Saturday, September 19, 2009

counting carbohydrates

i was recently asked how i count carbohydrates and how i estimate insulin boluses, etc. so this is my post in response to that.

i have been counting carbs ever since i became a diabetic, and i got stricter with myself when i went on to an insulin pump.

when i had my first few appointments at the doctors, they gave me all sorts of books with estimations in, and taught me a bit about different kinds of carbohydrates. But most of what I know has been self taught!

so i'll tell you what it's like for me, and this will hopefully be relevant in some way to those of you that read this. of course it will vary from person to person, perhaps you are on insulin injections, or you are a type 2 diabetic wanting to control your diet better, or perhaps you're a concerned relative who doesn't know what to feed their diabetic family member (i know there's loads of you out there!)

when i go to choose something to eat, i almost always choose it depending on the amount of carbohydrates, and the amount i want to eat will depend on:
- how hungry i am
- what i feel like eating
- what my sugar levels have been like that day
- what me levels have been like in the past few weeks
- what my level is at that moment
- what food is available to eat

there's a lot of trial and error involved in counting carbs, and the best way of being super accurate is to buy something from a shop that tells you exactly how much is in it on the label. make sure you read the correct figure, as quite often there's a per 100g and a per portion measurement.

my carb-insulin ratio is 10:1 which makes it easy to work out how much to bolus: i simple divide the amount of carbs by 10! it used to be 15, and then 12, which was much harder, much! your doctor or nurse should help you to come up with your ratio when you are first diagnosed.

ok, here's an example:

- in the mornings i usually eat about 60g carbs - either porridge, muesli (no added sugar) or wholewheat pancakes. i measured my porridge the first time i made it, and calculated how much was in there so i could eat the same-ish amount each morning. if i've had a bad level in the morning, my appetite will have decreased anyway, so i'll eat less so the other insulin can go to correcting out the sugars. if i've got a low level i'll drop the amount i bolus, so instead of 6 units, i'll give 5units.

here's some foods and their carbs (in the portion size i would eat):
- ben&jerry's - i used to eat this believe it or not, and would bolus a good 10units: more than 100g of sugar and the fat content is unbelievable too, so would have to bolus again when the fat turned into sugars and my level rocketed.
- chai latte in starbucks - another ridiculous thing is drinks out always contain a good 60g of carbs...especially fizzy drinks and sweetened hot drinks. another no go area.
- wholemeal bread - its usually about 10-15g a slice, depending on the size of the loaf
- vegetable soup - about 20g
- fruits - these can range anywhere from 5g to 30g depending on the fruit and how much you eat. an apple for example is about 5 and a few slices of tropical fruit could be 30g
- roast dinner - this is a pretty impossible meal, as the fat content is usually pretty high, i usually gues about 80g, but sometimes it's too low and sometimes too high, it depends on how many potatoes i eat, and who's cooked it!

so as you can tell, its a lot of guesswork, so if you're looking for something really easy to have, then buy a healthy premade meal like sandwiches or salad, that comes wrapped with the amount of carbs written on the back...then you'll get more of a feel for the amount of carbs that's in different things.

ps. if you are eating out at a popular restaurant, then ask the waiter for a nutrition guide. i did this once and the guy came back 5 minutes later with a hand written list of everything that was in the meal, and an apologetic look. this was still super helpful though, as different foods have different GI's and different kinds of carbohydrates.

if you are cooking for a relative with diabetes, then use far fewer carbohydrates, and cook low GI carbs (wholemeal varieties for example) if you have to. make most of the plate vegetables, and try not to cook too much fatty foods, and stop adding butter to the mix!

For dessert be more creative than a fruit salad, as diabetics get fed this all the time. My auntie once cooked a little dark chocolate cup, that was really delicious made me feel special, and only had about 15g of carbs because it was so small. I remember that to this day. Or check out my food blog at http://notjustapples.blogspot.com for ideas on healthy eating.

Saturday, September 12, 2009

On Board Airplane Diabetic Meals

Hi everyone!

I'm back from my long trip around the globe!

It has been an amazing adventure...I've done loads of amazing things and seen some beautiful sights. There are two things that have super struck me along this trip; the first is architecture, and the second is food. Of course the first can't really apply to diabetes, accept that the more beautiful architecture I walk around and up the better control I have of my sugar levels.

But food. That I can talk about! I found it pretty easy to find healthy things to eat...especially in New York and Sydney. The bigger the city, the greater the choice it seems. I ate kangaroo, tried pretzels, had a Gray's Papaya frank. Mmmm.

But one of the most interesting parts of the food journey has been the on board diabetic meals. I real surprise every time that's for sure!

The best plane food was flying from New York to London Heathrow with British Airways, the final meal of all. I had a herb chicken with cauliflower mash, with a side salad and roll, followed by heaps of summer berries and some dried cherries. Yummy!

The strangest diabetic meals I had were on Qantas. For breakfast on the way to Sydney they gave me chicken, spinach and boiled potatoes. That was so wrong. So wrong. I don't know anyone who has the stomach for boiled potatoes and spinach in the morning. Oh my.

Qantas also gave me white (high GI) rolls, rice and pasta. Strange. Sometimes I felt like I was being given the wrong meal...like the vegetarian option (once I got tofu) and other times I thought it was just low fat.

BA were the only ones to actually get it right, to pin the nail on the donkey. Everyone else was far off. Someone should totally have a word with the catering companies to let them know how inappropriate some of the food was. Diabetic food does not have to be boring or uninteresting, it does not have to be boiled and unflavored. Hmm.

There was a definite plus to the whole diabetic meal drama: I was always served before everyone else, which was nice, no matter who the carrier.