*Counting Carbohydrates*

Carb rstrictions for diabetics

Carbs,since they cause glucose in the blood,are a great enemy to the
diabetic.Even though it's not easy,a diabetic should probably restrict
carb intake to 50G per day.Famed diabetic doctor Richard Bernstein wants
his patients to keep daily carb count to 30-check Dr Bernsteins Diabetes
Solution on Amazon.The food triangle,for a diabetic,only leads to cardiovascula problems,amputated limbs,blindness,kidney failure and death.
I have had two diabetic friends die of kidney failure.It wasn't pretty.
A very carb restricttive diet,exercise and meds can keep diabetes in check.
Some diabetics,who exercise and keep dietary carbs low,can live without meds.Regarding meds,insulin is more effective and safer than diaberes pills
but insulin requires a difficult balancing act between insulin and carbs.
Eddie

Hi Eddie. Thanks for your post.

Ouch! Dr. Bernstein. That's a Love--Hate name. One thing I've
learned from being on Forums for 8 years. Don't push pumps or Dr.
Bernstein on People who don't want either. Turns them right off.
Discussing them both are Fine however.

I always managed to stay out of the arguments about Bernstein's
diet since I wasn't interested.

For certain, some Diabetics would achieve better control and they
may find Dr. Bernstein's diet and techniques Very acceptable.

For the others who are in control, they wouldn't see much of an
advantage. For those who find comfort in food, those who "just
love food" and for those who have the gene or syndrome that
enables them to eat a lot without feeling full, his diet would be of
no value, unless their meals were made special for them. Most of
these People need hands on motivational/feed back therapy and
support groups near-by them. Buying a book, in most cases, won't
help them much.

I'm Happy that he has helped you Eddie and if you would like to
start a thread about his diet/techniques please feel free. He
probably has tips that would help everyone.

I'm truly sorry to hear of your 2 Friends who have died of kidney
failure.

Carb counting/Bernstein

Bernstein is a type 1 diabetic who pushes a very strict very low carb diet-30G
per day.Bernstein also pushes insulin which is indeed safer than diabetes pills
but requires a very delicate carb-insulin balancing act.There is a lot of
very good information about diabetes in this book.There are some very good
locarb resources and recipes.For me,the book was very worthwhile though I
opt for 50-60G of carbs a day rather than 30 and,at this time,don't require insulin.Exercise also helps me a lot.I take 10mg Glipizide ER and 1500 mg
Metformin per day with my regimen to keep my glucose at normal level.
Please understand one thing: carbs are the enemy of the diabetic.Carbs
cause glucose in the blood,which,if it is high to begin with,causes very
high dangerous glucose levels.Even in my situation,if I completely go nuts
and eat a very high carb meal(i.e. mexican food which my wife loves) my
blood glucose skyrockets and I have to exercise like hell to bring it down.
My favorite meal is chicken fried steak with mashed potatoes,fried okra
and cornbread-I have that meal once a year on my birthday.Make no
mistake here-a diabetic,if they want to survive,cannot eat like a normal
human being.Locarb diet and extercise are the key.Meds help.
Eddie

I looked through Bernstein's site before(since some People were arguing
about his diet ideas)and watched a couple of his video clips. He certainly
does go into depth.

Although he has some Good ideas, I felt his diet was not for me. I don't
consume much as it is(except when we go out for supper sometimes or if
I feel like having something I shouldn't, occasionally).

I also have my other major disease which goes out of control when the
drugs aren't working. I tend to loose weight without me participating. I
also have Hypothyroidism(which has been in remission),a high metabolism
and I'm on Prednisone. So it's quite the interesting battle.

Like 2 weeks ago I felt lighter than usual. To my disappointment,
I discovered I was only 113 lbs. from 126 lbs. 2 weeks before. Therefore
I have to eat more in order to gain some weight back in order to keep my
strength up. Too many carbs are indeed bad for a Diabetic and others in
general. But we all need carbs to survive. Some People need more than others.

Here again, I thank God and Dr. Banting for Insulin. It allows me to consume
the extra food that I need during these weight-losses, so I can continue to
function and stay in the game.

Although both oral Diabetes meds. and Insulin have their cons, I also think
Insulin is the better choice when a Diabetic needs it.

I certainly agree that Diabetics should not/cannot eat like a non-diabetic
because their systems are wired differently. That is one reason that I worry about some (yes, I said some) People on pumps who think they can. Gee, the extra
weight-gain, higher amounts of Insulin, putting their sugars out of whack,
etc. For me, I find Diabetes the easier disease since I can usually control it.


You know, I may buy Bernstein's book now just to allow me to consider more
of his many ideas. You're a Good salesman. I'd be interested to hear what a daily day's 50 gm. meal would be for you.

My typical locarb day

Breakfast:
egg whites/cheese omlet
3 slices turkey bacon
1 slice of wholewheat toast
Lunch:
Atkins Advantage chocolate shake
Dinner:
6 ounce filet mignon
green beans
salad with red wine vinegar
1 slice of wholewheat bread
Desert:
1/2 cup Bryers locarb ice cream
That was yesterday.
Fairly typical carb day for me except when I go astray.
Honestly,I have to go astray sometimes or I'd go nuts.
And so it goes
Eddie

Hi Eddie:

Hey thanks for the day menu. Okay, I can easily do that.
Actually sometimes, I eat less. But you're a man. I don't
know how you could eat that little. Especially lunch.
Granted the stomach does shrink as a Person eats less and
less even to the point where you don't feel like eating sometimes.
Now you have self-discipline.

Well, as long as you can do it without feeling really deprived
and you still feel Well and satisfied most of the time. That plus
some exercise should keep you healthy and on a smaller doseage
of meds. for a long time.

You go astray?? I don't blame you. Not to worry, most
Diabetics do occasionally, including myself. I eat normal foods
mostly but small portions and I don't usually eat desserts since
I don't crave it.

Nice talking to you Eddie.

Counting Carbohydrates

Counting Carbohydrates: How and Why

By Blondy2061h and Lloyd

Carbohydrate counting is important for all types of diabetes, including: type 1, type 1.5, double diabetes, type 2, pre-diabetes and gestational Diabetes.

Some people can control their Type 2 diabetes with diet and exercise. Does that just mean eat good foods? Well, that is a part of it, but carbohydrates raise your blood sugar, not just sugar. Just because a food doesn't taste sweet, doesn't mean it won't raise your blood sugar. Exercise will usually lower it. If you are controlling your diabetes with diet and exercise, limiting your amount of carbohydrate intake can help control spikes in your blood sugar, and therefore help you reduce your risk of complications, such as heart disease, amputation, and eye problems.

Many people with type 2 diabetes are on oral medications to help them control their blood sugar. They work by different mechanisms. Some will prevent your liver from releasing too much glycogen (stored glucose), while others will increase insulin sensitivity, while still others will push your pancreas to release more insulin. Some medications work by multiple means. While these drugs can be a big help, most of them have as the number 2 listed side effect, after possible hypoglycemia, as weight gain, though weight gain for most people is a natural effect of controlling blood sugar. Added body weight usually leads to added insulin resistance, which raises blood sugar and you end up with still more fat stored- a vicious circle. This makes limiting carbohydrate intake even more important- it helps break the cycle.

A natural progression of type 2 is the pancreas cells "exhausting." The pancreas can no longer keep up with the high insulin needs, and needs help. The help comes in the form of injected insulin. There are many different forms of injected insulin, and all type 1s, most type 1.5s, and some type 2s and gestational diabetics need it in some way. Any way you do it, however, this basic concept needs to remain in your mind. Insulin and exercise lower blood sugar, while carbohydrate raises it. Therefore, you want these things to balance to prevent hyper and hypoglycemia.

If you are on an insulin pump, you tell the pump how many carbohydrates you are going to eat and most pumps do the math to give you the right amount of insulin to match the carbohydrates. If your carbohydrate factor is set correctly, this usually works out well.

You can also use "Multiple Daily Injections" to match your insulin dose to what you eat. With MDI you take a shot of long acting insulin once or twice a day, and then take injections of fast acting insulin every time you eat (unless, of couse, you are eating because you are low).

With an old school "2 shot a day" programs it was very important to keep track of carbohydrates, because the insulin peaked, meaning you had to eat the same amount at the same time everyday to cover this peak.

With gestational diabetes it's important to count carbohydrates because you want to consume enough carbohydrates to help your baby optimally, but you need to control spikes in your blood sugar too.

With pre-diabetes carbohydrate counting is important because it can help slow the progression to full-fledged diabetes.

Diabetes is a progressive disease. Type 1s leave the "honeymoon phase" while type 2s deal with increased insulin resistance and more beta cell exhaustion. Type 1.5s also are on a path where less and less insulin is produced. The further you are along this path, the harder glucose control becomes, and the more careful you need to be with your carbohydrate counting for success. Counting carbohydrates is part science and part art. You can read labels and check in books when at home; and measure and weigh foods. When you eat out, you have to guesstimate. That takes practice, the more you do it the better you get, just like most things in life.

How to count Carbohydrates:

Food scales.
A food scale is small, fairly inexpensive, and the most accurate way we know to measure portion sizes. In the US, anyway, we would look for one with both ounces and grams, and also what is called a taro function. That simply means it has a button it to set the scale to zero whenever you wish.

Here is a good way to use the scale:

Put a plate on the scale.
Set the scale to zero.
Add a food to the plate, until the desired amount shows on the scale.
Set the scale to zero
Add another food.

You end up with a plate with food on it, and you now know how much of each food you have. And you have not dirtied any measuring cups doing it. The package, can, box, or book you are looking in will tell you how many carbohydrates in a serving. You can weigh out 2/3 of a serving, you will have 2/3 of the carbohydrates.

If a food is only listed in a volume measure, like a cup of milk, you can do this:
Put a measuring cup on the scale
Zero the scale
Add a cup of milk
Write down how many grams a cup of milk weighs.

From here on, you can put a glass on the scale, zero it, and add a cup of milk without measuring, just add the right weight.

Some scales have even more helpful features. Some scales have food databases right in them, or let you enter the carbohydrates per serving and figure the exact carbohydrate for you- not just the weight. Some scales will even total it for you as you go along.

There are many, many ways to figure out how many carbohydrates are in foods. The Cozmo, Animas, and Omnipod pumps have food databases right in them, while Accu-Chek and Calorie King make a software program that can be loaded onto a PDA with a carbohydrate database.

There are a million and one books on carbohydrate counts- some with a focus on food in restaurants.

There are also many web sites, with CalorieKing - Diet and weight loss. Calorie Counter and more. being a popular and thorough one.

Another way to count carbs is to use "carb factors." This basically tells you how many carbs 1 gram of any food has. It's a very precise, though sometimes difficult way to count carbs, and works well with a food scale. You simply weigh the food and multiply it by it's "carb factor" to get the total carbohydrate value. More about carb factors can be found here: FWD-Carb Factors Resources

An "old school" way to count carbs was using the exchange system. It was designed to help people eat a balanced diet. We know you're not idiots though, and can figure out how to do it yourself. We further know that you don't want to eat the same exact thing everyday. Finally, the exchange system over complicates things, with no added benefit over straight out carb counting. So we don't recommend it. However, if you are used to the exchange system, it's easy to convert to carb counting:

1 Bread Exchange = 15 grams of carb
1 Fruit Exchange = 15 grams of carb
1 Milk Exchange = 12 grams of carb
1 Vegetable Exchange = 5 grams of carb
1 Meat Exchange = 0 grams of carb
1 Fat Exchange = 0 grams of carb
A free food is one with negligible impact on blood sugars.

(From page 67 of Think Like a Pancreas by Gary Scheiner)

No matter what your treatment, or what type of diabetes you have, carbohydrates are an inevitable part of life, and counting them will make your life so much easier.

- Lloyd and Blondy2061h