at
      If you have never used an insulin pump with automated insulin delivery (also known as a hybrid closed-loop pump), what are some of the reasons you’re reluctant, or obstacles you’ve encountered? Please select all that apply.
      For the last 5 years, the highest HbA1C I've had was 5.3. For the last 3 years the high, low, & average have been 5.2, 4.7, & 4.9. I'm not willing to go to an AID that sets a target of 6 to 7.
    • 1 day, 9 hours ago
      Wanacure likes your comment at
      If you have never used an insulin pump with automated insulin delivery (also known as a hybrid closed-loop pump), what are some of the reasons you’re reluctant, or obstacles you’ve encountered? Please select all that apply.
      I do MDI. For the last 7 years my A1C has averaged around 4.8. I have no reason to believe that a closed loop automated system could do that well.
    • 1 day, 9 hours ago
      Wanacure likes your comment at
      If you have never used an insulin pump with automated insulin delivery (also known as a hybrid closed-loop pump), what are some of the reasons you’re reluctant, or obstacles you’ve encountered? Please select all that apply.
      There are many reasons, as well as "something else." My arthritic fingers do not serve me well with a cell phone. I have trouble putting the needle covers back on to my insulin pen needles. If I had to take care of all the fine muscle issues associated with setting a pump up, I would probably require assistance. I am also not drawn to the issues I hear about tissue damage at the infusion sites, or knowing whether everything is seated properly and the insulin is actually flowing. Finally, I just have some kind of negative karma with electronics. I have worked as a lab biochemist. Somehow, I find the weaknesses of every machine in the lab. (the ideal industrial beta-tester) Having said that, what I hear about the numbers achieved with the tandem CIQ gives me pause to consider.
    • 1 day, 9 hours ago
      Wanacure likes your comment at
      If you have never used an insulin pump with automated insulin delivery (also known as a hybrid closed-loop pump), what are some of the reasons you’re reluctant, or obstacles you’ve encountered? Please select all that apply.
      Like others, the "closed loop" runs me too high - even the target bg is too high for me. I use the TandemX2 with BIQ integrated wqith my Dexcom G6. I also appreciate - and use - the temp basal function often. I would lose that with CIQ. L:ike Nilla Eckstrom (I think?) I like to be between 80-90, with maybe up to 120 after I eat.
    • 1 day, 9 hours ago
      Wanacure likes your comment at
      If you have never used an insulin pump with automated insulin delivery (also known as a hybrid closed-loop pump), what are some of the reasons you’re reluctant, or obstacles you’ve encountered? Please select all that apply.
      The constant refilling and site changes...doesn't seem worth it.
    • 1 day, 9 hours ago
      Wanacure likes your comment at
      If you have never used an insulin pump with automated insulin delivery (also known as a hybrid closed-loop pump), what are some of the reasons you’re reluctant, or obstacles you’ve encountered? Please select all that apply.
      Luddites just may be the most comfortable people on earth. 🙃 
    • 1 day, 10 hours ago
      Antsy likes your comment at
      For pump users: In the past 3 months, have you had issues with insulin delivery due to a bent cannula or occlusion?
      Holy cow! 8 to 10” bubbles? There is definitely something wrong if that is happening to you. I occasionally get 1/4” inch 10” is excessive. Have you gone in and shown your pump instructor how you’re doing it so that they can help you figure out the problem?
    • 1 day, 10 hours ago
      Wanacure likes your comment at
      Aside from the first year after your diagnosis, have you seen a registered dietitian for help managing nutrition and T1D?
      When I was put on insulin, the first dietitian I payed to see said I could eat whatever I wanted as long as I followed the set number of macros (carbs, protein, fats). The stupid diet had my blood sugars all over the map. She didn't care/listen when I told her milk, bread/pasta made me feel really sick. She said because I was on insulin I need to eat a high carb, low protein and low fat diet. What bad advice! Thankfully, I came to my senses and starting reading the experiences of other T1D's who were following the The Bernstein diet.
    • 1 day, 10 hours ago
      Wanacure likes your comment at
      Aside from the first year after your diagnosis, have you seen a registered dietitian for help managing nutrition and T1D?
      Saw one, recently out of school, when I was first diagnosed ten years ago. She insisted I needed 150 grams of carbs per day minimum and handed me a sheet with meal plans. She explained that I needed those carbs to keep my brain functioning properly. GEEZ. I can only hope she's learned a thing or two since then.
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    When you are giving a meal bolus, how accurately do you count carbs most of the time? Select all statements that you identify with frequently.

    Home > LC Polls > When you are giving a meal bolus, how accurately do you count carbs most of the time? Select all statements that you identify with frequently.
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    Sarah Howard

    Sarah Howard (nee Tackett) has dedicated her career to supporting the T1D community 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. Sarah and her husband live in NYC with their cat Gracie. In her spare time, she enjoys doing comedy, taking dance classes, visiting art museums, and exploring different neighborhoods in NYC.

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    20 Comments

    1. Melinda Lipe

      I’ve been on a pump and counting carbs for over 20 years, so I either know the count in most foods or can guesstimate carbs in a given meal.

      2 years ago Log in to Reply
    2. Britni Steingard

      The webpage wouldn’t let me pick more than one so I selected looking up carb counts in an app or web search. There are several that I’ve memorized, though, and I keep a cheat sheet for foods that I eat often. I do guesstimate, sometimes, though, if I don’t know the exact portion size.

      2 years ago Log in to Reply
    3. Mike S

      I chose other because there wasn’t an option to pick more than one. After so many years, some foods I just know. Some that I don’t eat as often, I may still have to look up to know for sure and sometimes, like at a restaurant, I have to make a guess and watch the CGM for adjustments.

      2 years ago Log in to Reply
    4. George Lovelace

      GRAM SCALE and Calculator are indispensable!! (and most of the other answers also)

      2 years ago Log in to Reply
    5. Tod Herman

      I selected several of the options because most of them apply. If I am cooking at home, I can calculate the carbs from each item. If I eat at a restaurant, then I have to guestimate the various items. Sometimes, it cab be nothing more than a wild ass guess.

      2 years ago Log in to Reply
    6. Sherolyn Newell

      Some things I know how many carbs to put in my pump, and it’s not always the carbs in the food. Some foods act like more or less carbs than they really are. Other stuff I look up. Some stuff I estimate by looking up and guessing how much I am eating. That’s usually at a restaurant, at home I can use a scale. If it’s a sweet at a restaurant, I go by size. I figure it’s mostly sugar, so I look at it and imagine how many teaspoons it is. Then I take a little bit and make whoever is with me eat the rest.

      2 years ago Log in to Reply
    7. David Smith

      At home, with foods I eat often, I’ve memorized the carbs and usually get it pretty close. With some foods, I use Calorie King to look them up. Eating out is the wild card. I know which kinds of foods have more carbs than others, and use that to make a guesstimate for my bolus. Then I follow my sensor and bolus more if I see my glucose headed north.

      2 years ago Log in to Reply
    8. Gene Maggard

      It’s pretty much a guestimate for me most of the time. I have to consider things like alcohol and its effect on the carbs (delays them acting), and certain carbs like pasta which metabolize over a longer period. I usually just keep a watch on my CGM reading and adjust as the day or evening wears on.

      2 years ago Log in to Reply
    9. lis be

      When at home it is easy to know carb count or google it.. But eating out or ordering in is difficult. Restaurants often add ingredients that have hidden carbs like sweaters, thickeners, or breading.

      2 years ago Log in to Reply
    10. Daniel Bestvater

      I used to measure and count carbs very accurately but found insulin timing to be far more important. I have discussed this with a number of other healthcare colleagues and many of us have found this to be the case. It seems fine to estimate the carb count then use a pre-bolus sliding time scale, anywhere from immediately before to 90 minutes before carbs depending on BG. Seems counter to what we have always thought but it may have to due with glucagon and glycogen stores in the liver.

      2 years ago Log in to Reply
    11. Sasha Wooldridge

      I don’t always think about the carbs, but rather how many units did or didn’t work last time I ate something like it. For instance, Chinese food… I just pre-bolus 10 units, then bolus another 10 when I start eating. That’ll keep me from skyrocketing, but sometimes I need another bolus later and I eyeball that depending on my BG trend. Another everyday example is my coffee in the morning. Bolus about 2 units when I start drinking it and I’m good to go.

      2 years ago Log in to Reply
    12. connie ker

      The power of Guesstimation has been good for me, as well as going by the numbers constantly and right before a meal.

      2 years ago Log in to Reply
    13. Dennis Dacey

      Breakfast $ lunch at home is very easy for me to know the exact number of carbs for meals I regularly eat. The exception to that is the apple [one of at least three fresh fruits I eat every day] at lunchtime which can range in carbs between 13 and 28 carbs depending on variety and size- experience has helped me with a good, educated quess. Supper is totally different, yet I can usually come up with an accurate estimate having lived with diabetes for over six decades, and began counting carbs in the 1970s. Restaurants, during non-pandemic times where we would eat a couple if times a week are more of a guessing game. during pandemic isolation my wife has become more creative [great for a gal well into her 80s] with supper, depending on the expanded stocks of foods our daughter has been delivering to our home. but despite this challenge, I’ve been able to maintain my TIR at +90%.

      2 years ago Log in to Reply
    14. Patricia Dalrymple

      Home is easy. Out I just do 90 grams because I can do anymore than that – will go low before I go high. Then I either increase my basal (have a high energy and low energy setting) or know within an hour I need to bolus again for about 1.8 – 2 units more. Works.

      2 years ago Log in to Reply
    15. ConnieT1D62

      I have been carb counting for so long that I ~ more or less know ~ the exact amount for certain portion size foods I eat on a regular basis; other wise I guesstimate, read labels, or look an unknown something up on an app like Calorie King.

      2 years ago Log in to Reply
    16. Janice B

      My breakfast is always the same so counting carbs is not an issue. During the week I do not eat lunch so no issue, and dinner is generally meat and vegetable so again easy. Weekend lunch when we go out to eat is more of a guessing game. After 25 years I have most items that I order down but there are always wild cards.

      2 years ago Log in to Reply
    17. Thomas Hatton

      I have made a list of carb content on my phone for the meals I eat and refer to that. Eating out (remember when we did that?) was always more difficult. I had to wait for the meal to be delivered. My wife was a dietitian and has been a tremendous help.

      2 years ago Log in to Reply
    18. Thomas Cline

      I always just guess based on experience, and then titrate subsequently based on my reaction after eating. Obviously I generally avoid foods that I know to be problematic (like Pizza) and I do eat the same things for breakfast and lunch every day. Since I seem to be quite variable (exercise is one factor having a big influence), I find this empirical approach allows me to reach my goal of staying at or below an A1c of 7. Of course during the pandemic, eating out has not been an issue — and that is always the hardest thing to manage.

      2 years ago Log in to Reply
    19. Molly Jones

      I have memorized how many carbs/g are in different types of food that I eat frequently, but I still have to weight them. When I don’t know the amount of carbs in a specific food, I google it or look it up in a food tracking app. I like the food data central from the government the best. I liked it better about five years ago before all the brands were put on. That data is on their container. Other: When eating out I it’s east to stick to chain restaurants as their nutrition is up on the internet. Otherwise I have to ask questions about whether or not sugar is added. I don’t worry about vegetables, I can roughly guess rice, potatoes, soups can be hard and sauces are are impossible.

      2 years ago Log in to Reply
    20. Pat Reynolds

      I mostly look know, or look it up., or my partner is doing the cookng and they tell me. Some things have to be guestimated because maturity and species mean that a one-size-fits-all ‘100g of this has X carb can be out, and you won’t know until its cooked (if then) – so personally I pre-bolus and leave Control–iq to deal with it..

      2 years ago Log in to Reply

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