Wednesday, November 15, 2017

Diabetes Month Tip of the Day


Question
Ok, so I learned where carbohydrates are, and which ones might be better choices, and I have a rough idea of how much might be a good idea to eat at each meal.  Now, how do I “count” these carbohydrates at each meal?
Answer
Great question, but the answer is going to involve some work. Let’s go step by step.
  1. Decide what kind of carbohydrate food to eat based on price, cooking skills, availability at store, and what everyone in the household likes to eat (Whew!). 
    1. If you are new to carbohydrate counting, start with the carbohydrate foods your family normally eats the most of.
    2. Better yet, choose something that you already have in the house as a staple.  We’re here to learn, not condemn our choices!
  2. Pick-up said food at the store or out of the pantry or fridge (let’s use rice as an example).
  3. Look up the amount of carbohydrate on the label, on your favorite carb counting smartphone app, or on the internet (I like calorieking.com).
  4. Finds out that 1/3 of a cup of rice (cooked) has about 15 grams of carb.
  5. Figures out how much dry rice makes a cooked portion. Sighs because even 2/3 of a cup (30 grams of carb) doesn’t seem very much.
  6. Cooks rice.
  7. Portion out about 30 grams worth for me and 45 grams worth for my husband, then pack up leftovers for lunch.
  8. Add in roasted chicken (protein) and steamed broccoli with olive oil and balsamic vinegar (non-starchy vegetables, healthy fats, non-caloric flavorings).  (You remembered to get that at the store and cook it, right?)
Seem complicated?  If it does, you might have an idea of why many people struggle with meal planning and/or struggle with keeping their carbs under a certain amount. Counting carbohydrates does get easier, but you have to practice—like learning any new skill. Sometimes you even have to practice that skill with a healthy dose of “I don’t want to but I know I’ll be better for this!” thrown in. In a later post I will address some “non-counting” methods of reducing carbohydrate intake since the idea of making all meals into a math exercise is not for everyone. Just for the fun of it though, try counting your carbohydrates today if you are not used to it.
If you have Type 1 diabetes, on the other hand, carbohydrate counting is definitely going to be your friend in keeping the blood glucose from going too high or too low (a dangerous condition called hypoglycemia).  If you are able to become proficient at counting/estimating carbohydrates your endocrinology team will be able to assist you in figuring out how much insulin to give yourself based on how much carbohydrate you eat.  This means that you are more likely to have your insulin regimen actually work more like a functioning pancreas to keep your blood glucose levels right where they need to be—not too high or too low.
Many people will turn to “sample diabetic menus” on the internet and/or from a pamphlet they got from their doctor’s office. On those same sample menus you might have seen the term, “carbohydrate serving” or “carbohydrate choice.” A “carbohydrate serving” is a portion of food that is equal to 15 grams of carbohydrate.  There is a history behind the use of the number fifteen (based on how many units of insulin are required to cover 15 grams of carbohydrate), but suffice to say, one particular group of educators wanted an “easier” way to keep track of carbohydrates. As a result, some wonderful group of people took all of those carbohydrate foods and gave us a list of serving sizes where each one is equal to 15 grams of carbohydrate (glad I didn’t have that job).  Once a person works out how many carbohydrate servings is suitable for them, they can choose from a list of carbohydrate foods and use up their “choices” however they want as long as the portions are within a certain amount.  I have never been fond of this method myself, but some people find this an easier way to conceptualize of their “carbohydrate budget.”
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