ASK AMY QA
For each monthly column, I select one or two representative email questions to address those that contain a core question expressed by many of you. Hope this is helpful!
Q: Hello Amy:
I just finished reading your column on counting carbs but have never seen any information anywhere on how many carbs a person should consume in a day. Does it vary by person or gender? Height and/or weight? Does it depend on which meal or time of day you are consuming your carbs? Any info you can pass along would be helpful. Thanking you in advance...
A: Why, yes, the recommended daily carb intake does vary by person according to age, body build, and gender! I understand a very general rule of thumb for people with diabetes watching their carbs is 45g per meal for average women, 60g per meal for average men. But then again, who qualifies as average? Here are some excellent links for more info:
The University of Maryland Medical Center offers an online Carbohydrate Calculator where you can enter your own stats to come up with a personalized recommendation.
The Joslin Diabetes Center recommends that ca. 40 percent of a persons daily calories should come from carbohydrates (some say 50-60%), and the total should not be less than 130g daily. So you can track your daily calorie intake, and then do the math.
Q: Dear Amy,
I can't believe I am writing this letter but I've been feeling so overwhelmed with my diabetes control lately that I am hoping this will be cathartic. I am a new dlife member and I have had a terrible time being "good" since Halloween. Reading your recent article about getting recharged as well as your article on "The Guilt of Diabetes" has helped me enormously.
I was the "perfect" diabetic patient for the first 2 years of my disease, and now that I am well into my third year, I am sick to death of it. I have been dreading seeing my endocrinologist in February because I know that my A1C will probably be much higher than my last one of 6.1.
I have been feeling so guilty about my inability to stay away from junk food because I know first hand that I could be setting myself up for some nasty complications. My younger sister died one week before her 28th birthday of diabetic kidney disease. She lost her sight at the age of 24, endured 2 kidney transplants (the second one did not work), had one eye removed, and was about to lose her feet and the other eye. She simply threw in the towel and stopped all of her treatments because she couldn't take anymore. She died two weeks later.
I have 2 and 1/2 Masters degrees and I am very well informed about what I need to do to try and control this illness. One would think that I would have enough sense to stay away from excess carbs. Right now junk food has such a physical and psychological hold on me that I think about cheating morning, noon, and night. (I should mention that I have had many more good days than bad but I don't want any bad days.) I have been beating myself up non-stop for the past 2 1/2 months for placing myself in harm's way. I know I have to forgive myself and move on because as you said, the guilt is paralyzing me. I will start by patting myself on the back for the good things I have done during this time. I have managed to keep my commitment to my exercise schedule and maintain my weight during this difficult time.
Again, I want to thank you for your articles. I was feeling so isolated and frustrated with myself. Trying to share my guilt with friends and family would simply open up the door to the diabetic police. And isnt that the last thing I need right now?
- Sincerely, M.M.
A: Hi M,
Thank you so much for taking the time to write to me. It's so great to know that my words might actually comfort someone else struggling with this frustrating disease.
All I can tell you is that maybe you can find a way to take the pressure off yourself: you can't be the "perfect diabetic" all the time, but you can be a pretty good one most of the time. Maybe if you set up a schedule allowing yourself certain junk food items at certain intervals, then you wouldn't be so preoccupied with "cheating."
I hope this helps.
Read more about Amy Tenderich.
dLife'sDaily Living columnists are not all medical experts, but everydaypeople living with diabetes and sharing their personal experiences.While their method of diabetes management may work for them, everyoneis different. Please consult with your diabetes care team to find outwhat will work best for you.
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Well maybe not so much a furor as a controversy. The question, bluntly put, is whether or not a single HbA1c reading should be sufficient and adequate to diagnose diabetes — and whether the conditions under which the test was conducted should have any bearing on the diagnostic or non-diagnostic value of the test. The lede from