I hate scales. I mean I really hate them. The kind of scales that you have to step on at every doctor you ever go to once you have diabetes; the kind of scales that taunt you sitting under your cupboard in your bedroom, knowing that it is “only recommended to weigh yourself once a week” but inevitably draw me to get on them most days and sadly, see no movement in the right direction; and most of all, the kind of scales my mum used to weight every gram of carbohydrate that passed my lips once I got type 1 diabetes.
Back in those days we were given a list of “Forbidden Foods” ( i.e chocolate, lollies, sugar, ice cream, honey, most cereals and anything with the word sugar or even a suggestion of the word sugar, even cough medicine!) and a list of “Free Foods”. Now this was more interesting as it included all the sliced meats, cheese and so on that were full of fat but NO carbohydrate so go for it!
Mum did what she was told and measured and counted all of my food. We had to learn and learn fast, where there was a “portion” in all foods, which at the time was measured as 10 grams of carbohydrate per portion. Of course this was different to how they did it in America and later, we shifted across to their exchange system which was 1 exchange = 15 grams of carbohydrate. It took me years to get this change over but now it is just the way I look at food.
At that time we also had pretty average insulin which was injected twice a day only and we had set portions for every meal, 6 times a day that MUST be eaten no matter what. Essentially we were injecting insulin and then “feeding the insulin”. Thankfully we now operate more on a matching insulin to what we eat system but in essence, the old portion or exchange system is still the mainstay of the “diabetic” diet. Whatever that is.
On an insulin pump you are told, you need to count every minute scrap of carbohydrate to “get it right”. This means if there is 2 grams of carbohydrate in your milk added to a cup of tea you “should” count this and have a tiny drip of bolus insulin. Hmmmmmmm, I am not sure in practice this is the case for most of us.
I certainly don’t count the milk in my copious amounts of tea every day!
The hardest thing of all is working out carbohydrates and how much bolus insulin to have when eating away from home. When you have a package and can work out carbs, not too bad; when you make something at home and can work it our fairly closely, better; when you are out and someone dumps a plate of food in front of you, or a nice dessert in particular – not so easy!Add to that the complexity of GI which we now know about and it gets even trickier.
Point in fact – I was at a lunch with a table of Diabetes Educators and a dessert plate with mixed little cakes came out – “how much carb do you guys think is in that?” I ask? “How much insulin would you all take?” Blank looks from all.
Nobody could possibly get this exactly precise.
At a Melbourne Cup charity lunchen we were working at this week my lovely volunteer who like me, has had type 1 diabetes for many years, is on a pump and knows her stuff – asked me how much insulin I would bolus for the yummy custardy dessert ( of which I had two!) – ” I don’t really know!” I replied. You know what I do? I “guesstimate”, then keep an eye on my BGL for a few hours, adding in small bolus if needed later. Is this “right”? I don’t think there is a right. I remember years ago hearing a presentation at a national diabetes conference where some dietitians had done a study with children “guesstimating” the carbs on their plate vs exacting every morsel – and they had almost the same outcomes – proving that the guesstimation was just as good.
I don’t know about you but I don’t carry scales with me; I don’t carry a carb food guide with me everywhere I go and then spend ages trying to find every food in the book before I eat a meal, get all the calculations of the various components of a meal and then add it all up before I ate. Maybe if I did I would be thinner as I would never get time to actually eat the food or would give up!
I say we are so lucky to have the vast array of foods we have here so enjoy food, be healthy, have regular treats, aim to keep BGL on target, do your best with making your insulin match the carbs you eat – but never ever become a slave to those dreaded scales and turn food into something to dread, rather than something to delight in and be joyful about.
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