I wrapped up carb counting yesterday, and I would be lying if I said I wasn’t relieved that I don’t have to poke my fingers anymore. I’m glad I did it – I got some good ideas for tips on how to make it hurt less (the side of the finger is the spot!). I did miss my insulin one day – I was on an overnight girls’ trip and thought I brought everything (got my meter, lancets, blood sugar log, and vitamin) but I somehow managed to leave my syringe behind. Phooey. There goes my perfect record.

As far as carb counting goes, it’s not awful. It gets tiresome and Halloween was definitely tough, but it wasn’t the hardest part. Getting the 30 minutes of activity 5 days per week was a challenge, but not the end of the world. Now, getting the 3 minutes of activity per every 30 of sitting – that was the sticker. Fortunately, the apps I discussed in this post made it easier. I’ll be writing a post reviewing the two apps soon! Even with the apps, it was downright impossible to do that every single thirty minutes. You know, I have 60-minute appointments and on girls’ day I drove for two hours there and two hours back. No exercise there. But I did the best I could and honestly, it really felt good to get up and get the blood flowing and joints moving on a regular basis.

As a special treat, my husband and I completed the #DiabetesDanceDare for Diabetes Awareness. Enjoy!

Managing diabetes is a struggle. It can be overwhelming and exhausting to try to keep your blood sugar under control. Here are 7 reasons I think people find it challenging to do the things they know would be good for them:

1. They are confusing. Nobody can agree. You get one recommendation from your doctor, one from an article you read online, one from a library book, and three others from your friends with diabetes. So who’s right? Sometimes no one, sometimes all of them. Diabetes recommendations (and bodies!) are so, so individual. Just because something is recommended for your friend or even the general public, doesn’t necessarily mean it’s right for you. Discuss your questions with your doctor and your dietitian. They should be able to help you weed out what’s right for you.
2. They are overwhelming. So much to do, so little time: checking blood sugars (sometimes 4-6 times a day!), taking medications, dosing insulin, watching your diet, and staying active. I get it – I’m living it temporarily and I’m already starting to wonder how people do this all the time. Managing diabetes is no joke. Sometimes I feel that as health professionals, we throw too many tasks at patients at one time. Be sure to communicate what’s realistic for you and tell your care team if you need to prioritize changes into smaller steps.
3. Presentation is key. Along the same lines, nutrition information for diabetes is often presented in a tsunami of recommendations to idealize someone’s diet and prevent every chronic condition under the sun. I have sat in on and (I hate to say it) helped teach classes that covered carbohydrates, proteins, portion control, fiber, saturated fat, unsaturated fat, heart healthy recommendations, exercise, and mental and sexual health in one mind-numbing three hour stint. How likely is it that those poor people are going to retain anything useful? In fact, I meet with patients on a weekly basis who have attended those types of classes and flat out told me, “I didn’t learn anything. There was way too much information.” My plea to my profession: BREAK IT UP, PRIORITIZE, and EMPATHIZE.

   
   
   

4. Portion does not mean portion. This is a big one. Diabetes educators and dietitians have adopted a term called “diabetes portion” or “carbohydrate portion.” This amount of a food has about 15 grams of carbohydrate and is intended to make carb counting easier. After learning the portions, someone can simply choose 3-4 per meal, 5-7 per meal, or however many their dietitian recommends, rather than track and count grams of carbohydrate. The unfortunate reality is that the word “portion” sends the message that that amount of carbohydrate is all they can have at once. I can’t tell you how many people I’ve worked with who say dejectedly, “So-and-so told me I could only ever have 1/3 cup rice at a time and that’s just never going to happen.” This misconception is suuuuuuper defeating for people who want to manage their diabetes, because they think they have to starve to do it. My solution? Change “carbohydrate portions” to “carbohydrate choices” or something less confusing so people know they can still eat!
5. It’s not black and white. Eating for diabetes is not a list of “good foods” and “bad foods,” which can be confusing. Carbs are not bad and they give us energy, but people with diabetes simply can’t process too many carbs at one time. It’s not total avoidance, it’s moderation. Sometimes that’s hard to grasp.
6. The media. Ohhhhhh the media…so useful in some ways, so full of garbage information in others.
7. It’s a moving target. Recommendations for managing blood sugar are based on a conglomeration of research in the field. You know what that means? New research = new recommendations. Every few years, the recommendations change a bit based on new information. That’s why it’s important, even if you’ve had nutrition education before, to meet with your doctor regularly and a dietitian at least once a year to keep up on what’s new.

For me, snacks are key to carb counting survival. In general, I feel satisfied after eating a carb-controlled meal but I’m finding myself hungry 2-3 hours after the meal. Snack time!

Ideally, a carb-controlled snack for my plan would have 15-20 grams carbohydrate and some protein (even better if it adds in fiber too!). The carbohydrates keep my energy up while protein helps keep the carbohydrates from raising blood sugar too quickly. My struggle is I’m finding the protein portion tough for some reason.

Some of my favorite example snacks include:

• 6-8 whole grain crackers with cheese
• ¼ cup unsalted nuts with 2 Tablespoons dried fruit
• 1 small apple with 2 Tbsp peanut or almond butter
• 3 cups popcorn with a drizzle of olive oil, dash of salt, and garlic powder, rosemary, and thyme (it’s delicious – and even though this one doesn’t have much protein, it’s a whole grain, it’s high in fiber, and the portion is no joke)

My challenge is that often snack time ends up being on my breaks at work, and proteins are either tough to pack or they need preparation and/or refrigeration. I did a stint with mozzarella cheese sticks and they worked out really well but I got a little bored with them. I haven’t been able to make it to Winco to get the bulk mixed nuts at a decent price (I refuse to pay the prices at most grocery stores), and I’ll be honest, I’ve been too lazy to get a little container to put peanut or almond butter in. I could hard boil a bunch of eggs to have ready and take with me, but here again – too lazy, too busy. Gah.

Many times this last week, my snack has ended up being 15-20 grams carb only, without the protein. That’s less than ideal because besides regulating blood sugar, protein helps a snack be more satisfying for longer.

As I gradually add in diabetes recommendations to follow, I have to say that there is a LOT to it. I hear that from my patients all the time, and they aren’t kidding. Remembering to pack a lunch is pretty much habit, but the snacks are often a last-minute afterthought and making sure there’s protein with them seems like a nice idea that only happens when the planets align just right.

Anyway, this is all good experience for me as an RD and it backs up what I hope I communicate to my patients: do the best you can, take one step at a time, and be prepared that life is going to push you back. Life happens. Life gets crazy. Motivation comes and goes. Just be steady and do your best. After all, your life is worth fighting for!

I gotta tell ya folks, sticking to the diabetes recommendations is exhausting, especially when life gets busy. With Halloween festivities and a rapidly filling schedule I’ve found it tougher to stick with the recommendations this week.

I did overdo my official dinner carb budget on Halloween, but I did it in a planned and intentional way. I spread my carbs out throughout the evening and only exceeded my carb budget by 15 grams. And that’s okay. It’s another case against the “diet mindset”: the recommendations are not hard and fast rules and it’s ultimately your life – you get to decide when to push on the guardrails, how often, and how far. The results are yours to own.

It’s going to be particularly tough this upcoming week, as I’m adding in goals to move for 3 minutes for every 30 minutes of sitting, check blood sugars daily, give myself a syringe poke daily (to simulate an insulin injection), and take a daily vitamin (to simulate taking oral medication for diabetes). It is definitely feeling a bit daunting, and I am only committed to this for another week!

The mental and emotional burden of managing diabetes is very, very real and goes far beyond what I’m facing here. When I don’t meet the recommendations, my body compensates and I chalk it up as a “Whoopsie, I’ll do better next time.” While that mindset applies for someone who has diabetes, they have the additional awareness that ongoing “whoopsies” can really do them harm.

For all those with diabetes, I salute you. Your road is not an easy one to walk. The obstacles and struggles on your journey can lead to diabetes burnout , which happens to everyone with diabetes from time to time.

 If you do feel lost, overwhelmed, or depressed (people with diabetes are more likely to be depressed, and depression worsens control of diabetes), please seek out some support and resources. A great care team, support group, dietitian, or even resources at www.diabetes.org can really help bolster your spirit and help you navigate all those tough barriers. You are not alone!

Today ends week 1 on carbohydrate counting and I gotta tell ya, this is my favorite “diet” by far. It doesn’t even really feel like a diet. I mean, check out some of the awesome meals I got to eat!

I think part of the reason it feels easy is that I have taught the principles so many times that I didn’t have much of a learning curve as far as learning how to carb count. I could recite carbohydrate portion sizes in my sleep…as a matter of fact, I probably do. You’d have to ask my husband.

The greatest part about carb counting is that it is not very restrictive IF you are intentional about balancing your plate with non-carbohydrate foods. You can eat pretty much anything, the most important keys are how much and when. There have only been one or two times throughout the week when there was something I wanted more of but I had already run out of carbohydrates. 

Carb counting feels more like a guardrail than a diet – there to guide me in the right direction and keep me from flying off a cliff on a carb binge.

The most difficult part has been boring beverages. Most of the time I would rather spend my carbohydrates on food than on beverages, which leaves me with tea only rather than tea and juice with breakfast and water instead of milk or a glass of wine with dinner. Overall, not that big of a deal but I have to admit I do miss drinking a glass of milk in the evening.

Here are the details for my first week on carb counting:

Though this particular meal plan has been very flexible, I’m looking forward to carb counting on my own and seeing how well I can do flying solo!

Have you ever been following a “diet” and then been faced with that darn thing called life?

Stress, donuts in the break room, or (like for me) date night can throw the best-laid plans out the window and then many people sit, riddled with guilt and feeling like a failure, wondering whether or not to throw their healthy goals out the window simply because they ate something their over-restrictive plan “didn’t allow.” That’s why I am all about focusing on including lots of nutritious choices, being aware of harmful foods and ingredients, and especially having a plan that includes the foods that make your life worth living!

Check out this great article written by a fellow RD about building a healthy relationship with food! I’m in agreement that the mental game of dieting and restriction can be just as destructive as poor eating habits!

“Yes, I’m a registered dietitian and I care deeply about nutritious, wholesome foods and eating. But I also wholeheartedly believe that there’s a time and a place for a treat.”
– RD Paige Smathers, quoted from KSL.com