Tuesday, July 6, 2010

Carb counting = not what I was expecting!

My Advanced Carb Counting class came and went on Friday. My ridiculous nerves resulted in a fun little BG pop that afternoon, but such a thing was completely unwarranted. First, I was wicked pleased with my CDE - she put on a good show and, more important, managed to be completely non-judgey or overly strict about eating habits and carb-counting skills. That's no easy feat, and it was nice to be reminded why I liked her so much in the beginning - right now, our relationship is mostly anxiety on my part (GOD, I hate this logging! Will I ever get the A1C I want? I had popcorn for dinner Thursday and was up at 187 1.5 hours later - what is she going to say?!) and almost relentless good cheer and endless number-tweaking on her part. And as much as I need the "Go team!" cheerleading, it can also be a bit maddening. Skip the "We'll get it next time!" lady - how about "No, I have NO idea why that number came up. This disease is idiotic."

I'm sure the other people in the class were also happy with her "If you don't get it right, it's not the end of the world. Just use the info for next time" attitude. I know I would have much preferred her to Evil Nan from 1993.

The first half of the class was a little more beginner than I'd expected, but I suppose any good class has to mention the basics at the outset just to make sure all participants are on the same page, right? So it was off to a bit of a slow start...and then I was met with the crushing "WHAT?! No plastic fruit?!" disappointment. I think I'd taken that "advanced" a bit too much to heart, and had expected a lot of Guess the Carbs food sitting everywhere.

Instead, we had a PowerPoint slide show and my lovely CDE. That being said, it turns out you can pick up quite a few tidbits that way. So here are my New to Karen carb counting tidbits:
  • When food logging for endos or CDEs, be sure to include any food brand names, as well as the source (homemade, cafeteria, deli, restaurant, prepackaged, frozen).
  • 8oz of meat - dose for 15g of carb. (Regular serving is that 3-4oz deck of card size. Apparently, doubling it requires some insulin.)
  • Eyeballing aids: soda can = 1.5oz, baseball = 1c, ice cream scoop = 1/2c, spread hand = 8" diameter (for wraps, etc.), palm width = 4", deck of cards = 3-4oz of meat. Now obviously we're all different sizes, and this needs to be just a guideline. That being said, it makes me want to go measure all my body parts so I can use them when eating out: "Waiter! Would you say this potato is bigger than my elbow?"
  • Dual wave bolus: recommended 2-3 hour square. I'd been doing 1.5 to 2, and am now looking forward to a pizza showdown on Thursday in Schodack.
  • Carb info: Calorie King, of course, but also the USDA. Makes sense, but who'd have thought it?
  • Carb loading: Any meals over 70g of carb or so - regardless of fat content - is going to act more like a MEF. She mentioned bagels and how they "just keep going!" Bolus accordingly, kids. And hey! Try 2 to 3 hours for that square....
All interesting tidbits to say the least, and then she whipped out her Eating Out guide. I think I'm going to write these down on a card to keep in my wallet. You all might already do that, but I'm a little slower on the uptake!
  • 1 pint of fried rice: 110g
  • Sushi roll: 5-10g per piece (the lower end is for 8-piece rolls, and it goes up as your rolls get fatter)
  • New York pizza slice: 60g (CDE: "They must have really small slices elsewhere in the country! Most guides say 40g")
  • New York bagel: 80g
  • Chinese food sauce: add 20-30g to your carb estimate if your food's in sauce
  • Sauce, general: Tack on 15g
  • Cupcake: from 35g (homemade size) to 65g
  • Breading: 15g
She had other tips, too, but I could never use them. My basal is so low at this point that my cat farting in the next room causes a BG spike, so I'm way too sensitive to be able to not dose for salad (even 5 or 7 carbs from a side salad) or alcohol (which is tricky math, but ALWAYS requires an up-front bolus for me).

Albeit imperfect, it was informative and I'm glad I went. Aside from the carb info, I also got to talk to her in person about some logs, and it was good to see how she went through the numbers and why she gave the advice she did. For example, she is WAY more aggressive about lows than highs, which I found aggravating since it doesn't help my A1C when all we worry about is the lows. But she was worried about them because they screw up the data for the entire day, not just for my safety. I can get down with that.

I want to take her out to dinner now, of course, if only to see if we could have a Carb-Off - a Wild Wild West sort of scene in which we both "draw" our carb guesses and see who gets shot down. She might win (she's the professional after all) but I'm confident I'd get a shot in.


  1. Awesome post! Good tidbits. Nice that you had formal training. My doctor gave me a Calorie King book and had me log my food and insulin units. I did my research mostly online and tips from my D-Tweeps. :-)
    Good luck and if it's not perfect, just like she said - use the info for next time.

  2. Great tips - and also a few that are new to me too. Like how much to estimate for sauces and gravy. That's always very tricky for me!!

  3. Thank you for the side tips. Its things like that, that we don't come inherently coded with. Also, those are the things we usually forget to calculate into our equations. Or at least I do. I usually seem to underestimate.
    Sort of makes me want to jump on board and find a class.

  4. Cat farts are known to raise blood sugars. It's science. ;)