Diabetes: Counting Carbs If You Use Insulin
Carbohydrate, or carb, counting is an important skill to learn when you have diabetes. Carb counting helps you keep tight control of your blood sugar (glucose) level. It also gives you the flexibility to eat what you want. This can help you feel more in control and confident when managing your diabetes. Carb counting helps you keep your blood sugar at your target level. It allows you to adjust the amount of insulin you take. This amount is based on how many grams of carbs you eat at a meal or snack. The formula used to find how much insulin you need is called the insulin-to-carbohydrate ratio. The insulin-to-carbohydrate ratio is not the same for each person. You and your doctor will find your ratio by keeping track of the food you eat and testing your blood sugar level after meals. To count carb grams at a meal, you need to know how many carbs are in each type of food you eat. This includes all food, whether it is a slice of bread, a bowl of lettuce, or a spoonful of salad dressing. Most packaged foods have labels that tell you how many total carbs are in one serving. Carbohydrate guides can help too. You can get these from diabetes educators and the American Diabetes Association. To find out how many carbs are in food that is not packaged, you will need to know standard portions of carbohydrate foods. Each serving size or standard portion has about 15 grams of carbs. By using the number of grams of carbs in a meal, you can figure out how much insulin to take. This is based on your personal insulin-to-carbohydrate ratio. For example: Your doctor may advise you to take 1 unit of rapid-acting insulin for every 10 to 15 grams of carbs you eat. So if your meal has 50 grams of carbs and your doctor says you need 1 unit of insulin for every 10 grams of carbs, you would need Continue reading >>
Carbohydrate Counting 101
Carbohydrate Counting 101 There are several different ways people with diabetes can manage their food intake to keep their blood glucose (sugar) within their target range and one such method is 'carbohydrate counting'. Carbohydrate, or carb counting is a method of calculating grams of carbohydrate consumed at meals and snacks. Foods that contain carb have the greatest effect on blood glucose compared to foods that contain protein or fat. Before starting any new treatment or meal plan, you should always consult with your diabetes care professional. What are the benefits of counting carbs? ·Counting carbohydrates is a good solution for many people with diabetes. Once you learn how to count carbs, you’ll find it easier to fit a wide variety of foods into your meal plan, including combination foods such as those in frozen dinners. For example, by checking the grams of total carbohydrate on the Nutrition Facts label on a frozen dinner, you can figure out how to fit the dinner into your carb allotment for a particular meal. Many people find carb counting to be much easier than using a more traditional exchange meal plan. ·Another benefit of counting carbohydrates is that it can bring tighter control over your glucose readings. Being as precise as possible with your carb intake and medication will help you better manage your blood glucose after meals. ·Lastly, if you take mealtime insulin, counting carbohydrates allows you to decide how much carb you want to eat at a meal, rather than having to eat a certain amount of carbohydrates, even if you do not want to. Who can use carbohydrate counting? Carbohydrate counting can be used by anyone with diabetes, not just people taking insulin. This method is also useful for people who are using more intensive methods of adjusting i Continue reading >>
Type 1 Diabetes – Know Your Carbs
It’s been a busy week for 17-year-old Lauren Stanford. She had powder puff practice, a Model United Nations meeting, soccer practice, and a dinner date with her dad. In between all these activities she still managed to go to the gym four times and work a few shifts at her part-time job. On top of all that, Lauren took time each day (as she does every day) to manage the carbohydrates in her diet. This is a major priority for Lauren because, since being diagnosed at age 6, she has been living with type 1 diabetes. Actively involved in JDRF’s Children’s Congress, Lauren is an advocate for diabetes awareness and a strong proponent for diabetes research. Diabetes: Know Your Carbs It’s important for people with type 1 diabetes to know how many carbs they eat. That way they can match their insulin dose with what they eat and ultimately have better control over blood sugar levels. Foods that are highest in carbohydrates are starches, fruits, and dairy, as well as combination-type foods like beans and rice, lasagna, and pizza. Non-starchy vegetables like carrots also contain carbs, but in smaller amounts (5 grams per serving). Each serving of starch, fruit, and milk contain 15 grams of carbs. A serving size can be one slice of bread, a small container of unsweetened yogurt or a 1/2 cup of strawberries. Protein and fat do not contain carbs. Lauren says she often overhears her friends talking about how many carbs are in different foods. “I want to interrupt and say there are way more carbs in them than you think!” she says. Lauren has had plenty of practice reading labels and watching portion sizes. Even though she now uses an insulin pump, which gives her a lot of flexibility with food, carb counting has stuck with her. She’s comfortable calling herself “a label r Continue reading >>
Patient Education: Type 1 Diabetes Mellitus And Diet (beyond The Basics)
TYPE 1 DIABETES OVERVIEW Diet and physical activity are critically important in the management of the ABCs (A1C, Blood pressure, and Cholesterol) of type 1 diabetes. To effectively manage glycated hemoglobin (A1C) and achieve stable blood sugar control, it is important to understand how to balance food intake, physical activity, and insulin. Making healthy food choices every day has both immediate and long-term effects. With education, practice, and assistance from a dietitian and/or a diabetes educator, it is possible to eat well and control diabetes. This topic discusses how to manage diet in people with type 1 diabetes. The role of diet and activity in managing blood pressure and cholesterol is reviewed separately. (See "Patient education: High blood pressure, diet, and weight (Beyond the Basics)" and "Patient education: High cholesterol and lipids (hyperlipidemia) (Beyond the Basics)".) WHY IS DIET IMPORTANT? Many factors affect how well diabetes is controlled. Many of these factors are controlled by the person with diabetes, including how much and what is eaten, how frequently the blood sugar is monitored, physical activity levels, and accuracy and consistency of medication dosing. Even small changes can affect blood sugar control. Eating a consistent amount of food every day and taking medications as directed can greatly improve blood sugar control and decrease the risk of diabetes-related complications, such as coronary artery disease, kidney disease, and nerve damage. In addition, these measures impact weight control. A dietitian can help to create a food plan that is tailored to your medical needs, lifestyle, and personal preferences. TYPE 1 DIABETES AND MEAL TIMING Consistently eating at the same times every day is important for some people, especially those w Continue reading >>
The Carbohydrate Counting In Adolescents With Type 1 Diabetes (ccat) Study
Abstract This article reports pilot study results evaluating the accuracy of carbohydrate counting among adolescents with type 1 diabetes. This cross-sectional observational study included 48 adolescents ages 12–18 years (mean 15.2 ± 1.8 years) with type 1 diabetes of > 1 year in duration (mean A1C 8.0 ± 1.0%) who used insulin:carbohydrate (I:C) ratios for at least one meal per day. The adolescents were asked to assess the amount of carbohydrate in 32 foods commonly consumed by youths. Foods were presented either as food models or as actual food, with some items presented as standard serving sizes and some self-served by study participants. T-tests were used to assess the significance of over- or underestimation of carbohydrate content. For each meal, accuracy was categorized as accurate (within 10 grams), overestimated (by > 10 grams), or underestimated (by > 10 grams) based on the commonly used I:C ratio of 1 unit of insulin per 10 grams of carbohydrate. Only 23% of adolescents estimated daily carbohydrate within 10 grams of the true amount despite selection of common meals. For dinner meals, individuals with accurate estimation of carbohydrate grams had the lowest A1C values (7.69 ± 0.82%, P = 0.04). The pilot study provides preliminary evidence that adolescents with type 1 diabetes do not accurately count carbohydrates. Further data are needed on carbohydrate counting accuracy and other factors that affect glycemic control. The incidence of type 1 diabetes is increasing worldwide,1 and the prevalence of type 1 diabetes in youth in the United States is 1.54 per 1,000.2 To prevent the complications of type 1 diabetes, the primary diabetes management goal is to maintain blood glucose levels as close to normal as is safely possible. The American Diabetes Associatio Continue reading >>
Understanding Advanced Carbohydrate Counting — A Useful Tool For Some Patients To Improve Blood Glucose Control
Today’s Dietitian Vol. 15 No. 12 P. 40 Suggested CDR Learning Codes: 2070, 3020, 5190, 5460; Level 3 Take this course and earn 2 CEUs on our Continuing Education Learning Library Click here for patient handout Carbohydrate, whether from sugars or starches, has the greatest impact on postprandial blood sugar levels compared with protein and fat. For this reason, carbohydrate counting has become a mainstay in diabetes management and education. Patients with type 1 or 2 diabetes benefit from carbohydrate counting in terms of improvements in average glucose levels,1,2 quality of life,2,3 and treatment satisfaction.3 Basic carbohydrate counting is used to keep blood glucose levels consistent, while advanced carbohydrate counting helps with calculating insulin dose. Both basic and advanced carbohydrate counting give people with diabetes the freedom to choose the foods they enjoy while keeping their postprandial blood glucose under control. This continuing education course introduces advanced carbohydrate counting as a tool for improving blood glucose management, evaluates basic and advanced carbohydrate counting, describes good candidates for advanced carbohydrate counting, and discusses strategies for counseling patients as well as precautions when using advanced carbohydrate counting. Basic Carb Counting Basic carbohydrate counting is a structured approach that emphasizes consistency in the timing and amount of carbohydrate consumed. Dietitians teach patients about the relationship among food, diabetes medications, physical activity, and blood glucose levels.4 Basic carbohydrate counting assigns a fixed amount of carbohydrate to be consumed at each meal and, if desired, snacks. Among the skills RDs teach patients are how to identify carbohydrate foods, recognize serving s Continue reading >>
Here’s The Carb Count Of The Top Halloween Candy
We share a JDRF chart, and highlight the carb count of the best-selling candy. Though the true intention of Halloween is to scare ourselves silly, many suggest that candy is responsible for our nation’s fixation on the spooky holiday. In 2012, Americans spent $12.6 billion on chocolate alone, a USA Today article reported, and by 2019 that number will jump to $25 billion. But for those kids (or adult children) with Type 1 diabetes who go out trick-or-treating, it’s not about what sells; it’s about what you “can” and “can’t” eat, and how much. Throw in Halloween-themed “Fun Sizes,” and counting carbs becomes a confusing nightmare. So here’s a candy carb chart from JDRF that you can print out: (Chart is Fun Sized. Click on it to make it full sized.) With this chart in mind, here are the 5 top-selling candies that you’re likely to come across this year, and their carb counts: 5. Kit Kats, which total 10 grams of carbs per Fun Size. If you do as their jingle suggests and “give it a break” into two pieces, it’s only 5 grams of carbs per chocolate wafer stick. 4. With over $300 million in sales, you’ll likely scrounge up some Hershey’s Mini chocolate bars, which contain about 5 grams of carbs each, on the door-to-door rounds. 3. Snickers are sure to make an appearance in the candy haul. With 10 grams of carbs, the Fun Size peanut-and-caramel chocolate bars are something to indulge in carefully. 2. With $500 million in sales, M&Ms, will surely be dropped into many a plastic orange pumpkin. The Fun Size chocolate packs contain 10 grams of carbs and the Fun Size peanut ones have 11. 1. Is it true that the peanut butter-to-chocolate ratio is better in the bigger pumpkin-shaped Reese’s cups than the regular-shaped ones? Hard to say, but the Hersh Continue reading >>
Culture Gap Makes Carb Counting Harder For People With Type 1 Diabetes
There is a broader problem understanding nutrient content of home cooked ethnic foods Patients with diabetes must work hard every day to count the carbs they consume, to avoid dangerous spikes or dips in blood sugar. Learning how to do it can be close to impossible, though, when language and cultural barriers make it difficult for doctors to understand what patients typically eat, a new case report suggests. "Carbohydrate counting is critical for accurate management of diabetes," said co-author Dr. Sumana Narasimhan, a pediatric endocrinologist at Cleveland Clinic Children's in Ohio. "If we don't fix this problem, families of children with diabetes from non-western cultures may continue to guess the carbohydrate count of their ethnic foods, resulting in inaccurate insulin dosing and poorly controlled diabetes," Narasimhan added by email. "The risk of diabetes complications is higher when diabetes is not managed properly." The case report in Lancet Diabetes and Endocrinology involved a child recently diagnosed with Type 1 diabetes, a chronic condition usually diagnosed in children or young adults. With this condition, the pancreas produces little or no insulin, a hormone needed to allow blood sugar, or glucose, to enter cells and produce energy. People with Type 1 diabetes typically have to test their own blood sugar levels throughout the day and inject insulin to manage them. Getting the insulin dose right requires patients to count carbs correctly. In this case, the child's mother asked doctors how to count carbs for the traditional Middle Eastern foods she prepared at home. Doctors found some pamphlets and online resources for following a diabetes diet that were translated into Arabic. But the information was still mostly based on a typical Western or European diet, n Continue reading >>
Macronutrients And Type 1 Diabetes
The ideal macronutrient composition for optimum glycaemic control is yet to be defined. Carbohydrate causes the majority of variation in glycaemia however it is known that protein and fat also play a significant role. Carbohydrate Carbohydrates are an important source of energy. The term carbohydrate encompasses both starches and sugars. Guidance from the Department of Health in 1991 recommended that we should consume 50% of our daily energy requirements from carbohydrate.[1] In June 2014 the Scientific Advisory Committee on Nutrition (SACN) released a draft report suggesting that we should continue to advocate this, with people choosing wholegrain varieties where possible (SACN, 2014). [2] The majority of this should come from the starchy form and only a small portion from sugary sources. The brain requires 130g carbohydrate per day but the reference nutrient intake is 260g per day, to allow for daily physical demands.[1] Diabetes UK found that consuming over 50% of daily energy from carbohydrates was not appropriate for everyone. In 2011, their nutritional guidelines were revised to state that there is not an ideal percentage of energy which should come from carbohydrate for optimal blood-glucose control. [3] Prior to the discovery of insulin in 1922, dietary restriction was the only treatment available for Type 1 diabetes mellitus with intakes of less than 10% energy from carbohydrate advocated. In the 1940s and 50s the suggested percentage energy from carbohydrate had risen to 25-30% and exchange lists came into use. Eventually in the 1980s restrictions were lifted with the initiation of carbohydrate counting programmes such as DAFNE. The use of low carbohydrate diets for the treatment of diabetes mellitus is a controversial topic. The term “low carbohydrate diet Continue reading >>
- Prevalence of and Risk Factors for Diabetic Peripheral Neuropathy in Youth With Type 1 and Type 2 Diabetes: SEARCH for Diabetes in Youth Study
- New type of diabetes discovered - Could YOU be showing symptoms of type 1.5 NOT type 2?
- Relative contribution of type 1 and type 2 diabetes loci to the genetic etiology of adult-onset, non-insulin-requiring autoimmune diabetes
Gadgets And Apps
There are many tools that can help make carbohydrate counting and insulin calculations easier tasks, including apps that you can download to your computer, Smart phones and iPhones. General Apps (Carb Counting and More) Android Apps BlueLoop Carb Counting with Lenny CarbControl FatSecret.com Calorie Counter Glucagon Glucose Buddy Medisafe MySugr OnTrack Diabetes iPhone Apps bant BlueLoop Carb Counting with Lenny CalorieKing CarbControl FatSecret.com Calorie Counter Diabetes Companion Diabetes Log Diabetes Pilot Glooko Glucagon Glucose Buddy Go Meals, by CalorieKing Medisafe MySugr Nutrition Database for iPhone Pumps 4 Kids (Hint: remember to change the glucose units to mg/dl) Sugar Streak Devices That Interface with Apps and Systems Accu-Check: Lets you send blood glucose test results to an app on your smart phone. CareLink: Provides a summary of all your glucose, carbohydrate, and insulin information and gives an overview of your glycemic control (daily, overnight, and at meal times). Dexcom Clarity: Allows you to upload glucose data, view the data in easy-to-read graphs, and email them to your doctor. diasend: Provides easy uploading of information from most glucose meters, insulin pumps, CGMs and mobile apps so patients and doctors can share, access and understand information. glooko: Download your diabetes device data to your iOS or Android device, integrate food and lifestyle data, and share reports with your care team. OneTouch Reveal: The One Touch Reveal App is being used a lot for the One Touch Verio Flex meter. TIDEPOOL: A variety of apps that make diabetes data easily accessible through a secure, modern platform. t:connect: A fast, easy way to display and save data from pumps, supported glucose meters and CGMs. Diabetes Calculator Click the BEGIN button below Continue reading >>
Carbohydrate Counting
Carbohydrate counting is a flexible way to plan your meals. It focuses on foods that contain carbohydrate as these raise your blood glucose (sugar) the most. Follow these steps to count carbohydrates and help manage your blood glucose levels. Your registered dietitian will guide you along the way. Step 1: Make healthy food choices Enjoy a variety of vegetables, fruits, whole grains, low fat milk products, and meat and alternatives at your meals. A variety of foods will help to keep you healthy. Use added fats in small amounts. This helps to control your weight and blood cholesterol. Choose portion sizes to help you to reach or maintain a healthy weight. Step 2: Focus on carbohydrate Your body breaks down carbohydrate into glucose. This raises your blood glucose (sugar) levels. Carbohydrate is found in many foods including grains and starches, fruits, some vegetables, legumes, milk and milk alternatives, sugary foods and many prepared foods. Meat and alternatives, most vegetables and fats contain little carbohydrate. Moderate servings will not have a big effect on blood glucose (sugar) levels. Step 3: Set carbohydrate goals Your dietitian will help you set a goal for grams of carbohydrate at each meal and snack. This may be the same from day to day or may be flexible, depending on your needs. Aim to meet your target within five grams per meal or snack. Step 4: Determine carbohydrate content Write down what you eat and drink throughout the day. Be sure to note the portion sizes. You may need to use measuring cups and food scales to be accurate. Record the grams of carbohydrate in these foods and drinks. For carbohydrate content of foods, check the nutrition label on food packages, food composition books, restaurant fact sheets and websites. Step 5: Monitor effect on blood Continue reading >>
Carbohydrate Counting In Youth With Type 1 Diabetes
Management of Diabetes in Youth, Biennial Conference of the Barbara Davis Center for Childhood Diabetes David Maahs, Darcy Owen, Franziska Bishop Outline Overview of data/literature on and rationale for carbohydrate counting in diabetes Overview of practical aspects of carbohydrate counting (i.e. what happens when the MD asks the RD to “teach them to carb countâ€) Current research at the BDC including a brief carb counting quiz Figure. Percent of male and female youth with diabetes who meet dietary recommendations: SEARCH for Diabetes in Youth participants in the dietary assessment protocol, prevalent 2001 and incident 2002. *P<0.01 for comparison of males vs females, adjusted for clinical site, race/ethnicity, and parental education level. (Mayer-Davis, JADA, ’06:689-97) Other Considerations Who will be responsible for carbohydrate counting Parent, child or both Math skills Carbohydrate counting at school MDI CSII Focus on Carbohydrate Main nutrient that is converted to blood sugar Emphasize total amount of carbohydrate not the source Carbohydrates are: Starches- grains, beans, starchy vegetables Fruits Milk and Yogurt Other Carbohydrates (i.e. sweets, desserts etc) 15 gm carb servings 1 small piece of fruit 1/2 cup (4 oz) juice 1 cup cubed melon 1/2 cup canned fruit, light or juice packed 1/2 cup applesauce, unsweetened Calculating a Dose 3 Step Process 1st Step: Insulin to Carb Ratio Determine how much insulin is needed for carbs eaten at meal or snack: Count up total carb grams Divide total grams by ratio Calculating a Dose 2nd Step: Blood Glucose Correction Determine How Much Insulin is Needed to correct blood sugar (bg) to target Check bg Calculate insulin amount needed to bring bg into target range (i.e. … 1 unit per 50 over 150- Individua Continue reading >>
Nutrition And Meal Planning
Pediatric Type 1 diabetes To correct for the lack of insulin in Type 1 diabetes, families learn how to match insulin doses to the amount of food (carbohydrates) eaten at meals. Foods contain a mixture of protein, carbohydrate and fat. One hundred percent of carbohydrates (carbs) are broken down to glucose. Meals and snacks should include a variety of foods, for good nutrition. Include colorful fruits and vegetables each day. Choose whole grains to add fiber to the diet. Protein and fat A minimum amount of protein and fat end up as sugar in the blood, so additional insulin is usually not needed to cover these foods. Protein and a moderate amount of fats are important for good nutrition and a balanced diet. They can help maintain a steady level of blood glucose and play a role preventing hypoglycemia. Include protein foods with two or more meals or snacks every day. Include low fat dairy to meet calcium needs. Most dairy foods count as carbohydrates; cheese is a low-carb protein substitute. Look for reduced-fat choices to help control saturated fat. Carb counting Carbohydrate is a broad category including sugars, fiber and starches (bread, cereal and starchy vegetables like potato). Carbs are found in many food groups, such as grains, fruit, milk and sweets. Food labels Reading food labels will help you control your diabetes, and is essential to learning carb counting. Prepared foods are required to have food labels, and reference books will help you find carb contents for ones that do not, like produce, meats and restaurant foods. It is important to compare your serving size to the serving listed on the nutrition facts label for accurate carb counting. If the food contains less than 5 grams of fiber, subtract half of the fiber grams from the total carbohydrate, as only p Continue reading >>
How Many Carbs Should A Diabetic Eat In A Day?
Diabetes affects the way the body metabolizes sugar. Whether you have type 1, type 2 or gestational diabetes, paying close attention to the amount of carbohydrates you're eating is critical. With proper planning and education, a healthy diabetic diet -- which includes carbohydrates in moderation -- is just as satisfying as a regular one. Video of the Day How Many Carbs Can Diabetics Eat? All foods that have carbohydrates raise blood sugar levels. But some carbohydrates raise blood sugar levels more than others. By keeping track of how many carbohydrates are in foods, diabetics are better able to control their blood sugar levels and subsequently manage their diabetes. The American Diabetes Association recommends that adults with diabetes consume about 45 to 60 grams of carbohydrate per meal, which adds up to 135 to 180 grams of carbohydrates per day. Note that some individuals may need more or fewer carbohydrates. Consult a registered dietitian for an individualized recommendation. The three main type of carbohydrates include starches, sugars and fiber. Starchy foods, also known as complex carbohydrates, include peas, corn, beans, grains, whole wheat pasta, oats, barley and rice. Sugars can occur naturally -- in milk and fruit, for example -- or be added during processing. Common names for sugar include table sugar, brown sugar, honey, beet sugar and high fructose corn syrup. Fiber is the indigestible part of plant foods that passes through the intestine when you consume fruits, vegetables, whole grains, nuts and legumes. The general recommendation is that adults consume 25 to 30 grams of fiber per day. Fiber offers an added benefit for diabetics, because it helps control blood sugar levels by slowing the release of sugar into the bloodstream after a meal. Carbohydrate C Continue reading >>
Carb Counting
Last week we talked about two types of diabetes meal planning tools: the exchange system and the plate method. While both of these approaches can work well, today, more and more people with diabetes are turning to carbohydrate counting. Carbohydrate, or “carb”, counting, really isn’t all that new. In fact, Dr. Elliott Joslin taught carb counting to his patients back in the early part of the 20th Century: “In teaching patients their diet,” he said, “I lay emphasis first on carbohydrate values, and teach to a few only the values for protein and fat.” Patients who came to Joslin Clinic in those days were taught by Dr. Joslin himself, and today, the walls of Joslin Diabetes Center are lined with pictures of folks from that period sitting in a classroom with gram scales in front of them for the purpose of weighing their food. Since those days, many aspects of diabetes care have changed for the better, but carb counting has made a comeback as an effective yet simple approach to help people better manage their diabetes. There are actually two types of carb counting. The first type, often called basic or consistent carb counting (or, as one of the doctors at Joslin likes to say, “CC”), is usually what most people with diabetes learn about these days. Basic carb counting isn’t a diet, but rather a tool to help you better plan meals and learn how your food choices affect your blood glucose levels. As you may know, most of the carbohydrate we eat turns to glucose (sugar) during digestion. Our bodies then use this glucose for energy. Let’s review the types of foods that contain carbohydrate: Bread, pasta, cereals, rice Starchy vegetables (corn, peas, potatoes, lima beans) Fruit and fruit juices Milk and yogurt Sweets and desserts (Non-starchy vegetables, such Continue reading >>
