July 13, 2012

Back to Diabetes Basics – Part 8

Learn to Count Carbohydrates

Many people say this is too complicated and try to guesstimate. This is a bad habit to get into and should be avoided. Do I guesstimate? Not that often and with eight years plus of calculating carbohydrates I have gotten fairly adept at doing this. I do make mistakes, but not that often. I hope that you will find some tips that you can use.

If you are lucky enough to have a class with a certified diabetes educator (CDE) or a registered dietitian (RD) and they cover how to read and understand food labels, absorb everything they tell you. I did not have either one that knew what they were doing and labels were to be ignored by them. Therefore, I had to learn on my own. Lucky for me a neighbor, at the time, was a nutritionist and she saw me reading labels in the grocery store one afternoon and asked if she could help. I admitted that I was having some success and that I would like to make it easier.

Now let me back up and cover a couple of other things first. Do not go out and buy cookbooks that have the word diabetic in the title. You will find that most are written by someone without diabetes and the recipes are overloaded with carbohydrates. Most are also for foods that few of us can actually afford some of the ingredients in the recipes.

Do consider buying some of the new editions of the standard cookbooks, Betty Crocker's and Better Homes and Gardens that have the nutritional information with each recipe. They also have the servings per recipe making calculations easier. Example: the recipe makes 6 servings and there is 28 grams of carbohydrates per serving, you have the information. Now I would normally say that it made 12 servings and that would mean I would have 14 grams of carbohydrates per serving. Granted, I normally chose servings of four so that I would only have eight servings to eat since at the time I was living alone.

I did cheat and have a gram scale and an ounce scale and still do and I use both. I would always weigh the container in which the food was to be cooked and then I could subtract that from the total weight or have a tare weight. If I wanted the recipe to serve six servings, I would weigh the plate or container to transfer the food to and tare the scale and then I knew how many ounces to transfer and could compute the carbohydrates. I could then add so many ounces of vegetables and compute their carbohydrates.

I do not know what food this label came from, but I will use it for a brief discussion.

Before going further, I need to point out that the FDA allows food labels to vary by 20 percent. This is bad for us with diabetes, but is the reason I always stress that you need to use your meter to see if the numbers are high or low after eating. Then you can have a variance of 20 percent with your meter. Did someone say this is a crap shoot. You may be right, but over time I have discovered that in general most canned foods are fairly close to total weight and carbohydrates. Now recipes in any cookbook with nutritional values may not be as close. There are too many variables for precise accuracy. To begin with when you purchase the ingredients, there may be a difference in the quality you purchased compared to the sample tested to arrive at the figures used in the cookbook.

This label is still a good example to use. Each serving has 40 grams of carbohydrates and only 4 grams of dietary fiber. Since I follow the rule of counting half of the fiber when fiber is 5 grams or more, I do not subtract any grams for fiber.

This is a point of debate by many and my former neighbor said only subtract one-half of the fiber if the total fiber per serving is 5 grams or higher. Some subtract all fiber regardless and others will subtract one-half of any amounts of fiber. Unknown on most labels is whether the fiber is water-soluble or not. The total grams are 275 grams so that if I have a 30-gram serving, then the carbohydrates would be 5 times 40 grams or 200 grams. Multiply 200 by 30 and divide by 275, which equals 21.8 grams of carbohydrates. Or, multiply 40 by 30 and divide by 55, which equals 21.8 grams of carbohydrates.

This is one reason I find the scales so useful as they can resolve carbohydrates amounts very quickly. So with the costs of the scales and a hand held calculator, I have gotten my money out of them many times over. Yes, I do spend a little more time getting this information, but it does allow me to be more accurate and know what I need to cover with insulin. Then my meter reading will confirm this and I will know that the serving size was correct. For oral medications, the meter becomes even more important to determine if the serving size was too large, too small, or just right.

Here are a few tools that you may find useful. First a book by Gary Scheiner M.S., titled The Ultimate Guide to Accurate Carb Counting. I have a different book, but this does come highly recommended. A website that may interest some is this one that has nutritional values that can be determined from a recipe. It is my understanding that you need to join to have access to the information here, and it is free. You may also get the nutritional value from a list of ingredients. There are other websites that you may find by using your search engine.

Diabetes Burnout

Why do people with diabetes have diabetes burnout? There are probably many reasons, but I think a majority of people just get tired of managing diabetes 24/7/365 with no vacation or time off. You test, eat correctly, exercise when capable, take your medications timely when you should and still diabetes is there waiting for you to make a mistake so it can gain the upper hand.

Will Ryan has several blogs and an introduction that often can help with diabetes burnout. His site “Joyful Diabetic” is worth reading and it does reflect his positive attitude. For many a positive attitude with managing your diabetes can help you through a down time and even burnout.

William H. Polonsky Ph.D., CDE, has written a book titled Diabetes Burnout: What to Do When You Can't Take It Anymore. This is one that I will be adding to my library. It is also available on Kindle.

Series 8 of 12

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