So my doctor has never had me count Carbs?

Hey guys, Im tabby

I was reading and noticing how you all talk about counting your carbs...when I was in the hospital a pediatrician doctor decided to keep me as his own patient so I now see him for everything... This doctor has never really even told me about counting carbs.. This is my schedule... I get up at 5am and take a shot of humalan, 11 am I take a shot of lantus and humalan, 5 pm I take another shot of humalan and then at 11pm I take another shot of lantus and humalan.. Thats 6 shots totall... I don't eat big amounts of food at all because I know it runs my sugar up.. with taking all of those shots youd think it would be low... It hits 300 atleast one time a day... My sugar will not regulate at all and I have never counted carbs and im not sure how to correctly... Which the way my schedule is, it is very tough.. If anyone would like to um help me in learning how to count carbs or just any tips please comment... I mean I do excersise daily and everything, but usually I cant' do much for feeling so bad with the high sugars :/

If you're 16 you shouldn't be seeing a pediatrician anymore..that's just a little weird. I switched from the pediatrician D clinic to the adult D clinic at the other hospital in town when I was 13 and started seeing my endo the same year.

I didn't start carb counting until about 3 or 4 years ago now. It doesn't regulate my levels much better since I usually end up giving myself around the same amount but if you're interested, you should tell you doctor. If he doesn't know what it is or how to do it, ask to be referred to another doctor or nurse who does. Once you get set-up to do carb counting, you'll need to go to a nutritionist to go over the general rules of how many carbs are in what and look over your current eating habits to see how many carbs you're normally eating in the day.

Well my doctor is forein, and he doesn't wanna let me see an endo. he thinks because im 16 that i should be seeing him and not and adult endo. I have recently made an appointment in may to see a new endo, and Hopefully be getting a pump!!

Counting carbs allows you flexibility in eating and can help your blood sugars be better.  Check out chapter 12 in the Pink Panter Diabetes book.  The section on carb counting gives a formula to estimate your carb count.  Then you'll have to try it out and adjust the number.  http://www.ucdenver.edu/academics/colleges/medicalschool/centers/BarbaraDavis/OnlineBooks/books/Pages/UnderstandingDiabetes.aspx

When I was just out of high school my carb count was 1 unit of insulin for every 18g of carb eaten.  Now I'm older and have gained weight, so my carb count is 1 unit of insulin for every 12g of carb eaten.  People who are insulin resistant have lower carb counts like 1u=6g but kids and other people with high insulin sensivitivity can have carb counts like 1u=100g.

When you start carb counting that means you have to estimate the number of carbs in everything you eat.  If you have a smart phone or iPod the Track 3 diabetes app (costs $6) or the Lose It app (free) can help.  The best book is "The Calorie King Calorie, Fat and Carboydrate Counter."  You can get it at WalMart or most book stores or on their website. 

hey tabby i'm Jozef and I have never heard of a doctor putting a diabetic on that kind of schedule. carb counting isn't that hard but it depends on the individual person on how their insulin to carb ratio is. for me every 10 gram of carbs i eat i use 1 unit of apidra ( this is the type of insulin i use so it might be stronger or weaker than yours)   in my shot. for example I drank a can of Pepsi and by looking at the nutritional box on the side of the can I know that it is about 40 grams of carbs so that is 4 units of insulin that i give myself. but I don't know what your ratio is so u have to ask your Doctor about that. also since you do exercise you should eat a snack of about 10 to 20 grams of carbs if your blood sugar is kinda low. I hope this helps but if it doesn't then their are a lot of books about this and i think this website can help  http://type1diabetes.about.com/od/foodandnutritiontype1/a/Carb_Count_how.htm . also you should talk to your Doctor about this

sorry, i started writing this before everyone else had posted so it sounds like im repeating what they said

Oh it didn't sound like you were repeating it, But thank you.. and when I was in school ( im homeschooled now ) the school nurse had me on 15 carbs a snack and 60-90 carbs per meal.. but they never told me about matching the amount of insulin.. he has me on a scale or something like that.. I am seeing a new doctor soon.. and an educator! Hopefully it all works out...

Tabby,

Don't listen to other posts--I saw a Children's Specialist until I was 18 for diabetes, since one of the big cities near me offered a better Children's Hospital endo treatment than regular endocrinologists--I would not recommend switching to an adult endo since you are still transitioning into college.  

However, I would seriously consider switching doctors if you can...I cannot believe he hasn't implemented carb counting in your regimen.  I can see if he looked at your eating patterns and based your shots off of that, but what if you randomly want a mocha or a late night snack?  You have to have a mathematical ratio that allows you to be more flexible.  For example, my body is used to doing 1 unit of insulin for every 6 grams of carbohydrate.  So if I have a sandwich with some turkey and wheat bread, I count 30 carbs for the bread, then divide that by 6 to get a total dosage of 5 units of regular insulin.  I am on the pump, but these ratios are pretty average, I believe for a 19 year old girl who weighs 145 lbs.  

Once you get the hang of counting carbs for certain foods, it becomes really easy to gauge how much you should do.  For example, I pretty much know how many grams of carb are in most foods I eat (i.e. a slice of wheat bread is about 15 g, a cup of milk is 13 g, a white mocha is about 30 g, etc.).   I really recommend the website calorieking.com (they also have a small book that you can buy) since they have carbs for everything, and if you have a smartphone, you can access it at a restaurant if they don't provide nutrition information (although there seems to be a health-craze right now, MANY restaurants do not have grams of carb available.  I've had workers physically go into the freezer and check the frozen bags they receive to check how many grams of carb a certain food contains--many workers are not this nice, so you'll have to figure it out yourself, unfortunately).  

Good luck!:)  

Hayley

I was diagnosed at 18. At the time I didn't have health insurance so when I came down sick (no clue I had diabetes) I went to a local clinic that bases the fees on your income. The nurse practitioner who saw me that day told me how to regulate my diabetes and insisted that I continue seeing her. First off, she started me out on 20 units of Lantus daily. I basically walked around with my numbers in the 60's, 50's, 40's, and even 30's for several days. I did not feel good at all. I felt HORRIBLE, but I knew nothing about diabetes. I had no information or knowledge and I didn't know those numbers were too low. 2 years later I am out of my honeymooning phase and STILL 20 units would be like an overdose to me. Now that I am on a pump I don't use Lantus at all, but on shots I would only be taking about 8 units daily. Anyways, this nurse practitioner still insisted that she could help me treat my diabetes and so I continued to see her for about a year (even though I did end up getting insurance). My control was seriously bad at first. I always seemed to be way too low, or way too high. After going to the eye doctor he informed me that I had nerve damage in 1 of my eyes. Which completely freaked me out considering I had only had diabetes for about a year. He explained to me that the constant highs and lows were too hard on me. Finally I found my own endo and started going to her. Things honestly did improve instantly. At the endo, they showed me insulin pumps and I got to play around with them. After going on the OmniPod my A1C dropped from a 9.7 to a 6.8 in only 3 months. My control is so much better now. The doctors (and nurses!) are very good. If I don't personally contact them to let them know how my numbers are running, they will call or email me. In the case of an emergency, I am able to page or call them at their home during the weekend or holiday. They are so helpful and seem genuinely concerned that I am doing well. I am glad that they have clinics based on income because some people need medical help and don't have insurance, BUT to be honest, I felt like a lab rat there. I don't think they were type 1 experts and they really couldn't give me the help I needed. You need to see someone who specializes in diabetes. Go see an endo!!! You will not regret it!

I didn't read to see if anyone mentioned this, but there's a book I believe Calorie King, it has over 500 restaurants and a list of many different foods with how many carbs are in everything. This helps me out a lot. I know it's not on counting, but it's a start. You'll have to find out an insulin to carb ratio. I remember when i started i took 1 unit of Insulin for every 15 carbs. Like a piece of bread is 15 carbs so for a sandwich the bread would equal 30 carbs which would mean 2 units of insulin. Let me know if you need something else, I know this is very broad and you might have already got help else where. I'm at work so I just read a couple posts then write :).

It sounds shady that your doctor is discouraging you from going to an endo. My doctor told me that I don't have to go to an endo if I don't want to but he didn't try to stop me from going to see one. Either way I really believe this is a disease that you can never know too much about. Find out as much as you can. And take control over managing it yourself as soon as you can. Learning to listen to your body and balance that out with the information you learn about your diabetes and being able to manage your own insulin needs gives you freedom. The doctors are there to help you control your disease, but not to control you.

How long have you been diabetic?

[quote user="Jozef "]

I have never heard of a doctor putting a diabetic on that kind of schedule.

[/quote]

 

it's an old type of regime they don't usually use these days except for new diabetics as they are learning everything else. it follows the diet where you have 3 set meals a day and 2 snacks. Each meal and each snack has to have a certain amount of eat food group and the insulin dosing is based on those. it's not used often by long-time diabetics because carb counting allows you to target the carb intake better than the older regime making it more flexible when it comes to doses for meals and snacks.

[quote user="Hayley Schreiter"]

Tabby,

Don't listen to other posts--I saw a Children's Specialist until I was 18 for diabetes, since one of the big cities near me offered a better Children's Hospital endo treatment than regular endocrinologists--I would not recommend switching to an adult endo since you are still transitioning into college.  

[/quote]

If she were seeing a pediatrician endo, that would be different if they were a better option than an adult endo, but it didn't sound like he was an endo. Then her statement "Well my doctor is forein, and he doesn't wanna let me see an endo" definitely leads one to believe he isn't. =/ even if she switched to a pediatrician endo it seems like it would be a step up haha

I saw a peds dr. for a long time but you def. need to see an endo. There is something wrong with you being advised otherwise by your current doc. Counting carbs will put you in check. Honestly it doesn't sound like this guy knows what he's doing. He could very well be putting your life at risk with long-term side effects of you going into the 300's everyday. Very worrisome to me! Counting carbs takes awhile to get used to but after all the work....trust me, you'll be feeling great with your numbers being in a comfortable range. Best of luck. Keep us posted :)

Well my doctor is just a pediatrician, But see when I went into the hospital, he had the choice of keeping me or sending me to charlston where the endo's are and He's like I wanna keep her as my own patient, He has other children patients that are diabetics but i don't think they go through the same thing. He didn't want me to see and endo, but we scheduled an appt, anyway... You all are very right he is old and he is old fashion, See I am only 17 and I have had this since october of last year, and my sugar still hits the 300's daily, I am very restless, stressed, its like the simpplest things bother me! With this doctor i am not sure how they do homebound in your state but the doctor is suppose to sign a paper and a teacher from the closest school comes to your house! Well since october, The teachers have been coming to my house, half the time since october those school days were counted against me because he forgot the papers, I am ready to go back to school now and I am only aloud to be on homeschooling, so I am not aloud to attend a public school until next year! It gets boring stayin at home all of the time. I miss school!  Having diabetes is way tougher than i ever imagine!

Wow, from the sounds of this you need to get yourself a new doctor as soon as you can. Preferably an endo, but even a different general practitioner might be better, because you are not getting the advice or treatment you deserve. When I was diagnosed, I was out of school for 1 week. It is also very likely that your high blood sugar is what is making you restless and irritated too, those are some of the classic symptoms. Good luck!