How I Learned the Importance of Carb Counting

This blog post was originally published on Hugging the Cactus on April 6, 2018. I’m reposting it today because most people know that carb counting is important to a person with diabetes, but they might not understand exactly why. This post features an example that demonstrates all too well the negative implications associated with neglecting to carb count. Read on to learn how I figured out the importance of carb counting…the hard way…

One recent evening, I was rummaging through the kitchen pantry and noticed a bag of “veggie stix” stashed away, waiting to get opened. The sight of the bag instantly brought back memories of a time I was blatantly irresponsible with my carb counting and insulin dosing…

I learned the hard way that neglecting to count carbs can lead to scary high blood sugars…

…It was my junior year of college. I had plans to meet with a friend for dinner at seven o’clock. While that’s a standard suppertime for many people, it was kind of late for me. So that explains why I decided to treat myself to a snack a couple hours before it was time to go, just to hold me until I had my meal. My snack of choice? A bag of veggie stix just like these were sitting in the kitchen of my on-campus apartment. I thought I’d help myself to a few, believing (naively) that I had enough self control to know when to stop shoveling them down my gullet. That’s right, instead of doing the right thing and counting out a bunch before stowing the bag away, I was blindly consuming handful after handful without dosing for a single stick.

I can’t even use the defense that these veggie stix are strangely addicting – they really are, they taste a little like those potato sticks that used to come in cans – because I knew what I was doing wasn’t good for me. I just didn’t care. I had munched my way through half of the bag when it dawned on me that it would probably be smart to stop myself from eating more. I rolled up the bag, returned to my room, and did some homework until it was time to meet with my gal pal.

Little did I know that my blood sugar was rising to potentially dangerous levels.

I didn’t find out how high I was – over 400 mg/dL – until I reached the sandwich shop and had a plate full of chicken pesto carb-y goodness waiting to be consumed. My face must’ve shown my shock, because my friend asked me if I was alright. I quickly explained to her my mistake, and took an extra large bolus to cover my food and correct my blood sugar. Once that was done, I somehow managed to stop panicking long enough to enjoy the dinner with my friend, even though I couldn’t eat a bite of mine until an hour or so after injecting my insulin.

Although it sucked to go through this, I’m kind of glad that it happened because I learned a major lesson from it: ALWAYS count my carbs. It doesn’t matter if I WANT to be lazy or pretend that my diabetes doesn’t exist, I HAVE to hold myself accountable. It may be mentally draining and a bit of a nuisance, but it’s my own health here. It’s up to me, and me alone, to manage it.

And by the way, I did just help myself to the above bag of veggie stix. I had exactly 24 pieces, which equals exactly 5.4 grams of carbohydrates – a much smaller amount than what I ate that one night five years ago.

The Forgotten Bolus

My friends and family have always complimented me for having a good memory.

What can I say? I have a knack for remembering names and faces. I’m slightly better than decent at keeping track of birthdays. And I’ve kept journals of some sort for most of my life, so I’m usually able to recall the date on which a certain event took place (or I can at least look it up fairly quickly).

But my memory can fail me sometimes, and it did just that the other day when I forgot to bolus for dinner.

I don’t think I’ve ever forgotten a mealtime bolus in more than 23 years of life with diabetes. I suppose there’s a first time for everything…

To give myself a little credit, I truly thought that I had bolused. I remembered picking up my PDM and entering my blood sugar and carbohydrate information, but I never actually hit the very important “enter” button that would start delivering my insulin.

Imagine my surprise, then, when I saw my blood sugar rapidly rising – I’m talking double “up” arrows here – approximately 20 minutes after I finished my dinner.

And at first, I decided to ignore it! I thought that my insulin just needed a little more time to kick in, so I waited. And waited. And waited. But when I saw that I was rising above 250 mg/dL, I figured I should increase my temp basal…perhaps my body just needed a bit more insulin than I anticipated.

That’s when I picked up my PDM and saw that I had zero units of insulin on board. Extreme confusion turned into extreme panic as I asked my mom if I could check her PDM – what if I had picked hers up instead when I bolused for dinner and mistakenly gave her the insulin that was intended for me?!

Thankfully, that wasn’t the case, and I slowly began to piece together that I simply forgot to hit the bolus delivery button.

Whoops.

Almost one full hour after finishing my meal, I was finally delivering my mealtime bolus and silently fuming over my high blood sugar that ended up lasting several hours. It was a completely avoidable situation that shouldn’t have happened, but at least one good thing came out of it: I don’t think I’ll be forgetting to bolus any time soon.