One of the tools we use to help us manage our type 1 diabetes a little better is carb counting or carbohydrate counting. And it’s incredibly useful regardless of what diet/meal plan you have chosen: Keto, low carb, high carb, no carb, Atkins or Bernstein. It’s still good to know how to carb count and all that comes with it.
To me, this makes perfect sense: after all, if the carbs that we eat are what has the biggest impact on our glucose levels then measuring them and matching them to an insulin dose seems like a good way to reduce the variability of this.
If you’re someone who hasn’t been introduced to carb counting yet I’ve included a few useful resources at the end,of this post. And If you’re not sure what the carb connection is with diabetes have a read of Section 5 of the Australian “Starter Kit for Newly Diagnosed Type 1 Diabetes” Page 41.
MY CARB COUNTIN' STORY
For the first ten years of my life with type 1 diabetes, I hadn’t a notion about what I was doing or why. I took insulin as directed, checked blood glucose as directed and I had an exchange list of foods I never ate.
Then, I moved to America where I met a diabetes educator who taught me about measuring carbs and adjusting my doses of insulin to match the food I was going to eat but also how to adjust for glucose levels that were too high or too low. Before this point it NEV-ER occurred to me that there may be a way to do this!!! (This was 2003 and social media wasn’t even a twinkle in Mark Zuckerberg's eye!)
Also, because this was 2003, I used a sliding scale (AKA absolute and complete guesswork) for correcting high and low glucose levels which I adjusted myself and then once I began using an insulin pump I graduated onto an insulin sensitivity/correction factor.
Fine tuning one of the biggest variables of living with type 1 diabetes made a huge difference in my diabetes management. And the most empowering one! I was doing it by myself, and not waiting on a six month appointment where I was told how much to increase/decrease my insulin doses. My appointments were a bit smoother too as I took more of the control.
CARB COUNTING HAS BEEN AROUND FOR A WHILE
It might surprise people to know that carb counting in some form has been around for a number of decades, in some form: remember the exchange list. I’ve read accounts from the longest living people with diabetes where people had figure out a connection and weighed food
It was also one of the diet strategies recommended by the DCCT, (the Diabetes Control and Complications Trial DCCT was a 10 year trial which determined that complications of type 1 diabetes could be prevented or delayed and was published in 1993). Yeah, I know, I only came across carb counting it in 2003!!!
I truly believe that carb counting is one of the most important skills we should have to help us live well with diabetes. Others seem to agree, Diabetes Daily published an article in 2016 including carb counting as one of the 7 Habits of People with HbA1Cs Under 53 mmols ( 7%).
WHERE DO I LEARN MORE ABOUT CARB COUNTING
In Ireland, at the moment, there are two types of structured diabetes education courses that cover carb counting for adults and one for parents/children.
DAFNE (Dose Adjustment For Normal Eating).
There are seven diabetes clinics who provide DAFNE. Find the list here.
there are twelve diabetes clinics who provide BERGER.
For children, teens and parents:
CHOICE (carbohydrate and insulin collaborative education) PROGRAMME
The list of those centers can be found here.
WHAT IF MY CLINIC DOESN’T HAVE CARB COUNTING COURSES
This is a very real possibility for people with type 1 diabetes in Ireland 2018. Most, if not all, our diabetes clinics are hugely understaffed and so the waiting lists for courses can be extremely long.
And sometimes your clinic just doesn’t have the specialist staff at all to provide structured education. But all is not lost, you do have some choices.
Here are some more links where you find out more about learning to carb count:
***** NOTE If you use a US based website for carb counting information be aware that you don’t have to subtract the fiber grams here in Ireland and UK like you would have to in the US.
- ONE TO ONE
Your clinic may not run group courses but they may have a dietitian who will work with you one to one during your appointments.
- PRIVATE CLINIC
Some private diabetes clinics provide a one day intensive course that you can pay to attend.
- FIGURE IT OUT BY YOURSELF
Regardless of where you learn to carb count a good place to start is to identify, weigh and collect the nutritional label information your carbs into a notebook or electronic notes for at least two weeks. This is usually what your first session with a healthcare professional will start with and at least you will be that one step ahead.
THE FUTURE OF CARB COUNTING EDUCATION IN IRELAND
The National Clinical Guidelines for Adults with Type 1 diabetes were launched in June 2018 and focus hugely on providing structured diabetes education to all adults within six months of diagnosis and to all young adults transitioning from the children’s service to the adult one.
Diabetes Ireland are campaigning that the funding for the extra staff to provide this education will be included in the HSEs budget for 2019. If approved we should see staff training begin towards the end of that year and this recommendation begin rolling out in 2020.
I will be 100% behind this Diabetes Ireland campaign in 2019. It’s time for the HSE to get serious about diabetes management.
I'M A FREE CARBER!
The debate between Low/No carb versus the High Carb advocates will probably continue forever and tends to get quite negative.
I have chosen my path is mine and it’s working really well for me, my family and my diabetes. However, I really haven’t declared what that path is in this post so please don’t make assumptions. I will not encourage anyone else to take the path that I have chosen because I believe they have to find the one that works for them, their families and their diabetes.