Carbohydrate Counting with Diabetes: Personalize to Get Precise

Posted by hope on Tue, 04/29/2014 - 07:59 in

Here’s a multiple choice question for you:

When it comes to managing diabetes and counting the grams of carbohydrates you eat, what resources do you rely on?

  1. A mobile app on your Smartphone which brags about a deep food database of thousands of foods.
  2. An online food and nutrient database.
  3. An easy-to-carry book loaded with carb counts.
  4. The total carbohydrate count on the Nutrition Facts label of packaged foods.

Is your answer “all of the above,” “a few of the above” or do you often just, well, wing it?

If you chose winging it, that’s quite understandable! It’s just plain time consuming to search through large databases, regardless of the ease of access, to gather the carb counts for the few foods you’re about to eat. But research shows you may be sacrificing accuracy.1,2 That’s unfortunate for two reasons. One, if you use an insulin pump, you’ve got a device which allows you to precisely dose insulin. Two is that research shows one way to achieve glucose control is to accurately match your insulin dose to your carb counts.3

Inaccurate carbohydrate counts may be a contributing factor to less desirable glucose control than you’d like.

Are you willing to consider a more personalized approach to carb counting that in the long run could make the job of carbohydrate counting a bit easier…and more accurate?

Here’s the Premise

If you are like most people, you’re a creature of habit when it comes to the foods you buy at the supermarket and then assemble into meals and snacks at home. The same is true for restaurant meals. Think about it: Do you frequent similar restaurants and tend to order similar menu items?

If you don’t initially agree with this premise, take a minute and think about your food habits. Do you agree that about 80% of the time you purchase and eat a similar repertoire of foods and meals?

While the concept of building your personal carb counts database may initially seem arduous and time consuming, it actually can end up saving you time by minimizing your need to constantly search for foods and their carb counts. Check out the following step-by-step approach to help maximize your carb counting accuracy.

Step 1:  Brainstorm a list of the 50–100 foods you regularly eat. Observe the foods in your pantry, refrigerator and freezer. Next, list the common restaurant foods you eat. Here’s a sample table you can construct and complete.

Food Amount I Eat                                        Carbohydrate Count (g)
Oatmeal, cooked
Milk, fat free
Banana
Apple, raw with skin
Whole-wheat bread
American cheese slices – 2% milk,
reduced fat

Step 2:  Fill in the amounts of these foods you usually eat. To be precise (yes, precision is key), weigh and measure the common amounts you eat or at least estimate portions carefully. For produce, such as apples, bananas, potatoes, etc., weigh them individually in the supermarket produce aisle or on a food scale at home for an accurate weight.

Food Amount I Eat Carbohydrate Count (g)
Oatmeal, cooked  1 cup
Milk, fat free  1/2 cup
Banana  1/2 large (8" to 8 7/8" long)
Apple, raw with skin  1 medium (3" diameter)
Whole-wheat bread  1 slice
American cheese slices – 2% milk, reduced fat  1 slice

Step 3:  Find the carbohydrate counts of these foods in the amounts you eat them. If available, use the Nutrition Facts label, realizing you may need to rejigger the grams of carbohydrate based on your serving size. It’s the most accurate data. If you don’t have a Nutrition Facts label for a food, use a reliable database. The USDA Nutrient Data Laboratory is a trusted and free database: http://www.ars.usda.gov/nutrientdata. It’s searchable, downloadable, calculates based on varied servings and includes approximately 8,500 basic and packaged foods. If you use the Omnipod insulin pump, the PDM (Personal Diabetes Manager) contains the nutrition data for 1,000 foods from this USDA database based on standard servings.

Food Amount I Eat Carbohydrate Count (g)
Oatmeal, cooked  1 cup  28
Milk, fat free  1/2 cup  6
Banana  1/2 large (8" to 8 7/8" long)  15
Apple, raw with skin  1 medium (3" diameter)  25
Whole-wheat bread  1 slice  18
American cheese slices – 2% milk, reduced fat  1 slice  2

If you’re eating restaurant foods or meals, particularly in the case of walk-up and order (“fast foods”), you may find their nutrition information on their website. Use this as a reference to assure you have their most current and accurate data.

Step 4:  Next, think about the foods you combine to make up your home- or restaurant-based meals and snacks. List these in a table using a format similar to the one below:

Meals Amount I Eat Carbohydrate Count (g)
Breakfast #1 - Cold Cereal
Oatmeal 1 cup 28
Milk, fat free 1/2 cup 6
Banana 1/2 large 15
Total: 49
Breakfast #2 - On the Run
Whole-wheat bread 2 slices/oz. 36
American cheese slices  2 slices/oz. 2
Apple 1 medium 25
Total: 63

Step 5:  Add up your total carbohydrate counts for the meals and snacks you commonly eat.

Step 6:  Put this data in a useable and portable format. Be as simple or high tech as you want: for example, use a few small index cards in your wallet or an app you can access from your Smartphone.

Note: You may find it easiest to complete this process over a couple of weeks as you put meals together and consume them.

Stay tuned for my next Suite D posts in the coming months on diabetes and nutrition. I’ll share tips to help increase your carb counting accuracy when you eat at home and at restaurants.

Did you know?

The Omnipod insulin pump allows you to create and name up to 36 carb or bolus presets in your PDM. Maximize on the time you’ve spent gathering and calculating the carb totals for your common meals and snacks and input them using these presets. This is an easy way to have your carb count totals at your fingertips.

To learn more about the Omnipod and try a free demo for yourself, click here.

___________________________________________________________________________________

  1. Brazeau AS, Mircescu H, Desjardins K, Leroux C, Strychar I, Ekoé JM, Rabasa-Lhoret R. Carbohydrate counting accuracy and blood glucose variability in adults with type 1 diabetes. Diabetes Res Clin Pract. 2013;99(1):19-23.
  2. Bishop FK, Maahs DM, Spiegel G, Owen D, Klingensmith GJ, Bortsov A, Thomas J, Mayer-Davis EJ. The carbohydrate counting in adolescents with type 1 diabetes (CCAT) study. Diabetes Spectrum.  2009;22(1):56–62.
  3. Evert A et al. Nutrition Therapy Recommendations for Managementt of Adults with Diabetes. Diabetes Care. 2013;36(11):3821-42.