Insulin Sensitivity Factor (ISF) and Insulin-to-Carbohydrate Ratios (ICR) for Advanced Carb Counting

Using ICRs can provide more flexibility in carbohydrate choices as you are dosing your insulin according to how much carbohydrate you actually eat at each meal. Depending on whether you use rapid-acting or regular (short-acting) insulin, your health care provider or registered dietitian-certified diabetes educator will use a formula to help you determine your ICR and ISF. These factors are an initial educated guess or starting point. Careful follow-up with your health-care provider is necessary to work through this process and assure your blood glucose levels remain within your target ranges.  

Diabetic Foot Care

Keeping blood glucose levels as normal as possible is the key to preventing complications associated with diabetes, including foot problems. Discuss your individual diabetes goals and target numbers with your health care provider. The general hemoglobin A1C (HbA1C) recommendation is less than 7%. 

Exercise and Diabetes

Well timed meals and snacks can help prevent exercise induced hypoglycemia. If physical activity starts 2 hours or longer after your last meal, a snack may be needed to keep glucose levels stable. If your blood glucose is 70 mg/dl or lower, it should be treated with a fast acting form of carbohydrate and possibly followed up with a small snack before engaging in physical activity.

Kidney Disease

A healthy diet that promotes blood glucose, blood pressure, and cholesterol control will go a long way in preventing diabetic kidney disease. Eat a variety of fruits, vegetables, whole grains, and non- fat dairy within your carbohydrate allowance. Limit saturated fats like butter, lard, and fatty meats and choose more fish, poultry, and lean meats. Olive, canola, and peanut oil along with nus and avocados are heart healthy fat choices. 

Self-Management of Blood Glucose

Carbohydrate-containing foods affect blood glucose levels the most. Fruit, starches, starchy vegetables, milk/yogurt groups are all carbohydrate-containing foods. A fast-acting carbohydrate food like orange juice will affect blood glucose more quickly than whole milk which contains carbohydrate, protein, and fat. The fat in the whole milk will take longer to be digested. The sugar takes longer to reach the bloodstream because the fat slows the digestive process. 

Summer Travel Tips for Diabetes

As summer nears, thoughts may be drifting towards spending time outside enjoying the warmth of the sun or taking a much-anticipated vacation.  Having diabetes requires a little more thought and preparation when planning an outing or vacation that might be necessary for others. Unexpected delays or a change of plans can prove to be a challenge for keeping blood glucose stable.