Clearing up the Confusion: 'We Don't Count Carbs' | Type 1 diabetes

Embracing a Therapeutic Carbohydrate Reduction/Low-carb nutrition strategy has transformed the way many families manage Type 1 diabetes. From getting off the daily blood sugar roller coaster to being more confident and reducing the stress and burden associated with managing Type 1 diabetes, families also experience a significant shift in the approach to counting carbohydrates.

When you are first diagnosed, you are taught to count carbohydrates, and this is the single most important factor in determining insulin doses and blood sugar response. In contrast to the conventional method of managing Type 1 diabetes, which emphasizes prioritizing carbohydrates—making up between 45% - 65% of the total meal—those families that follow a Therapeutic Carbohydrate Reduction/Low-carb nutrition strategy to manage Type 1 diabetes may not count carbs at all, or if they do, they count very rarely.

This can cause confusion to those new, or just starting out following a Therapeutic Carbohydrate Reduction/Low-carb nutrition strategy.

"What do they mean they don't count carbs?!"
"Then how do they dose insulin?!"
"Then what do they use to determine the insulin dose?!"

In this post, I'll share why many often hear from those who have been managing Type 1 diabetes via a Therapeutic Carbohydrate Reduction/Low-carb nutrition strategy for some time that they do not count carbs, and I’ll provide some tips to successfully navigating a Low-carb lifestyle.

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1️⃣ Prioritizing Protein Over Carbs: The Impact of a Low-carb Nutrition Strategy

Individuals who have adopted a Therapeutic Carbohydrate Reduction/Low-carb nutrition strategy to successfully manage Type 1 diabetes prioritize protein over carbohydrates. This means that protein takes the spotlight in meals, with fat ‘coming along for the ride,’ and carbohydrates playing a minimal role.

Protein-rich foods are loaded with essential nutrients our bodies require to survive and thrive, and as a result, these foods are prioritized. Protein foods also have a much smaller effect on blood glucose levels, allowing easier management of Type 1 diabetes.

This intentional shift also allows families to minimize the impact on blood sugar levels by reducing the amount of carbohydrates per meal. They focus on nutrient-dense, fibrous vegetables as the carb source, steering clear of options like grains and processed foods, which can have a dramatic impact on blood glucose levels, making managing Type 1 diabetes challenging.

Emphasizing quality Low-carb foods that are nutrient-dense ensures that the carbohydrates included in meals contribute to overall health without causing rapid spikes in blood sugar. In the Nutrition Effect program, I provide a list of nutrient-dense Low-carb food options that are packed with essential nutrients while having little effect on blood sugar levels.

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2️⃣ The Art of Not Counting Carbs: Knowing Your Food Inside Out

Now that the main focus of the meal is on protein, followed by fat, with reduced amounts of fibrous vegetables and fruit which have minimal impact on blood glucose levels, families who no longer count carbs during meals times have found success by following these tips:

👉 Select Wisely: Opt for Low-carb, nutrient-dense fibrous vegetables/fruits which have minimal impact on blood sugar levels.
👉 Standardize Meals: Establish consistent meals and closely monitor blood sugar responses.
👉 Factor in Protein and Fat: Recognize the impact of both protein and fat on blood sugar levels.
👉 Trial and Error: track and monitor the blood sugar response from the meal, and make adjustments as necessary. Over time, with confidence in your food choices and insulin dosage, you may ease away from carb counting.
👉 Stay Vigilant with Changes: When introducing new meals, they following steps 1 - 4!

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3️⃣ Long-Term Confidence Through Experience

Many families, including the ones I help, have successfully transitioned to a point where carb counting becomes unnecessary, or at the very least is not at the forefront of decision making as in the past. Through diligent trial and error, consistent monitoring, and a focus on Low-carb, whole foods, they gained a deep understanding of how specific foods affect blood glucose levels. This confidence allows them to enjoy meals without the constant scrutiny of carb counting.

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4️⃣ Caution with Packaged Low-carb Foods: Navigating the World of Packaged Low-carb/Keto Options

While whole foods become familiar territory, packaged Low-carb or keto foods require extra caution. Unlike the simplicity of a single-ingredient Low-carb food option such as a cucumber, these packaged options often contain various ingredients. Despite labels claiming low carb or keto, hidden elements might lead to unexpected blood glucose spikes. Approach packaged options with heightened awareness and engage in thorough trial and error. I help families navigate this 'minefield' by providing a list of the various ingredients which are used in Low-carb/keto packaged foods which should be avoided as they can cause unexpected blood sugar spikes.

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Conclusion: "We Don't Count Carbs."

These are the reasons why some families following a Therapeutic Carbohydrate Reduction/Low-carb nutrition strategy say that they 'don’t count carbs.'

👉 Carbs are not the central focus of the meal; instead, they are greatly reduced
👉 Low-carbohydrate foods selected are typically whole foods with little impact on blood glucose levels
👉 Achieving this stage takes time, trial and error, and patience.

This is a meal that we serve our children for breakfast which they really look forward to, courtesy of Ketosnakz (https://ketosnackz.com/), featuring sausages, cream cheese, peppers, mushrooms, tomatoes, onions (small amount), mozzarella cheese, and RAO’s sauce.

This meal, after careful trial and error, no longer requires our family to carb count, as the amount of carbohydrates in the meal is very small, the carbohydrates are made up of some Low-carb fibrous veggies, and the impact on blood sugar levels is well understood. We only consider dosing for the blood glucose impact from the protein and fat!

I have also included one of our dinner meals; grilled salmon, garden salad with olive oil & balsamic vinegar, sauteed mushrooms, and spicy mayo!

Hope this clears up some of the confusion you may have!

Let me know where you are on your Therapeutic Carbohydrate Reduction/Low-carb nutrition strategy!

For more info, visit:

👉 www.t1dnutrition.com

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p.s. Yesterday's post uncovered the 3 Key Elements to Successful T1D Management. Key Element #3. Food - understanding which foods have the greatest impact on blood sugar levels, AND, which foods are essential and required by the body to survive and thrive. Stay tuned for more...