Since being diagnosed at age 33 in July 2020, I have counted every carb. This is what my lifestyle allows–I only eat twice a day, all at home with stuff I prepare. I have a digital scale. I’ve kept track of how different carb types affect me differently–beans need much less insulin relative to my carb/insulin ratio than what is stated on the can of beans (that is, I treat beans as 50% less than what the stated carb amount is on the can). I’ve guessed and tried and corrected for what my dosage should be for different fruits (apples are 14 carbs/100 grams, watermelon is 3 carbs, sweet potatoes 19, etc.).
For a while I tracked fat and calories, but those don’t matter much for me w/ regard to insulin, so I quit that. I have no “target” carb amount–sometimes I’ll eat 30 in one day, a high day would be 110, and everything in between.
In the beginning, I did all this with the expectation that, eventually, I would know exactly what I needed to take when, and everything would be easier, and I would be fine at estimating carbs if I needed to.
Nope. I haven’t quit keeping close track of carbs, insulin dosing, correctiong, glucose readins, and exercise, b/c it’s never gotten easier. I finally realized that I do this not to get things right, but to not have things go terribly terribly awry. I’m just trying to avoid going terribly awry, at this point. If I didn’t keep close track, I don’t know how I’d manage.
I do MDI with a glucose meter. I tried a Dexcom for six months but the readings were so unreliable it was worse than MDI w/ meter, so I quit that.
I really feel for you, it’s so hard, it really is. If you have any ability to keep a closer tab on exactly how many and what type of carbs you’re eating, and prepare them as much as you can yourself, and perhaps even eat similar things for a while/rotate through a set of the same meals, I would try that. If you can’t do that (which is understandable), then maybe just try to eat similar things, at least for a while?
Also, I’ve had terrible experiences with corrections after meals with insulin, and realized finally that I need just the tiniest amounts to correct for high blood sugar, if I need any at all. For ex., for a 180 blood sugar, I would take at most a quarter of a unit, if that, maybe a tenth, maybe none, depending on how much insulin I think I have on board and how active I plan to be in the coming hours. You don’t want to hang out at a high number, but lows are worse, for me personally.
You mention too that you don’t know how to feel about your numbers. I totally get what you’re saying, I’ve felt the same way, had the same feelings of not knowing what to think. What helped most for me was paying attention to how I feel. If I’m below 100, I’m starting to feel crappy. 85 or lower isn’t good at all. So I try to stay over 100. I don’t feel great at 180, but it’s way better than 80. I feel good at 120 or 130. If I’m stable, 110 is great. If my food is just outrunning my insulin and I’m at 180 for a couple of hours, better that than risking taking too much insulin and going low and feeling way crappier later. If I’m 200 or higher, I don’t feel wonderful, but I am extremely conservative with my correciton doses. I might try to exercise if I can, instead of using insulin, then see where things are in an hour or so.
So, how should you feel about your numbers? Well, how do you feel, physically and mentally, at different numbers? That’d be my other suggestion for a guide.
Pre-bolusing is super variable for me–depends heavily on what my number is pre-meal, when I last took insulin, how much, how my numbers might be changing during the time pre-meal, and how active I’ve been that day. Sometimes (rarely) I need 20 minutes, other times none. Super hard to figure all this stuff out. You’re not alone, that’s just unfortunately the crappy nature of this disease. By the looks of the graph you posted, you’re doing great. 