[Richard157]

On Wed of last week my wife and I had lunch at Ruby Tuesdays. I had not had ribs for a long time because the carb count was very high! I really wanted some ribs and decided to take a big bolus and have a great meal. According to the Calorie King there were 78 carbs in the ribs with barbecue sauce and the veggies added another 25 carbs. That was a total of 102 carbs, perhaps the most carbs I have eaten at a meal since I started carb counting. My pump called for 12.7 units of insulin for the meal. We were going to do a lot of walking later, so I bolused 10 units. About 50 minutes after my bolus I felt low. I tested and it was 47. I ate 4 glucose tabs, waited 30 minutes, and I was 57. Two more tabs and an hour wait, and I was 48. Two more tabs, and an hour wait, and I was 61. I ate some watermelon at home. 30 carbs with no bolus. An hour later I was 138. My BG never went any higher and I was 94 at bedtime. Back on schedule.

I wondered why all the lows occurred and why it took 5 hours to get the BG under control. I had eaten 8 glucose tabs and 30 carbs of watermelon. I never required that much before to take care of a low. Then I looked at the front of my Calorie King, and it was dated 2007. I went to the online Calorie King listing for the current carb count for Ruby Tuesdays ribs, half rack, with barbecue sauce, and the carb count is now 28. I bolused for 78 and it was actually 28, so I took more than 6 units too much!! Six units would lower my BG about 90 points, without carbs. Mystery solved. I have now ordered a 2011 copy of Calorie King! Lesson learned. Always keep your books with carb listings up to date!!!

 

[Strawberry]

Richard - Those 'lows' you had must have been a bit scary? I've encountered a few situations like that myself lately. I just checked my Calorie King book and it is 2008, so it looks like maybe I better order a more recent one. Thank you for sharing your experience and I hope you are feeling better now.

 

[Shanny]

You're amazing, Richard. I'm glad you got your ribs, but I'm sorry the Calorie King threw a wet blanket on the celebration. Leave it to you to ferret out what went wrong though! Nice detective work!

 

[tgreen]

I made my own ribs last week. took about 8 hours to do them right but they were yummy. what really messed me up was when i did my BG test at 2 hours it came in at 238. i about fell off of my chair i havent been above 130 for months. i decided to wash my hands and test again. 105. i guess i still had a little BBQ sauce on my fingers, even though they looked clean.

 

[gphx]

I kinda thought the lesson was not to eat barbeque ribs but to each their own.

 

[Adjitater]

It is a prime example of what may of us go through every day with tring to match insulin to meals and the timing of the bolus's. Thanks Richard it was a fine example of what we have to do when the best of plans just go wrong.

 

[moon]

Thinking you have to rely on a restaurant's reporting of nutritional information - well, that is a bit scary!

 

[gphx]

Thinking you have to rely on a restaurant's reporting of nutritional information - well, that is a bit scary!

I'm not usually big on adding regulations but restaurants having to report nutritional content of their food is one I like. Having taken their ribs from 79 carbs to 29 carbs they should be proud of it. If they'd reported that to begin with Richard never would have had a problem. 29 carbs for a rare treat is pretty darn good.

Chefs don't seem to get it yet. Maybe if we line up 8 chefs, have them each drink one of 8 lemonades, then tell them one of the lemonades had antifreeze in it, guess which one, they'll understand what it's like for menus to be minefields and for no good reason. Doesn't have to really be antifreeze in a lemonade, they should get the point without it.

 

[naynay]

Richard, I am so glad to hear that you were okay! Lows are mighty scary. I had a bad one today myself, and I was driving home from work when it occurred. Scared the bejeesies out of me! Luckily I was within 5 minutes of home, but those 5 minutes seemed like hours! I don't know why I went so low, but as I got in the house (swaying on my feet) and grabbed my meter to check my bg, stuffing a fun size milky way candy bar in my mouth it came back at 55! Unfortunately it took several little fun size candy bars and a peanut butter and jelly sandwich on multi grain bread to level out. But, because I stuffed so much sugar and carbs in my system my number a few hours later was 408! I don't think I've ever been THAT high! The only thing I can come up with is that when I went to see the CNP last week, she adjusted my bolus insulin to a base of 12 units, and 2 units more for every 50 points higher than 150. Before I ate lunch my number was 211, so I took 15 units of insulin. I had a can of Progresso Beef Pot Roast soup (the whole can which I believe is 2 servings) and that was it. Unfortunately I did not look at the label to see how much carbs, fiber, sugar were in that can. I figured there was enough carb in it to sustain my bg. It was approximately 2 hours after eating that I was driving and went so low. And, on top of it, it came on so sudden it really surprised me. The only thing I can figure is that when the CNP gave me the scale to take my insulin, she was going on the assumption that I would listen to her and eat 3 servings of carbs with each meal (45 g). As I said on another post, no way am I going to follow that order! So, the insulin amount she figured was based on those 45 g of carb, and the insulin would be enough to cover that load. So, I'm going to try dropping back on the insulin amount to 7-10 units preprandial and see where that gets me. The worst part is I didn't have anything in the car with me to help bring that bg up immediately. Tomorrow I am going directly to the drug store and buying some glucose tablets or glucose gel to carry with me at all times. What if I had passed out while driving? I could be dead. That is scary.

 

[Shanny]

It's good to see that you're going with the glucose tabs, naynay - you'll get much quicker and efficient responses when you need it the worst. Just review what Richard described as he worked to raise his bg: "I ate 4 glucose tabs, waited 30 minutes, and I was 57. Two more tabs and an hour wait, and I was 48. Two more tabs, and an hour wait, and I was 61. I ate some watermelon at home. 30 carbs with no bolus. An hour later I was 138. My BG never went any higher and I was 94 at bedtime. Back on schedule."

Each glucose tab is 4g of carbs. He took 16g of carbs & waited 30 minutes (About.com lists one fun-size Milky Way as 12g). Then he took only 8g more and waited an hour. When his bg still see-sawed, he took 30g without a bolus, and that topped it off. No panic, no roller coaster - just patient treating, waiting, checking until it begins to stabilize. I hope I'm as cool-headed when/if I ever face a dangerous low.

 

[gphx]

Ruby Tuesdays and their 28 carb ribs have been calling my name ever since I read the OP. Good thing there's not one around here. Fwiw Walden Farms sells a few formulations of barbeque sauce. I've found them not to be so good cold but pretty nice slathered onto meat prior to cooking.

At 28 carbs for Ruby Tuesdays though for some it wouldn't be worth the trouble. Especially those who can bolus.

 

[Richard157]

Nay Nay, it would help if you knew how much one carb raises your BG level. That is called your carb sensitivity factor. One carb usually raises my BG about 3 points. Yours might be very different.

If I had a low of 55 and wanted to raise my BG to 100, then I would need to raise myself 45 points. I would divide the 45 by 3 (my sensitivity factor) and get 15. I would need 15 carbs to reach 100. Four glucose tabs have 16 carbs (4 carbs each) so that is what I would need, and it would avoid my going very high afterwards. The reason that method did not completely work in the situation I posted was because I had so much more insulin than I needed beforehand. Ordinarily the method I described here will work to raise your BG the appropriate amount, without giving you a terrible high.

 

[naynay]

Nay Nay, it would help if you knew how much one carb raises your BG level. That is called your carb sensitivity factor. One carb usually raises my BG about 3 points. Yours might be very different.

How do you determine what your ratio of carb sensitivity factor is? Do you eat a specific food and see how it spikes or raises? I would very much like to know how that works. I felt terrible all evening for eating all the stuff I did. The part that was the worst is this happened while I was driving. My husband just told me not long ago about a coworker who is diabetic and had a hypo episode while driving and he lost control and was pretty banged up. That scares me to no end! I did stop at the local drug store this morning and bought two tubes of glucose tablets. I will carry one in my purse and one in my car at all times!
Thanks for all the info though both Richard and Shanny. It really helps to know this stuff. Doctors do not tell you all this. It is shameful in my opinion. I could have ended up dead because of my sugar going so low. out:

 

[Richard157]

I wait until all the fast acting insulin is out of my system. That would occur about four hours after a meal, or after you took the previous dose of insulin. Then I eat a glucose tablet, which contains 4 carbs. Waiting an hour, and not eating anything else in the meantime, you can see how much your BG increases. If your BG was raised 20 points by the 4 carbs, then that would be 5 points per carb. That means your carb sensitivity is 5. Mine is 4, yours might be very different. Experiment this way a few times, on different days, and see if it is consistent. Your sensitivity might vary somewhat depending on the time of day.

 

[naynay]

I wait until all the fast acting insulin is out of my system. That would occur about four hours after a meal, or after you took the previous dose of insulin. Then I eat a glucose tablet, which contains 4 carbs. Waiting an hour, and not eating anything else in the meantime, you can see how much your BG increases. If your BG was raised 20 points by the 4 carbs, then that would be 5 points per carb. That means your carb sensitivity is 5. Mine is 4, yours might be very different. Experiment this way a few times, on different days, and see if it is consistent. Your sensitivity might vary somewhat depending on the time of day.

Richard, you are so helpful! I wish I could give you a big hug...guess I'll have to settle for the icon :hug:

I will try this over the weekend. It is too difficult to do during the weekday's since I work, and then get home and work some more! No rest for a working Mom, Spouse, Housewife! But thanks for always answering questions so quickly. You are a gem!

 

[hippiechic]

Richard I am very glad you are ok!

I have a question I'm confused If I make ribs at home (i dont like sauce on them none of us ever do we always use garlic and a bit of onion with some spices-no salt) then what is the carb count I thought rib..meat would have very little carbs?

Ok I reread the posts so its the sauce that has the carbs not the ribs persay?

TIA

 

[Shanny]

And Naynay? Now that you're using insulin, many insulin-dependent diabetics test right BEFORE they take the wheel - just to make sure things are as they should be - one more ounce of prevention.