I really believe carb counting alone is insufficient when it comes to my diabetes management. At least the simple way it’s taught. It’s just my opinion and I’ll explain why:
I’ve found that for ME, there are adjustments I make for different types of carbs. These are adjustments beyond just subtracting grams of fiber. A carb is not a carb. They vary spectacularly and learning their differences helps me keep my blood sugars in range and helps me decide which carbs to avoid.
I classify my carbs:
-Sugar/sucrose/plain fructose (no fiber)
-HFCS (High Fructose Corn Syrup)
-Chocolate, ice cream, and other high fat desserts
-Fruits and vegetables
When I eat anything with processed grains like white rice sushi or pizza or cookies, cake, or crackers, I have to watch out for a post meal blood sugar skyrocket. It doesn’t happen right away which is why it’s often confusing to dose for these kinds of foods. For example, last time you had pizza you were high afterwards so this time around you give more insulin, only to get low in the middle-towards the end of your meal.
I find that about 30 minutes after eating anything with refined or processed grains, I have to give another dose of insulin. An insulin pump option on a dual or square wave bolus works well for a lot of people, but from what I gather, people with and without pumps have a hard time keeping blood sugars in range with processed grains.
Eating something like candy made from glucose or sugar or drinking plain 100% juice or sugar sweetened beverage is a bit different. I find that if I’m going to consume this within a reasonably fast amount time (as opposed to snacking over a period of 30 minutes) then I count carbs and using my 1:15 scale, I give just that amount of insulin. Then I wait 15 minutes for the insulin to start working (more if I’m not in range). I find that the insulin cancels out the sugar carbs pretty well and there is no shocking aftermath.
High Fructose Corn Syrup (HFCS)
This one is interesting. At least for me (remember, this is just what happens in MY body). I find that candy or beverages made with HFCS works like when I eat refined grains. But that makes sense to me when I think about corn being a grain! It’s easy to forget because people serve it to kids and say “eat your veggies”.
High fat desserts
This gets it’s own category because of the large amount of fat (and because they’re my favorite!) I try to stick with dark chocolate for a low dose of sugar. I also make sure to buy desserts that do not have HFCS in it as a sweetener. I try to get the gourmet kind with minimal ingredients and then I count carbs and give insulin in the middle of eating since the fat content really slows down the absorption of most of these foods. If there is a lot of sugar I give insulin prior to eating as usual. I’m referring to a dessert like high fat truffles, mostly.
I count carbs and then add a tiny extra amount of insulin to my carb count depending on how much I eat. I don’t have to do this unless I’m really filling up on this protein source. I love how these foods fill me up and do very little to my blood sugars.
Vegetables and Fruits
I’m a fan of these, especially in terms of carbs. As you are well aware, the high antioxidant, vitamin, mineral, fiber, and water content of these foods makes them wonderful for our health. I definitely don’t need as much insulin for these foods. I count the carbs and then omit for fiber content. Fruit is something I stick to consuming in it’s natural state and in small quantities. The sugar in fruit is fructose and too much overloads the liver, causing fatty liver problems. Oh and it definitely affects blood sugars. My favorite are cherries, they are very low glycemic. Have you tried them for a low? It takes so many!
I know I didn’t talk about legumes or nuts. I don’t eat legumes anymore. I think I ate too many as a kid. I treat legumes like vegetables and I treat nuts like meat.
With any food: If I eat a lot, I need to give a little extra insulin for the full stomach effect that Dr. Bernstein has talked about in his books.
I adjust for a few other things. I’ve mentioned them before but here we go again:
-BM status. Eww, I know. But being backed up might make a person anticipate a need for more insulin. The opposite of that issue= less insulin. So watch out for major lows if you get food poisoning!
-Stress. If I’m stressed, I have to give a little bit extra insulin to combat the stress hormones and their affects on my blood sugars.
-Exercise. Different types of exercise require different diabetes management approaches. Read Ginger Vieira’s book for that info and so much more-even worksheets for getting all these changes right!
-PMS. Days before I start, I need to up my basal insulin.
-Sleep. If I stay up late (past midnight), I have to give some extra insulin (unless I’m active).
-Sedentary. If I’m being sedentary more than two days in a row due to sickness or diabetes burnout or whatever, I definitely have to up my basal insulin substantially (by 30-40%).
-Too much artificial sweeteners. Certain artificial sweeteners in high doses do contain carbs (it’s a small amount per serving so they’re legally allowed to round down to 0) so if you’re binging on diet coke, check your blood sugar and stay alert to a sneaky increase.
That’s all I can think of. It’s just an example of how you want to be aware of how your body reacts to different types of food and activity. You can see why I stick with meat/poultry/seafood, vegetables, and fruits. Much better blood sugar stability and less variability for me. But when I do splurge, at least being aware of how those foods act differently help me manage them for those occasions.
I write all this out because you can have tighter blood sugar management. It helps to learn yourself and the foods you’re eating. Again, get Ginger’s book or ebook and discover how to improve your blood sugars. I highly recommend it.