Can we all agree on a few facts? (Yes, this leads to carb counting)

General
1

I've been in a heated discussion on a previous post that led to carb counting.  I guess some people claim they don't do it and it really confuses me beyond belief.  So I wanted to establish a few facts.

I do not claim these to be true but to the best of my knowledge they are.

I really wish there was a doctor or dietician that could weigh in but here it goes. 

 

What I believe are scientific facts that should be established and known for all Type 1 Diabetics in these forums and elsewhere so we can avoid debate and get down to taking control:

1. Non-Fibrous Carbohydrates are the only thing that raise your blood sugar. (Basically if a carb passes through you, it can't raise your blood sugar nor can fat or protein.) 

2. Four things can lower your blood sugar.

a. Insulin

b. Exercise

c. Excretion - usually in the form of urine filtered by the kidneys.

d. Supplements - (I'm really not concerned into getting into a debate about which ones do and which ones don't but let's agree that there are things out there.) including things such as cinnamon, chromium, various herbs, etc.

3. If #1 is true and number #2 is true, taking a certain ratio of bolus insulin to non-fibrous carbohydrate intake needs to be established while taking into factor

a. basal amounts of insulin

b. rate of digestion of eaten carbohydrates

c. amount of exercise in the past 12 hours (this includes stress levels).

d. supplements taken

e. your body's ability to process/use the insulin (basically are you sick or not)

f. (Ok, I know there may be other factors but for sake of argument let's leave it at this unless I'm missing an obvious one)

to keep your blood sugar within a normal consistent range.

Conclusion:

If these facts are found to be true, there is no option other than carb counting to consistently maintain normal blood sugar ranges.

 

Can you guess all of the time? Sure but that does not make things consistent and you'll be going up a down like a yo-yo and . . . it's just a lame way of carb counting.

Can you eat the same thing day in and day out and maintain a military like type schedule? Sure but that is just a boring way to carb count.

Can you test your blood sugar religiously and take insulin based on your meter readings? Sure, but you are just carb counting in a very backwards manner because your blood sugar is only going up from carbs.  So if it's high, you've under guesstimated your carb count to insulin ratio and if it's low, you've over guesstimated your carb count to insulin ratio. It's like waiting to see the answer on a test then filling in the blank.

Anyway you slice it people, carb counting is not an option. The way you approach doing it is. Figuring out how to do it and paying attention to your body offers the most freedom. Is maximum freedom a goal for everyone?  Maybe not but it makes life easier for us and others around us and helps all diabetics in educating others how our bodies work.

Is carb counting an exact science. Yes, but who has time to do it. Well, you should. You have Type 1 Diabetes. Diabetes doesn't have you, right? It's all about maintaining your lifestyle. I'm a person first and a diabetic second. Personally, I never get it right all the time.  I carb count like most people, when I'm out to eat, I look at my plate, draw upon my knowledge of studying food labels and research and take a shot.  After many years, I'm pretty dead on in most situations. I still get frustrated when I guess wrong and I'm totally confused about certain blood sugar readings but that's why we're all here supporting each other.

Best, Jack

 

 

 

 

2

Jack,  I am with you on all points but I think you left out a huge variable.

You liver stores carbs (and lipids, and other stuff and things) in a form that can be quickly dumped to a blood stream.  Therefore there is another mechanism to raise blood sugar: intentional or accidental dumping of glycogen stores.  sympathetically, your body can lower blood sugar by storing glucose in glycogen chains.  Diseases of glycogen synthesis or decomposition can therefore raise and lower blood sugar, uncontrollably.

Glycogen stores can be released by exercise (my blood sugar GOES UP when I exercise) and a host of other things.

Synthesis of glycogen can cause a person's carb ratio to become unpredictable (I ate a loaf of bread and a can of coke and did not bolus and my blood sugar has been 71 all day)

we've both heard these thigs on the boards.

let's agree that blood suagr, and it's control can also be very complicated, well beyond carb counting.

3

That is a tricky variable I was unaware of and explains problems I've been having with my blood sugar going up, sometimes way up after exercising even when it starts out around normal and I haven't really eaten but 3 hours before hand.

Thanks for bringing that up.  I'm reading all about it right now.  Very confusing to get a good understanding of.

What do you do?  Keep a log of food an exercise to figure it out?

4

A small amount of protein and fat can be converted to glucose.  I forget the number, but it's something like 10% or so.  If I eat a meal and know the exact number of carbs, that often isn't enough information for me to figure my insulin dose.  If the meal also contains a lot of fat and/or protein I will need more insulin. 

5

Stress and hormones (especially for women) also play a huge part in blood sugar levels.

6

i'm not a dietitian (yet!) but i have the degree!

everything you eat is eventually converted to glucose (i did indeed say everything). this includes fat and protein. which means, they have an effect on your blood sugar. fat and protein are broken down slowly, meaning they will raise your blood sugars however it will be gradual and over a longer period of time, resulting in a slower less extreme peak in blood sugars. foods containing fiber also raise your blood sugar because they are coming from carbohydrate containing sources, however fiber also slows down the absorption of glucose into the blood, but it does not slow it down as much as protein and fat. forget everything you have heard about "net carbs" and such because recent studies are showing they effect your blood sugars equally as much as "total carbs." complex carbohydrates are going to be the fiber-containg carbs (these are the carbs absorbed more slowly into the blood). simple carbs are the carbs broken down and absorbed quickly, resulting in a quick spike and drop of the sugars.

carb counting is the best way to control blood sugars, however it is not the only way. and joe is correct--your liver is still pumping out sugar and glucagon. unless you have liver problems (or take a drug not approved for T1 diabetics) you can't get away from that. glycogen is the storage is of glucose in the liver and muscles. when you are sleeping or fast for extended periods of time, your body is using glycogen for energy. however, all glycogen stores are depleted within 8-12 hours, hence the need to "break the fast" with breakfast or small meals/snacks after exercise.

other ways to control blood sugars are carb choices (1 choice - 15 g of carbohydrates), exchanges (based on carb, protein, and fat). some are solely based on counting the number of carbohydrates, while others incorporate carbs into a more complex formula. typically used with T2 diabetics, eating restricted carbs along with exercise are another way to attempt to control sugars. with diabetes, whether T1 or T2, it should be tailored to the individual. there are multiple ways of handling diabetes and for some, carb counting simply isn't it. working in a diabetes clinic, i have met with several patients who are T1 and have been for years, and simply refuse to carb count. there are ways around it. it is up to the individual.

7

Gee plaidjack you really got a bee in your bonnet over this one don't you.  But one thing is for certain.  You can't get 5800 people to agree on anything.   So you've stated your case.  Great.  Now you're going to go nuts if you continue to try to get every person on here to say, "plaidjack is right, carb counting is the only way to go."  Ain't gonna happen.

8

hahaha. i agree. if i could get everyone to agree with me, they'd be paying my rent while i live carefree :o)

9

Well put, DDRumminMan.

BP

10

i'm still giggling over "bee in your bonnet." i don't know why, but it's a funny visual.

11

I wonder if bees in bonnets were frequent occurrences which gave rise to the saying, kind of like "ants in your pants".

12

HA. ants in your pants. another funny mental picture.

13

My point is that you can't say that counting or keeping track of or whatever you want to call knowing how many carbs you've eaten is an option.  It's not.  No one has disputed that.

And yes, protein can be broken down into glucose but that is really only if you don't eat any carbs.  Which brings me back to my original point, you must keep track of or be aware of or for heaven's sake, count carbs. 

The best analogy I can think of is when people say they don't watch TV but know everything that happened on the last episode of the Simpsons.  When you ask them how do they know what happened when you don't watch TV and they reply that they watched it on the internet well, I say bull, you are still watching TV.  If it makes them feel better about themselves to say they don't watch TV, so be it but it's misleading at best and a lie at worst.   

Why does this bee in my bonnet/ant in my pant bother me so much?  For one, look at the top of the page.  There's probably an animated ad running about ignorance and inconsiderate behavior towards Type 1 Diabetics.  And if you look close, it looks like someone's trying to get  a diabetic to stop eating a cup cake. Everyone on this site has probably encountered a situation in which they have gotten disapproval or dirty looks when eating something sweet.  And when I do the simplest way to explain to them why I can eat what they think I can't is carb counting or knowing how much insulin I need to take to counter act the carbs entering my system.

For two, young and new diabetics should not be discouraged from counting carbs by reading that people on this site are perfectly fine and don't count carbs when in fact they do but do it by eating the same things every day or testing 12 times a day.

For three, it's a necessary practice for people like me who can't afford to test their blood sugar twelve times a day. 

Is being diabetic as simple as being a carb counter, no. There are far too many variables that go into it that I don't have time to explain to people but in the end we are all counting carbs and basing our insulin intake on the amount of carbs we eat (along with taking into account said variables).  How you go about doing this is optional.  Knowing is not and that is my point.  No one can or has disputed that.  

14

[quote user="plaidjack"]

young and new diabetics should not be discouraged from counting carbs by reading that people on this site are perfectly fine and don't count carbs when in fact they do but do it by eating the same things every day or testing 12 times a day.

[/quote]

 

maybe i missed something..but where were either of them telling new/young diabetics they shouldn't carb count?? what i read was: they simply don't carb count and that works for them, though it doesn't work for everyone.

time for glasses maybe?

so you can't afford to test 12times a day...i don't technically carb count and I don't test 12times a day. what does that or being able to afford to have to do with any of this?

 

just give up dude. you're digging a bigger hole.

15

[quote user="plaidjack"]

That is a tricky variable I was unaware of and explains problems I've been having with my blood sugar going up, sometimes way up after exercising even when it starts out around normal and I haven't really eaten but 3 hours before hand.

Thanks for bringing that up.  I'm reading all about it right now.  Very confusing to get a good understanding of.

What do you do?  Keep a log of food an exercise to figure it out?

[/quote]

The thing that works for me is to eat within 1 hour of activity.  I eat a carby meal (60-80 grams) if I know I will be doing a lot of exercise/activity, and I only bolus for about half odf the carbs.  I also pump so I can easily get away with the following: I set my basal rate to 10-50% of normal, about 40 minutes before, and the go do whatever.  works like a charm but what a pain in the a$$.  The other thing is Symilin, havent experimented yet with that but I think it's in my future.

16

Perhaps you need glasses I said "discourage" not telling people not to.  I mean you even quoted me. Seriously?

When people go around bragging that they don't carb count it discourages other people to try.  It's like watching Kobe Bryant or LeBron James take 3 steps when driving the lane and effectively traveling (which is against the rules of basketball).  Do they get away with it, yes.  Does that mean everyone should start traveling while playing basketball, no.  But it's very discouraging to watch and have to explain to kids or people learning the game that well, they can get away with it but you can't.  They're not telling them not to but their actions are discouraging. Get it?

I'm trying to establish some indisputable facts so that we can all move forward.  It's like establishing the alphabet so that we can all communicate. Will some people refuse to learn the alphabet and claim they are very happy not being able to read, sure.

Another reason I'm going on and on about this is that there are diabetics in the previous carb ratio post that had no idea what people were talking about because it had never been explained to them how carbs effect blood sugar.  They thought insulin injection levels were based on calories or simply the amount the food they ate.  It's not.  It's based on carb intake and a handful of variables.  Am I crazy for thinking that? Can we all agree on that?  Because probably 99.9% of doctors and scientist have.

And what does this have to do with money?  Well, in the carb ratio post some of the most uninformed people were those that have no health insurance.  They made statements about having to jump through hoops to get cheap test strips and supplies.  So when Happy Vegan claims that testing blood sugar every two hours as an alternative to carb counting (which in reality she's just carb counting backwards), its just not an option for lots of people with diabetes.

I probably will never understand why Carb Counting is such a dirty word to some diabetics.  It just is.  I accept that but any way you slice it every diabetic needs to be aware of their carb intake and how it effects their blood sugar.  Right? That's all am asking people to agree on.  I know it took a while for people to come around to accepting certain physical truths like gravity but they did.  And you know what, understanding things like gravity and agreeing on certain facts made it possible for us to fly.

17

[quote]

i don't technically carb count and I don't test 12times a day. 

 

[/quote]

Technically you do carb count Batts.  Unless you are eyeballing your plate and counting protein and fats and basing your insulin intake on that. Are you? No you're not you're guesstimating carbs.  Otherwise known as carb counting. 

And that's my point, technically we are all carb counting.  You may not want to admit it or call it that but you are.  There are different options in tracking your carb intake but any way you cut it your carb counting.  And I want people to stop saying they aren't when they are.  It's detrimental and discouraging to diabetics and everyone around them.

So stop it!

18

[quote user="Joe"]

[quote user="plaidjack"]

That is a tricky variable I was unaware of and explains problems I've been having with my blood sugar going up, sometimes way up after exercising even when it starts out around normal and I haven't really eaten but 3 hours before hand.

Thanks for bringing that up.  I'm reading all about it right now.  Very confusing to get a good understanding of.

What do you do?  Keep a log of food an exercise to figure it out?

[/quote]

 

The thing that works for me is to eat within 1 hour of activity.  I eat a carby meal (60-80 grams) if I know I will be doing a lot of exercise/activity, and I only bolus for about half odf the carbs.  I also pump so I can easily get away with the following: I set my basal rate to 10-50% of normal, about 40 minutes before, and the go do whatever.  works like a charm but what a pain in the a$.  The other thing is Symilin, havent experimented yet with that but I think it's in my future.

[/quote]

Thanks for sharing Joe.

Symilin, eh?  More medicine and more money.  Sounds like a real pain but if it works it works.  I look forward to hearing your experiences with it.

19

i simply look at my plate and decide how much insulin i wanna take for it. i rarely actually THINK about how many carbs that piece of toast is, and how many carbs are in that pasta. i just decide if i feel like taking 6 or 8 units for that meal. the only meals i dont do that for, are for mcdicks or a&w where i've gone online and found out the excat amount of carbs for the meals i always have. only case where i'm really thinking about carbs when i decide how much i wanna take.

 

i don't consider that carb counting..what do you care? does it effect how YOU treat your diabetes? i didn't think so. am i telling people they should do it my way? nope.