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Matching your insulin dose to the carbohydrates you are eating is considered the gold standard for managing food with Type 1 Diabetes. It also can be very effective for those with Type 2 Diabetes with or without insulin and Gestational or other Diabetes types.

By Nicole Walker

Matching your insulin dose to the carbohydrates you are eating is considered the gold standard for managing food with Type 1 Diabetes. It also can be very effective for those with Type 2 Diabetes with or without insulin and Gestational or other Diabetes types. If you aren’t carb counting now – I would definitely encourage considering it and you will notice the difference within days! It isn’t as hard or annoying as it sounds…with the right advice!

This article is for those already carb counting. As carb counting isn’t without its challenges, I am here to help you with some small tips, tricks and reminders. Also check out my other blogs on Carb Counting – if they are not here yet then stay tuned!

Tip 1. Use the scales at the start and to calibrate your brain along the way!

When I first introduce carb counting yes, I do encourage the use of scales for measuring how much rice, pasta, cereal, portion of fruit etc that you are eating to plug into an app and know exactly the carbs you are eating. With the proviso that it is useful to start at the top with the gold standard then make it less burdensome where possible along the way. From then your guesstimates will start to get pretty accurate and you can probably put the scales away for most foods. To keep your guesstimates calibrated or accurate every few months get the scales out again and check your app. It is surprising how quickly we start to under or over estimate our portion sizes again! Also do this with changes in seasons. We also tend to eat different foods such as salads and BBQs in summer and stews, roasts and soups in winter. We might also change our portion sizes of carbs as it gets warm and cosy.

Tip 2. Know what you need and be realistic on the first helping!

There is nothing worse than finishing your meal, having dosed already but you are still hungry. If you go back for seconds, you’ll need another dose and have to carb count again IDEALLY. But what tends to happen is we might nibble, or guess the carbs on seconds, or not bother to dose at all and then despite our best efforts with the first round, need a correction later on for high BGLs. Or the opposite might be true – which is a bigger problem. You might dish up a large serve with your eyes bigger than your belly! Then not be able to finish it. But you have dosed for it – therefore you need top up carbohydrates such as juice or ride it out and see if you can catch the downward trend to prevent a hypo. This is where mindful eating and intuitive eating come in handy. Check in before you serve up your meal. How hungry are you? Realistically how much do you normally eat? If you aren’t sure about these things then practice tuning into your body for next time.

Tip 3. Apps are your friend!

Apps that you can look up the carbs on the go are useful for being able to carb count anytime! I would recommend Calorie King or Easy Diet Diary. They also take the guessing out and help you to look up foods you are unsure of or new foods you haven’t eaten before. Some have foods from chains like Subway so you can know what the carbs are even when eating out and some even have pictures to compare the portion sizes. Some apps you can create recipes and others, a food list of your usual foods so you don’t have to keep looking it up. Besides they are much more convenient than having to carry around a book or food list your Dietitian gave you!

Tip 4. Carb count recipes

Apps like Easy Diet Diary and My Fitness Pal you can create recipes where you add all of the ingredients of say a lasagne dish then divide it by the number of serves and voila! You have the carbs in your serving of your home-cooked lasagne. This helps to reduce the inaccuracies of guesstimation! It also helps to build a bank of carb counting experience for foods for when you are eating out.

Tip 5. Ring a friend

Get your family or partner on board with carb counting! How lovely is it to have a delicious meal cooked for you? Or perhaps you are being the lovely one, cooking for your family or other half. Consider also sharing the carb counting duties. If you are cooking, perhaps your carb counter is looking up the carbs in Easy Diet Diary and gets the scales out ready to go while setting the table. Or maybe if they are giving you a night off – they serve up the steak and mash with a little helpful prompt – I am putting a cup of mash on your plate tonight dear. Reminding you not only to take your insulin but making diabetes life just that little bit easier counting the 30g of carbs. Some people are taken aback by this idea – not wanting to burden or trust others with information that will determine their insulin dose. I understand that, however diabetes is a significant emotional and mental burden over time and finding ways to make it a little bit easier day to day will help in the long run. The benefit for them? You both get to eat your dinner warm!

Tip 6. Put the scales away

Diabetes is tiring. Carb counting perfectly all the time by weighing all your foods is very tiring! Yes, there is a time and a place for scales – when you are learning to carb count, for those foods always worth checking like rice and cereal, and for when you are “calibrating” your carb counting estimation brain. Many people who carb count on a regular basis get pretty darn close with their guesstimates. The reality of flexible insulin dosing is that it is all one estimate after another anyway. Having a carb ratio of 2u:10g could be 10% off what you actually need at that particular time, then you need to round up or down to the nearest unit or half unit then add a rounded correction, then take into account a % for exercise – if your carbs aren’t 100% accurate it often will smooth out in the wash if your guesstimates say within 5g carbs give or take. To save mental energy, time and burden of weighing Every. Single. Meal. Give it a break for a while! Use household measures for example; put the measuring cup IN your cereal box. Use heat and eat rice cups for which the exact carbs are on the packet and estimate the size of your potato or fruit from your experience of counting exactly before. Remember diabetes is a marathon not a sprint and anything you can do to preserve your endurance is key.

Not carb counting yet or need a refresher?

If you are not yet carb counting and you have any form of diabetes – Type 1, Type 2 or GDM get in touch and see how it can help you manage your diabetes! I am all about tailoring carb management to the individual. If you want the most advanced advice – I will get you up to speed, if you prefer to keep it simple then we can definitely meet where you find yourself comfortable. Perhaps you have been taught before but haven’t seen a Dietitian for a long time or feel a bit rusty – a refresher is always useful. I would recommend to catch up with a Dietitian once a year to keep up to speed with all of the awesome tools that are rapidly becoming available. I have LOTS of resources, time and I must say proudly (not modestly of course), quite a good success rate with teaching carb counting. Mainly because I work with YOU wherever you are at, at your own pace to meet your goals with it. Come and have a chat – check out my services, get in touch, request an appointment or refer your patient.

Nicole Walker

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