Carbohydrate Blues

Learning how to count carbs is a skill worth developing.

with Amy Tenderich

straightup-hiresEditor's Note: While this columnist is no longer writing for and we have ceased to update the information contained herein, there is much to be read here that is still applicable to the lives of people with diabetes. If you wish to act on anything you learn here, be sure to consult your doctor first. Please enjoy the column!

September 2005 —Anyone who thought the low-fat craze a while back was over the top must have been stunned by the outrageous fanfare around Low-Carb eating these past few years. I know I was! And even though the trend seems to be waning, everyone keeps telling me how good it was for us people with diabetes: more general understanding of our needs, more low-carb products to choose from, etc. But, as usual, "magic formulas" are more difficult in real life than they look – especially when the method is not some quick-fix diet to fit into a party dress, but a new essential way of life!

As a person with diabetes, you simply gotta learn this stuff. You need to know how many carbs are going in, plain and simple, in order to keep your glucose levels in check with your oral medications and/or to set insulin doses. Carb-counting is an awesome tool for controlling diabetes that we didn't have even five or 10 years ago. Continuing to "guess" is kind of like doctors continuing to guess at what ails their patients, rather than using the newest methods and procedures for more accurate diagnosis. Why do it?

So, allow me to take you on a quick tour of a few major stumbling blocks, and the best ways around them that I've found.

I. Carbo-What??
A little knowledge is a dangerous thing, no? When my mother was recently told she has "pre-diabetes" and thus needs to "control her carbohydrate intake," she began acting like a dark cloud was trailing her, moaning about not being able to eat anything she really likes! When I sat her down to review her worries, I discovered that Mom didn't even know exactly what "carbohydrates" are.

Carb foods are those that break down to glucose (sugar) in your body – mainly grains and starchy foods (pasta, potatoes), along with obviously sugary foods of all kinds. Yes, Mom, this includes fruit! But it doesn't mean you can't enjoy your morning nectarines. It just means you need to be very mindful of how much you're eating, and it's best to mix up the carb foods with other foods – including protein (meat, cheese, nuts), veggies, and a little bit of fat – to slow the absorption of the sugar content into your blood.

Keep in mind that real, unprocessed foods will always do you better than any fabricated "low-carb" product. That stuff is often extremely high in fat and chemicals, and has in some cases even been altered specifically to be indigestible, so that your so-called "free" chocolate will create a nasty stomachache.

II. I Hate Math! (Use Your Hands)
But what about counting the carbs? What a pain! Do I eyeball it or weigh it? Do I really need that fancy kitchen scale? Whoa! Slow down... Yes, carb-counting books and gadgets are big business these days. But I've found that the most useful unit measure is still your fist, which costs nothing and is always handy, so to speak. Think of it as a ball of 15 carbs. It's fairly easy to compare a pile of rice or pasta to your fist. Looks about the size of two-and-a-half fists? That's about 38 carbs, my friend.

If you still like to see it in black-and-white, I've found that the best books are pocket guides that you can easily stash and carry. The ADA's little Pocket Guide to Diabetic Exchanges and the "Fast Facts Series: Carb Counting Made Easy are both just 64 pages of extremely portable and useful information.

I was skeptical when my nutritionist kept insisting that most of us eat the same dozen-or-so foods repeatedly, and that after I a while, I'd just learn how many carbs are in those familiar dishes. But she was right! Trial and error can teach you more than any book or counselor. This is why it's important to write down what you're eating and calculating/dosing, at least for a while -- until you can see that you've got it right, and then stick with that.

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Last Modified Date: June 19, 2013

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