Counting carbohydrates is the end all in diabetes management, right? Seriously, if it were only that easy. I don't know about you, but in my house, we find some meals can rock our blood sugars regardless of diligent carbohydrate counting.

A recent study on this subject reported in Family Practice News found: "Meals high in fat or protein cause hyperglycemia (high blood sugar) among children using intensive insulin therapy for type 1 diabetes."

If you use an insulin pump, this is what all those fancy delivery systems — slow wave, square wave, delayed distribution — do. But who uses these anyhow? Not many people I know. They are confusing and people get lost with how much and when they received insulin and usually end up under or overdosing themselves.

However, this kind of research makes sense to me: It proposes counting fats and protein as well as carbs. Why not? After all, we know it's not simply about carbs. But how do we take fat and protein into account when dosing insulin? Well, not so fast — this study didn't outline how to do it, just that this phenomenon occurs (I'm sure we could have saved them the trouble).

So, we're still somewhat on our own for figuring out how to manage these issues. I recommend talking to your doctor or CDE about it, and wanted to share some of my personal experiences:

Pizza. Pizza night may ring a familiar bell with you. Counting carbs is usually not an effective means to an end with this meal - unless you are really active after you eat it of course. The high fat, protein and carbs present in pizza are difficult to match with insulin.

Eggs. What is the deal with eggs anyhow? My daughter cannot eat eggs for breakfast without a shift in glucose. So, zero carbs with that meal but zero insulin equals no bueno. Troubleshooters at heart, we've created our own egg ratios for insulin at breakfast.

Mexican food. And for Mexican fare - yet another nemesis for us. There is plenty of fat, protein and carbs to be found in south of the border meals. I know I'm not alone in this, at least that is what these researchers have found.

Perhaps the next phase of this study can focus on dosing regimens for the fats and proteins as well.