Today’s topic for Diabetes Blog Week:
To Carb or Not to Carb.
“Let’s talk about what we eat. And perhaps what we don’t eat. Some believe a low-carb diet is important in diabetes management, while others believe carbs are fine as long as they are counted and bolused for. Which side of the fence do you fall on?”
Nothing seems to ruffle feathers like the Great Carbohydrate Debate. I hate that I’m supposed to pick sides here. So I’m not going to. Rather, I’m just going to be blunt, and share my conflicted feelings on the subject:
First off, who doesn’t love carbs? Pretty much all of the food items that fit the 
descriptions “yummy” and “comfort foods” are carbohydrate-rich. Let’s face it, humans crave carbs. And for good reason. They do provide most of the immediate fuel that our bodies run on. One of the most torturous things about having diabetes is the guilt associated with eating carbs.
Guilt? Why yes, because I do recognize that the fewer carbs I eat, the steadier my blood sugar will remain. Carbs spike your blood sugar, some more quickly than others, which is of course what the Glycemic Index aims to explain.
But I’ve tried to live strictly low-carb, and I find it extremely difficult. I feel that my food choices are unacceptably limited; don’t forget, I’m allergic to wheat along with the diabetes. This actually helps me keep my carb intake low naturally, since I can’t indulge in “real” bread, baked goods, or pasta. I take my carbs mostly in the form of tortilla chips, various types of granola bars and rice, and some occasional fruit and wheat-free crackers. I also like my yogurt with a little bit of flavor in it. So shoot me. At least I’ve got the insulin dosing down pretty well now.
I describe my approach as eating “carb-consciously.” I think of it as having a stipend to spend at each meal. Usually I try to keep it down to 45g or less of carb per meal, and then I have to decide how to “spend” that stipend: will I go for a big scoop of pinto beans with that skirt steak? Or skip the beans and eat the strawberries afterward instead? I think this is a good way to go about it, as you’ve only got so much carb to go around, and you don’t want to waste it on something not-yummy-enough to be bolus-worthy!
Besides struggling to ration my “carb bucks,” what I find difficult is the hard-line some folks take on the low-carb issue. You may find it satisfying to stick with Dr. Bernstein’s recommendation of 12g carb per meal (like what? six blueberries?), but I do not. Please don’t judge me, or try to push your convictions on me. Eating carbs does not make me an irresponsible patient. It just makes me human. Have some respect for fellow PWD’s lifestyle choices, please.
Food choices are such a touchy subject. And I’m not even trying to lose weight!
I was more than a little surprised when expert CDE Gary Scheiner actually recommended eating carbs for snacks (I’d been gravitating towards low-carb choices like cheese, salami and nuts, which are rather high-fat). Gary says that all snacks will effect your blood sugar, and that carbs are easier to predict and therefore easier to dose for. What do you know?
So do I carb? Yes, I do. But I am always, always on the lookout for some good new low-carb foods that I can enjoy — without spending too many of those precious carb bucks.
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Editor’s Note: For more of my thoughts and some great Guest Posts on carbohydrates and diabetes, please browse the Food Section of this blog.
I think what you do is very responsible. I don’t think I ever see you complain about numbers all over the spectrum. It is the person that eats what they want and adjust the insulin to compensate and then complains that their numbers are all over the place. I restrict my carbs as low as I can and then on occation let myself eat a special meal.
To each his own but don’t complain. The only exception are children(under 21yrs) they should have ‘good carbs’
I suppose that is how I deal with the carbs, too, deciding how to spend my ideal amount per day. Most of the time I make good choices, sometimes I indulge.
Carb Bucks… Now that’s awesome. Truly. I’m with you on this one, Amy. Give me carbs, even if they aren’t good for me. I’ll bolus as needed, thank you very much! Thanks for sharing your perspective.
I do something similar, but I probably eat more carbs – about 130-180g a day. Mainly because I find my diabetes is difficult to control if I exceed a certain point, or eat certain foods. I try to keep those foods occasional, and avoid the ones I don’t really like. I’m gluten-free also, so that eliminates some of the tougher choices.
Hi Amy,
I’m with you. I love food too much to stress about minimizing my carb intake. However, I also tend to ‘ration’ out my meals (based on the carbs that were in each of my meals on the old school exchange system). Usually I aim for between 50-70g CHO. If I’m exercising, I’ll only bolus for about 2/3 of the carbs I’m consuming. Less insulin for the same amount of food? Cool =)
Cheers,
L.
I find that when I try to get in all those lovely antioxidants that my carb count goes up. Having read that a nutritious diet consists of things like sweet potatoes and fruit as well as green veggies I just cannot keep a very low carb count, especially for breakfast. I am trying to fast one day a week do I can keep the carb count higher the other days. Cutting out all dark colored fruit and veg means cutting out all the good stuff for me.
Hi! I have type 2 diabetes, and was diagnosed in February. I was more repulsed by the thought of “special” diet than any other aspect of diabetes. My endocrinologist started with offering a challenge – try to stick to 45 grams of carbs per meal, and 15 – 30 grams of carbs for snacks. I found that this is not unreasonable. (Actually, I lost 35 pounds in 12 weeks with this!)
I think it’s important to be committed to the life style, but not slavishly committed. Sure, I blow my carb budget sometimes. (See? I too like the idea of comparing counting carbs/calories to finance.) The thing is, I don’t stress or berate myself when it happens. In fact,just last week I had a day when I saw that what I was eating was clearly going to “overdraw” my carb account. I saw this early in the day. So I declared it a free carb day. I counted but wasn’t concerned about the numbers. When I talked to a CDE about this, she said that we all have times when our cravings seem to demand tossing numbers out the window. That’s OK, as long as we get back to counting the next day, and don’t ignore numbers very often. (Even when I did ignore carb counts, I still was close to my total carb budget for the day.) It takes commitment, a positive mindset and a good emotional approach to this life style. But impossible, maddening, depressing? I think not.
with histamine, lactose, nickel and sorbitol intolerance my food choices are rather limited.
so i do eat carbs daily, but not more than 45g carbs per meal, just like Amy, more if i exercise hard (or I use less insulin, of course).
my basic carbs are mainly spelt bread and spelt pasta, 65% wholegrain. fully wholegrain is out because then nickel is a problem.
spelt has a nice and gentle way of trickling into the blood and peaks after about three to four hours, which works fine with my Insuman Rapid. i do not tolerate wheat well, but spelt is a very friendly companion. no great surprises here.
2 slices of buttered spelt toast with a small trickle of honey are my tacos. worth an extra bolus or two. on sundays.
i do not feel guilty about eating. i only feel bad if i don’t exercise enough.
I love the idea of Carb Bucks! It is a perfect way to explain how I eat.
I too have long subscribed to shooting for about 45gm/meal and “spending wisely” so I limit weight gain. In fact, I know using a pump that I should use about 35 to 40 units of insulin per day. This is also known as Total Daily Dose (TDD). I notice when my TDD starts to drift up into the 50′s or so, it is either because I had a special occasion (that’s fine) or it’s because I’m having to do more correcting than usual (not so fine). Each morning I get up and check my TDD and see how yesterday went–then I proceed into the day “spending” my carbs as wisely as I can.
Many eons ago, when I was trying to lose weight by counting calories, I was on a 1000-calorie diet. I used real money to keep track. Every penny was 10 calories. A dime was 100 calories. At the beginning of the day, I’d put $1 worth of change in a jar. As I had meals, I’d remove the appropriate amount of change.
The advantage was that if I saw the jar was getting empty, I’d be careful not to spend all my “money” on lunch.
Then again, it’s “carb-guessing,” right? (see Amy’s previous post on this.) I often don’t *really* know. I will look at the meal on my plate and punch in, hmmm, 52 carbs – that sorta thing. Today’s post, however, and the tip on watching TDD (above) reminds me to be a little more of a spend thrifty with carbs. Good reminder.
(Now as for treating post-exercise lows… whole nother story!)
I always like to say that I’m “carb conscious” rather than low-carb or high-carb (there’s so much debate on what those terms mean anyway!) There’s a lot to be aware of besides how many carbs you’re eating.
For those of us who don’t inject insulin to get our BGLs back into line after eating carbs, strictly limiting carbs (ala Dr. Bernstein or Atkins) is a must to stay as close as possible to the normal range (mid-80s) in order to avoid diabetic complications.
For me, that means around 20 net carbs or fewer per day and no more than about 8 net carbs per meal (1 or 2 for breakfast when my BGL is pickiest). This is not as difficult as it sounds if you eliminate sugars, grains, and other carby foods. In order to keep it fun and satisfying, I dream up recipes using the ingredients my BGL will tolerate and share them with others who are also wanting to keep their carb intake to a minimum.
You can find my recipes and other info at: http://dardreams.spaces.live.com. I recently posted about willpower and cookies there!
For me carbs are a no-no, I have forever struggled with the carbs debate for a long time till I decided to just Eliminate them as much as as possible, I will be lucky if I consume 50 grams a day. I was having such a hard time with my fasting numbers until for a while so I just eating carbs with my dinner, Now most of my carbs intake come from lunch and that’s it. Eating 6 times a day also keeps me full and helps me avoid the hunger pangs and shakes associated with a low carb diet.
I was just recently diagnosed with type 1.5 and this is exactly what my endo recommended – 45 g carbs each meal and about 15-25 for snacks! Makes sense to me and isn’t too hard to follow.
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