Diabetes and Carb Counting For Dummies

Introduction 1

About This Book 2

Foolish Assumptions 3

Icons Used in This Book 3

Beyond the Book 4

Where to Go from Here 4

Part 1: Getting Started with Carb Counting and Diabetes Management 5

Chapter 1: Delving into Diabetes and Carb Counting 7

Getting Up to Speed on Diabetes Basics 8

Checking out concerning trends in the diabetes epidemic 8

Improving outcomes and preventing complications 8

Building your diabetes team 9

Staying up to date with advances in diabetes care 10

Examining the Carb-Glucose Connection 11

Getting Acquainted with Carbs 12

Introducing the so-called simple carbs 13

Catching up on complex carbs 13

Noting the nutrition in carb food groups 13

Acknowledging that staying healthy isn’t just about carbs 14

Making the Case for Carb Counting: To Count or Not to Count? 15

Counting carbs with type 1 diabetes: An essential tool 15

Gaining tighter control over blood-glucose levels with type 2 diabetes 15

Sticking with consistent carb counts when you’re on set insulin doses 16

Managing weight with carb counting and portion precision 17

Regulating Carb Intakes 18

Figuring out how much carb you need 18

Timing your carb intake 18

Counting Carbs Successfully 19

Looking at the label lingo 19

Gathering carb-counting resources 19

Increasing carb-counting accuracy 20

Living Well with Diabetes: The Seven Pillars of Diabetes Management 20

Eating a healthy diet 20

Staying fit with exercise 21

Taking your medication 22

Monitoring your blood-glucose levels 22

Managing stress 23

Discovering how to problem-solve 23

Reducing risk with healthy behaviors and regular medical checkups 24

Chapter 2: Exploring the Diabetes-Carb Connection 25

Wrapping Your Brain around Diabetes and Related Conditions 26

Seeing how the body is supposed to process carbs 26

Discovering what causes diabetes 27

Noticing the symptoms of diabetes 28

Distinguishing the types of diabetes 29

Recognizing Diabetes Risk Factors and Getting Diagnosed 32

Type 1 diabetes risk factors 32

Type 2 diabetes risk factors 33

Diagnosing diabetes 34

Moving Forward with Managing Diabetes 35

Knowing that diet matters 36

Keeping in touch with your diabetes team 36

Embracing your central role in your own self-care 37

Chapter 3: Calling All Carbs: Recognizing Carbs in the Foods You Eat 39

Looking at the Chemical Structure of Carbohydrates 40

Introducing the So-Called Simple Carbohydrates 42

Going au naturel with glucose, fructose, and lactose 43

Finding other forms of sugar: Sucrose, maltose, honey, and syrups 44

Spotting simple carbs in the grocery aisles 45

Checking Out the Complex Carbohydrates 45

Identifying the starches 45

Focusing on fiber 46

Spotting complex carbs in the grocery aisles 48

Recognizing Carb-Free Counterparts 49

Pumping up with proteins: Meat, fish, and other sources 49

Finding the healthiest fats and oils 50

Exploring the role of noncarb foods in diabetes management 51

Chapter 4: Tracking Carbs through the Body 53

Filling Your Tank and Fueling Your Cells 54

Settling in your stomach 54

Extracting glucose via digestion 55

Pumping through your bloodstream 56

Fueling your cells 56

Saving Some for Later: Glycogen, the Storage Form of Glucose 57

Making a layover in the liver 57

Maintaining the muscles’ glucose reserves 58

Noting What Happens When Glucose Levels Remain Elevated 58

Spilling glucose into the urine 58

Sticking glucose where it doesn’t belong: Glycosylation 60

Recognizing the Risks of Undereating Carbs 62

Depleting glucose reserves and dealing with hypoglycemia 62

Making glucose but losing lean body mass 63

Producing ketones 64

Chapter 5: Finding Your Sweet Spot: The Right Amount of Carbs for You 67

Checking Out the Official Diet Guidelines 68

Advice from the American Diabetes Association 68

The 2015–2020 Dietary Guidelines for Americans 68

Intakes and allowances from the National Academy of Sciences 69

Figuring Out Calorie and Carbohydrate Intake Targets 69

Estimating your caloric needs 69

Adjusting calories for your weight target 71

Deciding on carb intake targets 72

Distributing carb intake 74

Leaving room on your plate for protein and fat 74

Tweaking Your Carb Intake Target When Conditions Change 75

Changing needs throughout the life cycle 75

Altering intake to account for activity 76

Adjusting portions when blood glucose is out of control 76

Managing sick days 76

Chapter 6: Timing Your Carb Consumption 79

Distributing Your Daily Carb Intake 80

Striving to eat three meals per day 80

Opting for smaller meals with controlled snacks 81

Stabilizing Blood-Glucose Levels at Breakfast and Dinner 82

Breaking your fast: The importance of breakfast 83

Considering the merits of an earlier dinner 83

Understanding Insulin Action 84

Comparing insulin options 85

Checking out concentrated insulins 85

Looking at blended insulin preparations 86

Pumping and inhaling insulin 87

Coordinating Insulin Action with Meals 88

Enjoying the flexibility of insulin-to-carb ratios 89

Keeping carbs consistent when using sliding-scale insulin dosing 90

Basing injection timing on pre-meal blood-glucose levels 91

Being regimented if you use 70/30 insulin 91

Managing Carbs on Oral Diabetes Meds 93

Keeping the carbs appropriate 93

Knowing your limits 94

Part 2: Carb Counting: From Basic to Advanced 95

Chapter 7: First Things First: Reading and Deciphering Food Labels 97

Finding Your Way around Food Labels 98

Paying particular attention to amounts 98

Viewing versions of traditional labels 100

Taking a sneak peek at newfangled food labels 101

Scrutinizing the Nutrition Facts 104

Sorting out serving sizes and servings per container 105

Calling out calories 105

Finding the fat 105

Noting the cholesterol content 106

Surveying the sodium 107

Focusing on total carbohydrate 107

Pinpointing the protein 110

Taking note of other valuable nutrients 111

Investigating the ingredients 111

Identifying allergens 111

Heading to the Grocery Store 112

Being skeptical about label claims 112

Preparing your carbohydrate cheat sheet 115

Developing supermarket savvy 115

Chapter 8: Mastering Carb Counting and Portioning Fundamentals 117

Estimating Carb Counts for Foods without Labels 118

Relying on food composition lists 118

Solving carb-counting conundrums in mixed dishes and ethnic foods 124

Calculating carbs in your favorite recipes 126

Preparing your carbohydrate cheat sheet 126

Sizing Up Servings with Measures and Weights 127

Measuring with standardized cups and spoons 127

Weighing in on whether to weigh foods 128

Dealing with Special Cases 132

Controlling carb intake when eating out 132

Keeping track of the carbs you drink 133

Guesstimating: When Carb Counts Aren’t Critical 133

Balancing your plate with the plate model 134

Handling portions with the hand model 136

Chapter 9: Adding Tools for Carb-Counting Ease and Accuracy 137

Reviewing the Printed Resources 137

Reading the fine print for carb counts 138

Looking at labeling regulations for chain restaurants 138

Tapping into Online Resources 139

Digging up chain restaurant food facts 139

Foraging through Internet food databases 140

Using your search engine to count carbs 140

Enlisting the Assistance of Apps: One More Reason to Love Your Smartphone 140

Finding useful diabetes apps 141

Integrating apps and a food scale 142

Part 3: Going Beyond Counting Carbs 143

Chapter 10: Accounting for Variations in Digestion and Absorption Rates 145

Comparing Digestion Speeds for Fluids and Foods 146

Looking at liquid carbs 146

Singling out sugars 147

Figuring out fruit 147

Focusing on complex carbs and fiber 148

Recognizing the fat factor 149

Considering other variables 149

Gauging the Glycemic Index and Glycemic Load 150

Reducing Blood-Glucose Fluctuations: Tips and Tricks 152

Controlling portion sizes of foods that pack a blood-glucose punch 152

Adding activity for extra carbs 153

Combining foods to reduce glycemic effect 153

Altering the order in which you eat the components of your meal 154

Aligning Insulin and Digestion Rates 154

Optimizing mealtime insulin coverage 155

Using your insulin pump’s fine features 156

Chapter 11: Rethink That Drink 159

Noting the Importance of Hydration and Low-Carb Drinks 159

Exploring the Pros and Cons of Different Drinks 161

Giving water a special place in your life 162

Sipping and swigging low-carb beverages 162

Mentioning the merits of milk and nondairy milk substitutes 163

Facing the facts about fruit juice 165

It’s Not Just the Carbs — It’s the Calories Too 167

Last Call for Alcohol: What’s the Verdict? 169

Being informed about the risks 169

Going behind the scenes: How alcohol affects the body 170

Looking at liquor’s carbs and calories 171

Drinking safely 173

Chapter 12: Let Me Call You Sweetie: Sugars and Substitutes 175

Comparing Sugars: The Sugar Showdown 176

Introducing the heavyweights: Sugar, honey, syrup, and other notables 178

Pointing out the qualities of natural fructose and agave nectar 180

Examining Sugar Alcohols 182

Opting for Alternatives: The Sugar Substitutes 184

Digging into the differences of the substitutes on the market 186

Exploring sugar-substitute safety records 186

Using substitutes in cooking and baking 188

Part 4: Embracing Whole Health and Happiness 189

Chapter 13: Eating for Health and Happiness 191

Eating a Rainbow of Fruits and Vegetables 191

Loading Up on Whole Grains 193

Identifying best-bet grains 193

Increasing your options and trying new grains 194

Leaning Toward Leaner Proteins 194

Choosing the healthiest options 195

Fishing for reasons to eat more seafood 196

Vegging out with meatless proteins 197

Daring to Do Dairy 197

Watching the fat content 198

Packing in more protein 198

Boning up on calcium 198

Checking out nondairy substitutes 199

Focusing on Healthy Fats 200

Having Diabetes and Dessert, Too 201

Making your own treats 201

Dressing up healthy fruits 202

Enjoying dessert while controlling the carbs 202

Trying Cooking and Serving Tips that Support Health and Weight Goals 203

Opting for lower-fat cooking methods 204

Controlling portion sizes 205

Chapter 14: Reaping the Rewards of Fitness 207

Exercising Safely 208

Getting the green light from your doctor 208

Being prepared: What to keep handy 210

Encouraging Exercise for Everyone 211

Developing an exercise plan 211

Enjoying the benefits 214

Being mindful of medical limitations 215

Clarifying What’s Going On Behind the Scenes When You Exercise 217

Controlling blood glucose: How hormones are supposed to do it automatically 217

Identifying how diabetes alters fuel use 218

Sustaining exercise by tapping into fuels 219

Understanding hypoglycemia 219

Exercising with Type 1: Staying Safe While Having Fun 220

Monitoring matters 221

Fueling up or dialing down: Fine-tuning carbs and insulin 221

Knowing when to postpone activity: Too high or too low, don’t go 223

Exercising with Type 2: Why It’s Right for You 223

Improving glycemic control 224

Reducing cardiovascular risks 224

Supporting weight-control efforts 225

Chapter 15: Getting a Handle on Hypoglycemia 227

Understanding Hypoglycemia 228

Defining a low blood-glucose level 229

Identifying causes of hypoglycemia 229

Recognizing the symptoms of hypoglycemia 235

Losing symptoms of lows: Hypoglycemia unawareness 236

Treating Hypoglycemia 237

Choosing quick-acting carbs 237

Taking the right amount of carb 237

Rechecking your blood-glucose level 239

Watching out for rebounds 240

Requiring assistance: Severe lows and glucagon 240

Strategizing for Common Hypoglycemia Scenarios 242

Managing mealtime lows 242

Sleeping safely after a bedtime low 244

Considering insulin action when treating hypoglycemia 244

Preventing Hypoglycemia 246

Being prepared 246

Looking for patterns and problem-solving 246

Reflecting on prior exercise 247

Remembering your carb intake 247

Enlisting Your Doctor’s Help 247

Keeping and reviewing blood-glucose logs 248

Sharing your data with your doctor 249

Chapter 16: Keeping the Beat with a Healthy Heart 251

Eating Smart for Your Heart 251

Getting the facts on cholesterol and fats 252

Acquainting yourself with types of fats 253

Choosing fats wisely 254

Adding soluble fiber to your healthy heart regimen 257

Creating a heart-healthy grocery list 258

Cooking your foods the heart-healthy way 259

Handling the (Blood) Pressure 260

Taking a look at the DASH diet 260

Shaking the salt habit and opting for alternate seasonings 261

Identifying hidden sodium suspects 262

Deciphering label claims related to sodium 263

Embracing Heart-Healthy Habits 263

Managing stress 264

Avoiding tobacco and secondhand smoke 264

Staying active 264

Controlling weight 265

Chapter 17: Living with Diabetes throughout the Life Cycle 267

Raising a Child with Diabetes 267

Beginning with basic pointers 268

Addressing type 2 diabetes in youth 271

Managing Diabetes in Pregnancy 273

Planning for pregnancy when you have type 1 or type 2 diabetes 273

Developing gestational diabetes 274

Understanding blood-glucose targets and fluctuations in pregnancy 275

Employing eating tips for diabetes during pregnancy 277

Keeping the Golden Years Golden When You Have Diabetes 279

Evaluating seniors’ dietary concerns 279

Keeping physically fit 281

Chapter 18: Going Gluten-Free (Or Not): Does the Batter Matter? 283

Weighing In on the Gluten-Free Debate: Fad or Fact? 284

Avoiding gluten fastidiously when you have celiac disease 284

Forgoing gluten if you are allergic or have an intolerance 286

Choosing to go gluten-free for personal reasons 287

Against the Grain: Beginning a Gluten-Free Diet 288

Avoiding grains that contain gluten 288

Eliminating gluten-containing foods 290

Finding hidden gluten 291

Avoiding cross-contamination 292

Staying Gluten-Free Without Nutrient Deficiencies 293

Embracing foods naturally free of gluten 293

Incorporating gluten-free grains 294

Watching out for nutrient deficiencies 295

Part 5: Sampling Menus Complete with Carb Counts 297

Chapter 19: Beginning with Breakfast Menus 299

Starting Your Day Right with Breakfast 299

Personalizing Your Breakfast Meal Plan 303

Chapter 20: Looking for Lunch Menus 305

Loving Your Lunch Options 305

Personalizing Your Lunch Meal Plan 310

Chapter 21: Delving into Dinner Menus 313

Determining What’s for Dinner 313

Personalizing Your Dinner Meal Plan 317

Chapter 22: Surveying Snack Ideas 319

Choosing Carb-Controlled Snacks 320

Picking Packaged Snacks 325

Part 6: The Part of Tens 327

Chapter 23: Ten Tips for Monitoring Your Blood Glucose 329

Picking a Meter for Your Needs 329

Safely Obtaining a Blood Sample 330

Acknowledging Error Issues 331

Assuring as Much Accuracy as Possible 331

Disposing of Lancets and Needles Properly 332

Varying Your Test Times 332

Knowing Your Blood-Glucose Targets 333

Keeping a Log and Reviewing Your Data 333

Getting Your A1C Done Regularly 334

Considering Continuous Glucose Monitoring 336

Chapter 24: Ten Tips for Controlling Carbs 337

Saving a Step with a Measuring Cup 337

Weighing Fruits in Advance 338

Having a Carb-Counting Contest 339

Making Better Breakfast Choices 339

Packing Your Own Lunch 340

Choosing Wisely at the Deli 340

Considering the Condiments 341

Fitting in a Favorite Dessert 341

Planning and Portioning Snacks 342

Curbing Late-Night Snacking 342

Chapter 25: Ten Worthwhile Websites to Help You Manage Diabetes 343

American Diabetes Association 343

American Association of Diabetes Educators 344

Academy of Nutrition and Dietetics 344

U.S Food and Drug Administration 345

American Heart Association 345

UCSF Diabetes Education Online 346

Mayo Clinic 346

Joslin Diabetes Center 346

U.S Department of Agriculture Food Composition Databases 347

WebMD 347

Part 7: Appendixes 349

Appendix A: Diabetes Exchange Lists 351

Starches 352

Fruits 354

Milk and Yogurt 356

Nonstarchy Vegetables 357

Meats and Meat Substitutes 358

Lean meats and meat substitutes 359

Medium-fat meats and meat substitutes 360

High-fat meats and meat substitutes 360

Fats 361

Free Foods 363

Appendix B: Conversion Guide 365

Index 367