CARBOHYDRATE COUNTING–GUIDED INSULIN DOSING

Question 1

What is the carbohydrate-to-insulin (C:I) ratio?

Answer 1

An estimate of the grams of carbohydrate that will be covered by each unit of insulin

Question 2

What does a C:I ratio of X:1 signify?

Answer 2

1 unit of insulin should be given for each X grams of carbohydrate to be consumed

Question 3

How is the initial C:I ratio calculated?

Answer 3

500 divided by total daily dose (TDD) of insulin

Question 4

What is the optimal postprandial glucose excursion range for individuals?

Answer 4

30–50 mg/dL rise from premeal value to 2-hour postmeal value

Question 5

What is the first step to determine if the current C:I ratio is correct?

Answer 5

Consume something easily covered at the meal before the test meal

Question 6

What glucose levels should be avoided before the test meal?

Answer 6

Below 70 mg/dL or above 140 mg/dL

Question 7

What should be done if glucose before the test meal is in the desired range?

Answer 7

Eat a meal with well-known carbohydrate content and about 20 g of fat

Question 8

What is the target glucose excursion after the test meal?

Answer 8

About 30 to 50 mg/dL

Question 9

What should be done if the glucose rise is greater than 50 mg/dL?

Answer 9

Strengthen the C:I ratio

Question 10

What is a high blood glucose (BG) correction factor (CF)?

Answer 10

An estimate of the glucose drop expected for each unit of insulin given when glucose is elevated

Question 11

What does a CF of N:1 mean?

Answer 11

1 unit of insulin will drop the glucose N mg/dL

Question 12

How is the initial CF for a patient calculated?

Answer 12

1650 divided by TDD (some use 1800, 1700, or 1500 divided by TDD)

Question 13

What are BOB and IOB in insulin management?

Answer 13

BOB indicates how much insulin is still active; IOB is similar but refers to active insulin time

Question 14

What is the typical duration of insulin action (DIA)?

Answer 14

Often 4 hours, but can vary based on individual experience

Question 15

What is the formula to calculate BOB?

Answer 15

BOB = (Bolus 2 - Bolus 3) * (elapsed time since bolus) / DIA

Question 16

Do patients using basal-bolus insulin need to perform these calculations before every meal?

Answer 16

Yes, especially for those using multiple daily injections (MDIs)

Question 17

How do insulin pumps assist with insulin dosing?

Answer 17

They calculate and display the recommended dose of insulin for carbohydrate content and correction doses

Question 18

What does a continuous glucose monitoring (CGM) system measure?

Answer 18

Interstitial glucose every 3 to 5 minutes

Question 19

What additional information does a CGM provide?

Answer 19

Current blood glucose value and trend arrow indicating glucose direction

Question 20

What adjustment is recommended for glucose rising at a rate of 1 mg/dL/min?

Answer 20

Add 1 unit of insulin to the correction factor (CF) dose

Question 21

What should be done if glucose is dropping at a rate of 1 mg/dL/min?

Answer 21

Subtract 1 unit of insulin from the CF dose

Question 22

Fill in the blank: The glucose excursion from premeal value to 2-hour postmeal value should be about _______.

Answer 22

30 to 50 mg/dL

Question 23

What is carbohydrate counting?

Answer 23

A method for managing carbohydrate intake, particularly for those with diabetes

Question 24

Who typically teaches carbohydrate counting?

Answer 24

A certified diabetes educator

Question 25

What is essential for providers managing patients with diabetes on insulin regimens?

Answer 25

Familiarity with the basics of carbohydrate counting

Question 26

How many grams of carbohydrate are in 1 slice of bread?

Answer 26

15 g carbohydrate

Question 27

How many grams of carbohydrate are in 1 medium apple?

Answer 27

15 g carbohydrate

Question 28

Fill in the blank: 1 cup of cooked pasta contains _______ of carbohydrate.

Answer 28

45 g carbohydrate

Question 29

What is the carbohydrate content of 1 small potato (3 oz)?

Answer 29

15 g carbohydrate

Question 30

List three foods that contain 30 g of carbohydrate.

Answer 30

• 1 medium potato (6 oz)
• 1 cup of corn
• 2/3 cup of cooked rice

Question 31

True or False: ½ cup of mashed potatoes contains 30 g of carbohydrate.

Answer 31

False

Question 32

How many grams of carbohydrate are in 2 Oreos?

Answer 32

15 g carbohydrate

Question 33

What is the carbohydrate content in ½ cup of fruit juice?

Answer 33

15 g carbohydrate

Question 34

Fill in the blank: 1 tablespoon of sugar (15 mL) contains _______ of carbohydrate.

Answer 34

12 g carbohydrate

Question 35

How many grams of carbohydrate are in a can (12 oz) of regular soda?

Answer 35

40 g carbohydrate

Question 36

What is the carbohydrate content of 1 bottle (20 oz) of regular soda?

Answer 36

75 g carbohydrate

Question 37

List two items that contain 45 g of carbohydrate.

Answer 37

• 1 cup of cooked rice
• 6 Oreos

Question 38

What is the carbohydrate content of 1 teaspoon of honey (5 mL)?

Answer 38

5 g carbohydrate

Question 39

How much carbohydrate is in 1.5 cups (12 oz) of regular beer?

Answer 39

15 g carbohydrate

Question 40

Fill in the blank: 1 tablespoon of honey (15 mL) contains _______ of carbohydrate.

Answer 40

15 g carbohydrate

Question 41

What is the carbohydrate content of 1 cup (8 oz) of milk?

Answer 41

12 g carbohydrate

Question 42

List three foods that contain 10 g of carbohydrate.

Answer 42

• 1 small corn tortilla
• 1 teaspoon of sugar (5 mL)
• 1 tablespoon of honey (15 mL)