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April 30, 2004

Insulin, Meal Planning, Food and Diet

Question from Valparaiso, Indiana, uSA:

If I normally take one unit of insulin for 15 grams of carbohydrates, how many units should I take for an "Glucerna" meal bar. I don't understand what the sugar alcohols do. Also, I don't understand why their nutrition label does not add up. It says total of 34 grams of carbohydrates, two grams of fiber, 11 grams of sugar, eight grams of sugar alcohol. What is the rest of the package? 2 + 11 + 8 = 21 grams total. Where are the other 13 grams?

Answer:

According to the American Diabetes Association, one can subtract all fiber in a food from the total carbohydrate if it contains five grams or more of fiber per serving and you can subtract one half of the sugar alcohols from the total carbohydrate. So, in your example, you cannot subtract any of the fiber, but 4 grams of sugar alcohol can be subtracted. So, I would dose your insulin on 34 grams carbohydrates minus 4 grams of sugar alcohol=30 grams “net carbohydrates”. And since your insulin to carbohydrate ratio is one unit/15 grams carbohydrates, two units of insulin would do. The remaining carbohydrates other than the sugars, alcohols, and fiber is what is referred to as “other carbohydrates, ” namely starches, such as flours, etc.

JMS