Diabetes and Carb Counting For Dummies. Shafer Sherri

caloric needs. Choose a daily carbohydrate budget based on calorie goals and personal preference.

       Timing your carb intake

      There’s something to be said about proper meal spacing. If meals are too close together, blood-glucose levels can climb. If meals are too far apart, appetite can overtake willpower and make portion control difficult. Going to bed on a full stomach can lead to elevated glucose levels overnight and into the next day. Try having dinner at least three hours before going to bed. Eat three main meals four to six hours apart. Tuck in a snack if needed to curb appetite or to supply energy for exercise. Determine how to divvy up the carbs among meals and snacks to regulate appetite and blood-glucose levels in Chapter 6.

      Matching insulin timing to digestion timing takes a bit more finesse. It’s critical to understand onset, peak, and duration profiles for the insulins you use. Chapter 6 reviews insulin action times. Chapter 10 looks at the variables that affect digestion timing. Some foods digest quickly (liquids, simple sugars, and refined grains), while others digest more slowly (whole grains, foods with fiber, and meals higher in protein and fat).

Counting Carbs Successfully

      Make use of the many carb-counting resources available to you. The following sections introduce food labels, food lists, menus, brochures, apps, websites, and more.

       Looking at the label lingo

      Nutrition details are clearly marked on packaged foods. Look for the Nutrition Facts food label. First, identify the serving size. The calories, total carbohydrate, fiber, and everything else on the label refers to “one serving,” not necessarily the whole package. Did you know that fiber isn’t digestible so you can subtract it from the total carbohydrates to get a more accurate carb count?

      Tune in to Chapter 7 to sharpen your supermarket savvy and find out all about food labels. You can even take a sneak peek at the new look; the food label is undergoing a makeover.

       Gathering carb-counting resources

      Some of the most nutritious foods are harvested, not manufactured. Don’t let the lack of a label keep you from reaching for wholesome foods. You can still closely estimate carbohydrate counts in fruits, vegetables, legumes, and grains with food composition lists (see Chapter 8 and Appendix A). The Exchange List concept groups foods by macronutrient composition; the items on a list have similar amounts of carbohydrate, protein, and fat. Every item on the fruit list, for example, identifies a portion size that equals 15 grams of carbohydrate: A small apple or orange, 17 grapes, 1 cup of cantaloupe or raspberries, or ½ banana all provide the same amount of carbohydrate. Variety isn’t only the spice of life; it’s also a great way to assure you get a wide array of important nutrients.

      Measuring cups are essential for accuracy. Cooking from scratch? No problem! Chapter 8 also walks you through figuring out how to calculate carbs in your homemade recipes. Add tools to your carb-counting tool chest by tapping into online resources (flip to Chapter 9).

       Increasing carb-counting accuracy

      With type 1 diabetes, insulin doses must be carefully matched to carbohydrate intakes. Once you’ve mastered carb counting 101 (food labels and carb-counting lists), you’re ready for more advanced carb-counting strategies.

      A food scale can verify exact carb counts on numerous foods, including fruits. By weighing foods occasionally, you’ll hone your ability to accurately estimate carbs in the future. Chapter 8 provides a list identifying the number of grams of carb per ounce of fruit. Weighing nails the carb counts in baked potatoes or a chunk of French bread.

      Apps and web-based food databases offer nutrition facts on ethnic foods and combination foods, including pizza and lasagna. Chapter 9 describes how to combine the technologies: your food scale and a food database or app. Weigh your food item – a tamale, for example – and then plug the weight of your tamale into the food database to get an exact carb count on the item you’re about to eat. There is no need to do this for every food every time, but it sure helps to improve your ability to guestimate more accurately in the future.

Living Well with Diabetes: The Seven Pillars of Diabetes Management

      Eating for health and happiness and reaping the rewards of fitness should be a lifelong commitment through all ages and stages of life. The following sections cover these and the other pillars of diabetes management.

      

We are all responsible for what we think, what we say, and what we do.

       Eating a healthy diet

      Food should be a positive part of creating and maintaining health, and it should be something to enjoy and savor too! Chapter 13 provides pointers for choosing the foods that promote health and wellness: colorful fruits and vegetables, whole grains, legumes, nuts, lean proteins, fish, vegetarian protein alternatives, heart-healthy fats, and dairy foods (or nondairy substitutes).

      

If you eat wholesome foods in appropriate portions, you’ll have the right recipe for health. This book provides you with a deeper understanding of how food choices affect your diabetes, weight, blood pressure, cholesterol, and cardiovascular health.

      If you have celiac disease or gluten intolerance, it’s time to go gluten-free all the way. Chapter 18 provides details.

GIVING THOUGHT TO GOING GLUTEN-FREE

      Gluten is a protein found in wheat, rye, and barley. Celiac disease inflicts intestinal damage if gluten-containing foods are consumed. The treatment is strict, lifelong avoidance of all sources of gluten, no matter how minute. Exposure to even a crumb can damage the linings of the intestine, impair nutrient absorption, and cause numerous diseases related to vitamin and mineral deficiencies.

      People with type 1 diabetes have an increased risk of celiac disease because both diseases are autoimmune disorders. Whether you’re avoiding gluten because of celiac disease, wheat allergy, gluten sensitivity, or preference, Chapter 18 provides the information you need to get started.

       Staying fit with exercise

      Exercise has long been recognized as a foundation therapy in the treatment of type 2 diabetes. If you have prediabetes, exercise coupled with moderate weight loss has been shown to prevent or delay the onset of type 2 diabetes.

      Everyone can cash in on multiple health benefits related to physical fitness. Exercise helps with weight control, improves blood pressure and cholesterol, strengthens bones and improves circulation, relieves stress, and improves sleep. No one comes back from an exercise session saying, “I wish I hadn’t done that!” On the contrary, most people feel better and actually think, “I’m so glad I did that! I’ll have to do that more often!”

      

If you aren’t currently engaged in regular exercise, start by building more activity into your usual day. Don’t sit for hours on end. Get up and move around. You can decide whether you move for one minute or for ten minutes. The first step is simply taking the first step. Walk while talking on your mobile phone. Do leg lifts and use hand weights while watching television. Put on some music and dance in your living room. Join an exercise class or a water aerobics group. Chapter 14 can help you get off on the right foot with fitness. The chapter also provides guidelines for building a safe exercise regimen.