I can not understand why anyone who has type 1 diabetes would eat anything and not take a shot beforehand. If I eat 10 grams of carb as a snack, I take about 1 unit of Humalog. In my view people are having lows and highs because doctors don’t ask them to adjust insulin levels based on what they eat. If you give a large injection at the start of the day and tell someone to eat snacks you set them up for lows, and then highs. I can go all day with nothing to eat and have no problem because I take only enough insulin to keep by blood sugar at normal

I completely agree with you about the issue of making sure people match their insulin intake to the amount of food they take in. Because of that concern, we try to have all our patients utilize carbohydrate counting. This is not just to make sure the food content of the meal is similar from one day to the next. It is also so that we can use a ratio for dosing their insulin. In that way, the patients with type 1 diabetes have a way of matching their insulin to the meal size. It is unlikely that people eat like robots, eating the same thing each day. In fact, that is why we see blood sugars vary so much from one day to the next.

JTL