30 Grams

I haven’t been able to stop thinking about a really enlightening article I read at Diatribe in recent weeks. Cherise talked about a glass ceiling that she had for the number of carbs she entered into her pump, and explored why she was hesitant to declare the actual number of carbs that she was eating.

I’ve lost count of the times where I’ve subconsciously entered 30 grams of carbs into my pump, even when I know I’ll probably be eating more.

30 grams is the number I’ve been conditioned into thinking is the ‘right’ amount of carbs for a meal. Many corners of the diabetes community send out messages that less insulin is better, and even worse, demonise food choices.

Today, my mentality has evolved to eat as much as I need to meet my own needs and not some unrealistic ideals of what is right. However, I can’t think of too many times where I will enter more than 30 grams into the bolus calculator of my insulin pump. It’s more of a wait-until-my-blood-sugar-starts-going-up until I’ll top up with more insulin.

30 grams also feels like a safe number. Even moreso after weeks of nasty hypoglycaemic episodes caused by a combination of hot weather and correcting extremely stubborn blood sugars until I’ve over-done it. You know, the ones where I have to stop what I’m doing completely because I can’t concentrate and I feel yucky.

My time in range has been suffering, for a while now. It was definitely a contributing factor to the fatigue that led me to take a pump break over Christmas. But even now that I’m comfortably settled back into pump life, that problem is still glaringly obvious.

50, or 60% at best, does not reflect my best effort. I know that I’m not supposed to judge myself on my numbers, but I feel guilty at seeing so much yellow and red on my Dexcom Clarity reports. Not to mention that my diabetes just feels so much harder to manage.

One of the hardest things about managing diabetes is that the dynamics are always changing. There are times where I need less insulin because it’s hot and I’ve been more active than normal. Then there are times where I need more because I’ve been ‘slacker’ than usual. You always have to stop and think about what’s going on, and what to do to fix the problem.

The lockdown that much of Western Australia was plunged into earlier this month, quite honesty, came at just the right time. It was just the perfect chance to take away some of those distractions – that background noise that comes from the daily grind – and just give my diabetes a little bit more love and attention that I can’t always seem to muster.

I think Cherise’s post couldn’t be more accurate, especially in the context of my own hesitation to go beyond 30 grams – and it will definitely be a focus for me going forward.

2 Comments

  1. Rick Phillips

    Frank I read this as I was entering 75 carbs in my pump (I was under a little). I am afraid I did / do not understand this line of thought. If i was estimating carbs by the seat of my pants, then yes. i used to enter 45 for almost everything. But once i got a telephone app and recorded everything I realized how far I had been off. At first I often tired this experiment. I did an estimated number, then i calculated it. I found I was right about, well none of the time. go figure!!

    Nowadays I am more honest and accurate. but its all good. I cringed when I read Cherise’s post this week. i thought, yeah that was me once. I am glad I do it more realistically these days.

  2. Richard Connelly

    Hi Frank,
    Thanks for your continued posts.
    I think I’ve understood where you’re coming from in wanting to cast off whatever messaging we receive about how we ‘should’ be managing our diabetes and letting us get on with our lives.
    Having said that, now let me make a suggestion which flies in the face of what I’ve just said.

    I’m a type1 Diabetic for over 30 years now. I would say that I have good BSL control. I manage that good control by following a ketogenic diet.

    Now, not wanting to sound like a keto-evanglist, I must say however that I used to fool myself thinking that, “if i want that chocolate mud cake with my dessert, then all I need is just to take more insulin. That’s what insuling is for after all!” What’s wrong with a meal that 30-40 grams CHO, I hear you say.

    Well, I’ve noticed that, funnily enough, when I don’t eat carbohydrates, my sugars don’t go up. And when I don’t take mountains of insulin, funnily enough my sugars don’t come crashing down,

    While not arguing that everyone should drop down to 20-30 grans CHO per day, like a strict keto person, there are great benefits to choosing to take less carbs.

    I’m actually more free now from the burden of managing my diabetes as I don’t have to respond to insuilin generated BSL responses.
    If people are struggling to make sense of diabetes control I’d encourage them to try and drop the carbs as much as possible. I’ll have my steak and salad any day, just hold the chips.
    Cheers
    Richard

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