Carb Question

By Sheryl Latest Reply 2009-01-06 11:34:54 -0600
Started 2008-12-23 13:53:26 -0600

Hi all and Happy Holidays…I am considered pre-diabetic right now. My fasting BG is always under 110. When I get into trouble is when I If I could give that up I would have beat the problem…
My question is regarding carbs. I know there is no exact science on any of this so I am only asking for a 'general' answer.
How many carbs should one get at each meal?
And is there such a thing as a 'daily' carb count?
For some reason I find this part extremely confusing. My friends with this disease have all been given mixed information when it comes to diet so I haven't bothered to go to get more confused.

13 replies

Debe Pendice
Debe Pendice 2009-01-04 06:09:36 -0600 Report

Since I want tolower my carb count, I need to address this with my dietitian before the put me on this pump. I don't want to use hi carbs but also don't know much yet about the pump and how to use it with the carbs. I just don't want them to ajust it to like 45 carbs a meal and I doing lower and might down out. Any suggestions from people on the pump?

John Crowley
John Crowley 2009-01-06 11:11:54 -0600 Report

With the pump, you will simply have a ratio to help you know how much insulin you need for how many carbs you're eating. You won't be required to eat a certain amount.

For example, you may have a ratio of 1 unit of insulin for every 10 grams of carbohydrates. So you would simply count the total number of carbs in your meal and then bolus the right amount of insulin to match.

Or some pumps even do the calculation for you. My son simply punches into his pump how many carbs he's eating, and the pump does the rest. Pretty cool.

Debe Pendice
Debe Pendice 2009-01-06 11:34:54 -0600 Report

Thanks John, Went this AM to get my A1C done. See my endo on the 26th of this month and I hope all systems are ready to go from there. I am excited about getting on this. Thats so sad to think I'm excited to get this…Debe

Amy Tenderich
Amy Tenderich 2008-12-24 13:34:31 -0600 Report

As a very general rule, the experts tell newly diagnosed diabetics to stick to 45g carb per meal for women; 60g carb per meal for men.

Your mileage may vary, as you'll find that 45g carb adds up pretty quickly. The trick to learn to count carbs with some level of accuracy.

Here's a good list of resources for that:

All the best,

Debe Pendice
Debe Pendice 2009-01-02 16:46:25 -0600 Report

That is what the dietian has suggest to me. 45g carbs per meal. I feel that is an aweful lot. Am I wrong to fel this way?…Debe

SkipT 2009-01-02 16:54:50 -0600 Report

If you are a type 2 is is more of a concern that you watch your carbs. Unless you are taking insulin you can't adjust for overeating them. I follow a very strict low carb diet. A meal of 45 grams of carbs would send me into astronomical numbers. I am controlling my diabetes thru diet only now. By staying low carb I have been taken off all diabetic meds. I was taking 30mg actos and 2000mg metformin when I was diagnosed two years ago.

gma 2009-01-02 17:11:10 -0600 Report

my Dietian told me 30gm for breakfast 15gm snack 60gm for lunch 15gm snack 45gm for dinner and 15gm for snack

Sheryl 2008-12-24 13:25:57 -0600 Report

Thank you all for your replies. I appreciate all you 'insight' on this. and as I suspected, still complicated stuff! lol…
I do test twice a day. My morning/fasting readings are always great it's the evening meal test that I can't figure out. I can eat the same thing and one time have a great reading the the next time be over 200. I don't think I will ever understand this.
Test strips are a little pricey to be doing alot of testing. Probably costs the manufacturer a penny to make and us a dollar or more per strip. Hummm
Went to my Dr yesterday and she would not increase the Metformin, I take 1000mg a day but said if my A1c was over 6.5 she would. I think I am going to find a diabetic Dr next year, mine doesn't seem to be very helpful.
Again thank you all for such wonderful replies and I hope you have a wonderful Christmas and a Great New Year. Lets all hope the 2009 will be better for all of us. Keep hope alive..

Susan Rose
Susan Rose 2009-01-02 14:16:11 -0600 Report

Hi Sheryl, my daughter finds it difficult with her Dr. as well. Kelly gets upset and fustrated with the diabetes and trying to balance it. Her Mom Susan

2008-12-23 22:03:18 -0600 Report

Hi Sheryl,
I just went to a Diabetes school refresher class and the 'guidelines' for carbs with meals is 45-60 per meal and 15-30 per snack for women. Low end of that if you are inactive and the high end if you are active (exercise daily). 3 meals and 2-3 snacks every day, at about the same times every day. Portion control is the biggest thing. The guys are right, it's up to you to figure out which carbs you are going to eat and that's where your meter comes in. It will tell you how certain carbs affect you and which ones are ok for you. That's where 'everyone is different comes in'. Sticking to whole grains, fruit, vegetables and low fat dairy as your carbs is a good start. Do some experimenting and see what whole grain bread does for example. It will take some time because obviously you can't test too many at the same time. But that's the basics that I learned over the years and it was reiterated to me at the class. (7 years and they haven't changed their tune at all.. hmmmm) Anyway, that's what I know. Some will agree, some won't (more conflicting information!!) If you need any help trying to figure it out, let me know I'd be glad to help :) When you are testing foods, test before eating anything and then at intervals after if you can afford the test strips. 1 hour, 2 hours, 3 hours etc… like KD said to see where you get your highest numbers and then use that hour everytime. : )


kdroberts 2008-12-23 15:39:24 -0600 Report

Basically, you have to figure it out yourself. That's where your meter comes in. Test to find out how long after eating you are getting your highest number then test at that time after each meal. If something isn't working for you you will see it. If something is good you will see that too. If something isn't working for you, you can try different preperations, different combination, different portion sizes, etc to see if you can make it work for you.

Just forget completely about a daily amount. Carbs are not like calories, you can't save them up. If you eat a low carb meal then you've "lost" those carbs, you can't add them to the next meal.

I personally don't like Toma's PCF ratio because I eat a fairly high calorie diet so 50% carb is too much for me. It would be somewhere around the 70-80g per meal and 2 30-40g snacks which is too much.

John Crowley
John Crowley 2008-12-23 15:21:47 -0600 Report

So there's probably a pretty good reason that you've received so many different answers and that's because it kind of depends.

For instance, most Type 1's approach the carbohydrate question completely differently than a Type 2. A Type 1 will simply match the carbs they eat with an injection of insulin. So for a Type 1 it's more about knowing how many carbs you've eaten rather than staying within a limit. However, there are some Type 1's who are still on a meal plan that tries to get them to eat the right amount of carbs to match a pre-set dosage of insulin. (That is a crazy way to try to manage this disease. But that's a discussion for another day.)

Then with Type 2 diabetics, each person can have very different needs. Because insulin resistance is not the same for every Type 2, some experience higher blood sugars than others when eating precisely the same food.

So that was a really long way to say that it's best to simply find what works for you. If you have a glucose meter, then experiment with different foods and amounts of carbohydrates. You can use your meter to help you form your personal meal plan.

The last thing I will say is that I know Toma Grubb, our resident diet expert, likes to use a PCF (that's Protein-Carb-Fat) ratio to plan a healthy meal and diet. His goal is a 20-50-30 ratio. This means he tries to plan his meals so that he gets 20% of his calories from protein, 50% from carbs, and 30% from fats.

Here's a link to some of his tips and to his website.

From his site, you can download a free copy of his book.

Hope that helps.

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