One of the many reasons why I love the diabetes community is that I’m constantly learning new information, finding inspiration, and enjoying support from my fellow friends living with T1D. Sharing our stories with one another leads to us finding that it’s more than diabetes that we have in common.
Here’s an example: My friend, Cherise Shockley, recently wrote an article for DiaTribe in which she made a confession to herself regarding how she counts her carbs. I recommend reading the extremely well-written article to get a full sense of what she discovered, but in short, Cherise recently realized that her carb counting is inaccurate because of the “glass ceiling” for entering carbs into her pump for bolus calculations. In other words, Cherise’s personal maximum of carbs that she was comfortable with dosing for using her pump wasn’t aligning with the actual amount of carbs she was consuming. This excerpt explains part of it:
That was my moment of truth. I told Natalie I ate my favorite chocolate chunk cookie that day. She asked me how many carbs the cookie contained, and I told her 68 grams; she wondered why I only bolused for 55 grams. I paused before I replied – I did not know the answer.
Natalie then asked me if I had a glass ceiling for entering carbs in my pump. She explained that this means even though I know I eat 63 carbs, I will only enter 50 carbs in my pump because anything higher than that concerns me. What she said was interesting; I had never heard anyone describe it to me in that way.-Cherise Shockley
When I read this, I said, “Yes! Finally, someone is able to articulate exactly how I handle carb counting!”
This is the truth about my carb counting: I have limits when it comes to how many carbs I will bolus for at a time, but those limits do not apply to the actual number of carbs that I consume.
To explain, I am only comfortable with bolusing for a maximum of 60 grams of carbohydrate at a time. I do not know how I came up with this particular number, but I do know that there are situations (e.g., holiday celebrations) in which I am absolutely consuming more than 60 carbs in a sitting, and yet I only bolus for that amount.
Still confused by what I mean? Read the full article to understand, but this excerpt from it helps to explain why this fear of bolusing for more than 60 carbs at a time exists for me:
To learn more about carbohydrate glass ceilings and why some people have one, I talked to Dr. Korey Hood, a professor of pediatric endocrinology and psychiatry and behavioral sciences at Stanford University who has lived with type 1 diabetes for over 20 years. Dr. Hood told me that all parts of diabetes management can be challenging, and carb counting is particularly tough because it is hard to be accurate and precise. He always recommends people with diabetes meet annually with their diabetes educator (CDCES) to get a refresher on different aspects of diabetes management, including carb counting.
Dr. Hood said that the glass ceiling is most likely due to one of two issues – worries about hypoglycemia or the meaning behind taking such a big dose of insulin. Dr. Hood said that “many of us with diabetes, particularly those on insulin, worry about going low. Why wouldn’t we – it is a terrible feeling! We often experience fears of hypoglycemia because we had a terrible low in the past and have a desperate desire to avoid it in the future. When we worry about hypoglycemia, we scale back our insulin dosing. This prevents the low but also likely results in high glucose levels. So, it really is not a good strategy.”-Cherise Shockley
This was a major revelation for me because suddenly I realized what my reasoning is for my carbohydrate glass ceiling: I have a hypoglycemia fear. I have experienced scary episodes in the past (fortunately, none of which have required medical attention). I have friends who have experienced severe hypoglycemic episodes, and when a colleague of mine experienced a low episode that was so bad that I had to call 911 for him, it left a mark on me. So on the occasions that I do eat more than 60 carbs in a sitting, I simply don’t take the amount of insulin that I should to account for those carbs, and I wind up going high, exactly as Dr. Hood describes in the quote above.
When it comes to diabetes, there is no such thing as “perfection”. My blood sugars cannot and will not be perfect 100% of the time. But one thing that I do have control over is doing the absolute best that I can with carb counting and bolusing. It’s time I hold myself more accountable to my carbohydrate glass ceiling…in fact, it’s time for me to smash through it.
A ginormous thank you to Cherise for being so open and honest in this piece and for inspiring me to own my carbs, too.
5 thoughts on “The Truth About My Carb Counting”
Hi. Just read your email. My glass ceiling was set because early after diagnosis I calculated 20 carbs but actually bolused 20 units. Major problem. I discovered my error and then after panic subsided, ate carbs to cover. Still afraid to change glass ceiling. I just do multiple boluses if I need to exceed my limit. BTW, love your posts. Bonnie
On Wed, Feb 10, 2021, 8:02 AM Hugging the Cactus wrote:
> mollyt1d posted: ” One of the many reasons why I love the diabetes > community is that I’m constantly learning new information, finding > inspiration, and enjoying support from my fellow friends living with T1D. > Sharing our stories with one another leads to us finding that it'” >
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Hi Bonnie – Thanks for your comment! That’s how I’m currently dealing with my carb glass ceiling – multiple boluses over time. Baby steps to break through it!
I use WW (Weight Watchers) which means i track almost every morsel of food that gets in my mouth. What is so interesting about it is that I dose based on the carb counts for the food in the WW app. The one thing I knwo for certain is that even when my food is measured and recorded, I still do nto get the carbs right. Why? Because food is more than weight or portion, it is also density of the food. A highly dense carrot has more carbs than a less dense carrot.
Carb counting is about averages. At restaurants portion control is about averages. Those numbers for carbsare averages. Take each number and do plus or minus 15% and you are pretty close. Is a swing of 30% in carbs acceptable? Of course not. Exact carb counting is a a myth.
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Good point, Rick! I agree that exact carb counting is a myth. But a reality for me is that I kind of “pretend” that a slice of banana bread has only 20 carbs, when it’s really probably closer to 30-35 carbs. (Unless it’s a super-skinny slice of banana bread, but who am I kidding? Go big or go home!)
[…] I attempt to control by only bolusing for what I feel is an agreeable amount. I’ve written about this phenomenon of mine before and my desire to get over it, but as I continue to work through it, I think it can only be […]