If you have lived with type 1 diabetes for most of your life, then you treat food like you treat putting on your clothes in the morning: you stop for a second, think about your options, but most days you arbitrarily pick whatever is easiest. It’s amazing how many times our endos will look at our meter or pump downloads and seem surprised at the amount of manual boluses or carb “guessing” that us old-school diabetics use to guesstimate our insulin needs. While most of us can tell you exactly how many carbs are in any particular food item, we choose to say, “I know how my body reacts to that bagel, and I know I need 5 units for it. Period.” Unfortunately, that answer doesn’t work when we visit our CDE on a quarterly analysis of why our A1c is stuck at 7.5.
I often say that those of us who were diagnosed back in the days of the exchange system actually fare better because we are not only conscious about carbs themselves, but where we get our carbs from, and we try to incorporate a more balanced diet. While those who have been diagnosed with diabetes in the last ten years or so were basically taught that they could eat anything they wanted, as long as they counted carbs and took enough insulin to cover them. All of us, diagnosed in this decade or the last, need to take a giant step back this New Year’s and do something good for our diabetes, which may include taking an extra second to think before we eat. While this may seem time-consuming, it will take you just as long to check your blood sugar and correct for the high as it would to correctly count your carbs!
Here are a few tips on some things we can do to improve our carb accuracy:
- Make a list of the most common foods you eat during the week (e.g., English muffins, bananas, sandwiches, yogurt, etc.), refer to the nutritional value information, and write down how many carbs are in each serving, and memorize that list. Because as much as you may think you already know, you would be surprised at how changing a brand of yogurt or type of bread for your sandwich can change the amount of carbs you consume.
- Think about the places where you go out to eat during the week: Starbucks, D’Angelo’s, the local pizza place…and make a conscious effort to look up the amount of carbs in the items you choose at these quick stops.
- If there is a favorite recipe you or a family member makes on a regular basis, and you’re not really sure how many carbs are in a serving of it, take the recipe to your next CDE or dietitian appointment and have them help you estimate how many carbs are in that item.
- There’s an app for that! In order to help you with the above suggestions, download an app for your smart phone to help you quickly look up the carb content in some of the more popular food chains. One particularly helpful app is Carbs Control. It’s free, and it’s great for such common places as Panera and Subway. Ask around the diabetes community to find out about other apps that are recommended.
- Also, while you are looking up all of this information, think about how you can add one fruit or vegetable to each meal. Remember those of us that had our exchange meal-plan hanging on the fridge when we were young? Pick one fruit and/or veggie exchange per meal or at least as a snack and pretend like your life depended on it!
- Finally, stop and think about how you’re managing your insulin doses with your carb intake. I know we are all so spoiled now with fancy fast-acting insulin. But remember the days when we had to stop and consider that our regular Humulin insulin wouldn’t peak for 30 minutes? Even fast-acting insulin needs at least a five-minute head start, particularly if you are consuming fast-acting carbohydrates (anyone who tells you that you can wait until after you eat is assuming you aren’t eating any fast-acting carbs). So, if you have fallen into the bad habit of waiting until after you are done with your meal to take your insulin, try to get back into the good habit of taking it before you eat (unless you are low of course—treat the low first!).
When looking at all these suggestions, don’t try to overwhelm yourself by accomplishing all of them at once. Focus on two or three of them this January, and see if you notice a positive difference in your blood sugars, and maybe even your weight.
Regina Shirley RD, LDN Diabetes and Nutrition Expert at ServingUpDiabetes.com