Carb counting for blood sugar control

0:00
foreign
0:08
I'm so pleased that you're joining us
0:11
today
0:12
diabetes deep Dives is a series of
0:14
videos designed to dive deeper and
0:16
Beyond the surface of different areas of
0:18
diabetes management we are exploring
0:20
those burning questions that you may
0:22
have by featuring Dynamic and engaging
0:24
guests with knowledge or lived
0:26
experience on the topic our goal is to
0:29
share information in ways that will
0:30
spark continued interest and learning
0:32
and leave you with practical tips and
0:35
tools that you can easily use
0:37
we'll be dropping a new video every
0:39
month so subscribe to our YouTube
0:41
channel and click on the notification
0:42
Bell to be notified about new content
0:44
you can also check us out on social
0:47
media to find out when the next one will
0:49
be posted to our YouTube channel
0:51
just a reminder that the information
0:53
shared in these videos in no way
0:55
replaces the advice and direction from
0:57
your Healthcare team if you have
0:59
questions about your care please speak
1:01
to your healthcare provider and team to
1:03
make sure that you are getting the best
1:04
advice
1:06
in this episode our guest speaker
1:08
Gabrielle Schmid will offer her
1:10
practical advice on navigating the
1:12
complex world of counting carbs when
1:14
enjoying your meals with different
1:16
ingredients all mixed together
1:18
Gabrielle will walk us through the key
1:19
learnings that we hope you will get from
1:21
this video
1:23
Gabrielle is a registered dietitian
1:25
certified educator and pump trainer she
1:28
currently works at LMC Healthcare as a
1:31
diabetes educator and clinical
1:33
coordinator for the diabetes education
1:35
program
1:36
she has been living with type 1 diabetes
1:38
for 25 years and ultimately she is
1:40
passionate about driving change in the
1:42
healthcare provider approach to help
1:44
Empower all people living with diabetes
1:49
we hope that you will find this video
1:50
informative and that it will support you
1:52
in managing your blood sugar while
1:54
enjoying your favorite mixed dishes and
1:56
now over to Gabrielle
Welcome
1:59
hi everyone and welcome to diabetes
2:01
Canada deep Dives today's topic is tips
2:03
and tricks on carb counting my name is
2:06
Gabrielle Schmid I'm a registered
2:07
dietitian and certified diabetes
2:10
educator in Ottawa
2:11
so let me first start by saying that
2:13
curb counting is a very difficult skill
2:15
to learn you may have learned this early
2:17
on in your diagnosis or maybe you're
2:19
learning this for the first time but
2:21
when we learn crowd counting we learn
2:22
about food labels looking at the grams
2:24
of carbs subtracting our fiber for a
2:26
total amount of carbs or maybe learning
2:29
how to use a food scale but what if our
2:31
environment changes right we don't have
2:32
access to these food scales and food
2:34
labels in a restaurant out with friends
2:36
Etc so today I want to help teach you
2:39
some tips and tricks to help you learn
2:41
more about practical skills so we're
2:43
going to learn practical carb counting
2:45
methods how fat protein and the glycemic
2:47
affects carb Counting hidden sources of
2:50
carbs how to make a best guess when carb
2:53
counting using technology to help and
2:56
Insulin strategies
Practical Methods
2:58
so here we're looking at practical
3:00
methods so you'll see on the left hand
3:02
side actually two in one so we're
3:04
looking at both the plate method and
3:06
also a visual like using your hand so if
3:09
you're looking at the plate method here
3:11
you'll see that in the plate you're
3:13
divided in three you have your grains
3:15
and starches in one quart of the plate
3:17
protein in the other quarter of your
3:19
plate and half your plate is vegetables
3:21
although this might not be new to you
3:24
you can actually use this method let's
3:26
say in a restaurant right you can order
3:27
a dish that might mimic this and it
3:29
might help you look at it and understand
3:31
more about your
3:32
carbohydrate portions
3:34
um so looking at your corner of your
3:36
plate now maybe the restaurant plate is
3:37
much bigger but at least you have a
3:39
better understanding of how much
3:41
carbohydrate is in your plate versus a
3:43
mixed dish or something like that
3:45
at the same time you can see the hand so
3:48
beside the graves and starches you have
3:50
a fist so that once this tier you're
3:52
looking about a cup of food so if you
3:54
have a big plate at the restaurant and
3:56
you think you have about two fifths of
3:58
food that's approximately two cups so
4:00
then you can do the math in terms of
4:01
what you think the carb count is
4:04
another practical method that I like to
4:06
use is actually using a dry measuring
4:08
cup to actually serve the food on
4:10
someone's plate or my own plate so
4:12
instead of using like a ladle or a big
4:14
spoon I don't know how much that later
4:16
that spoon is actually going to give me
4:17
in terms of the amount of food but if I
4:20
actually use
4:21
um a one cup measuring cup I know that
4:23
I'll be serving myself one cup of food
4:25
and I can do my curb counting a little
4:27
easier that way so using a dry measuring
4:29
cup is actually quite useful for
4:31
actually serving the food on someone's
4:32
plate same thing for liquids if you
4:35
actually want to measure the amount of
4:38
liquid going into a smoothie for example
4:39
maybe pouring it up in a measuring cup
4:42
to see how much milk you're getting or
4:44
fruit Etc to give you a better sense of
4:47
the amount of carbohydrate
Hand Visuals
4:51
here's another document to show you more
4:54
visuals so just understanding more
4:56
household objects versus your hand but
4:59
certainly you may not have access to
5:00
these things if you're at a restaurant
5:01
but you have your hand right so looking
5:04
in at your fist was again one cup the
5:07
palm of your hand is about a quart or
5:09
half a cup sorry
5:11
um the Palm here
5:13
is about three ounces a handful another
5:17
ounce so looking at different ways to
5:18
use your hand to look at you know uh how
5:21
much I may be eating in my plate of food
5:23
you could even maybe print this off and
5:25
have it handy for the first couple of
5:26
times just because you may not be sure
5:29
um but you'll get used to it so if you
5:30
start using this now even at home when
5:32
you're in a restaurant or someone else's
5:34
house to eat it might get easier over
5:36
time
5:37
so looking at both household objects and
5:39
also your hands could be another
5:40
practical tip to help you with your carb
5:42
counting a little more accurately
Non Carbs
5:46
so what about non-carbs so we know that
5:48
when we eat carbohydrate if we just eat
5:50
the carbohydrate alone it's pretty
5:52
predictable how it might act in the body
5:54
but if I have something that's high fat
5:56
and high protein with the carb food it's
5:59
actually going to slow down the
6:00
absorption of the carb so if I take
6:02
insulin for my carb counting and I think
6:05
you know when I eat it alone and I think
6:07
that it's going to work within two hours
6:09
Etc it might not be the same thing when
6:12
we're actually adding something like
6:13
cheese or something that's deep fried or
6:15
something of that sort you may have that
6:17
experience yourself when you in
6:19
something like pizza or nachos right the
6:22
spaghetti or the noodle itself or the
6:24
chip itself uh maybe the chip because
6:26
it's higher in fat but let's say the
6:28
noodle itself is pretty predictable in
6:30
terms of how it affects your sugar but
6:32
when you add a lot of that cheese or a
6:34
lot of that meat sauce it might change
6:36
the way that it works so looking at
6:38
strategies to help you with that could
6:39
be either using the extend bolts feature
6:42
if you're using an insulin pump if
6:44
you're on injections you might want to
6:45
split urine injection in two and of
6:48
course discussing this with your
6:49
diabetes team to help you learn more
6:51
about those features and understanding
6:53
how to split your injection
6:55
but just understanding the fact that you
6:57
know if I have a plate of food and it
6:59
seems to be quite high fat high protein
7:01
the outcome is going to be different
7:02
than if you're just having a
7:04
carbohydrate with more predictable food
7:05
on the plate like a side salad and a
7:08
small piece of fish or something like
7:10
that
Glycemic Index
7:12
and what about the glycemic index so the
7:15
glycemic index is a way to look at how
7:17
carbohydrate is going to impact the
7:19
sugar just the carbohydrate alone so an
7:21
example would be let's say bread if I'm
7:24
eating a white uh bread or one slice of
7:26
white bread my blood sugar might Spike
7:28
fast versus if I have something like
7:31
sourdough bread or rye bread
7:33
surprisingly even though they are still
7:35
white by visually looking at it the way
7:38
that it's made and fermented actually
7:40
it's quite different and so the outcome
7:42
or the absorption of the carbohydrate
7:44
may look differently than just having
7:45
that white bread so if I have to
7:48
pre-bull this let's say for my sandwich
7:49
with white bread I may not need to
7:51
pre-bull this if I'm having something
7:53
with sourdough bread or rye bread
7:55
because the carb even though the carb
7:57
count might be similar it's how the
7:58
carbohydrate is actually behaving in my
8:00
body once I've eaten it so again it's
8:03
not all about carb counting learning the
8:05
grams of carbohydrate but understanding
8:07
kind of what foods do what and when we
8:09
pair it on top of fat and protein again
8:11
right understanding of that there might
8:13
be a change in the outcome of your sugar
Hidden Carbs
8:18
and what about those hidden sources of
8:20
carbohydrate so certainly if you're at a
8:22
restaurant right this is my this might
8:24
be where you might come to face this
8:26
challenge just because if you're at home
8:28
you have more control in terms of what
8:30
you're putting into your recipes
8:32
Etc so if I'm at a restaurant remember
8:34
to look at the sauces the salad
8:36
dressings the condiments the breaded or
8:40
crispy options right those are going to
8:41
be more or higher in carbohydrates so if
8:45
you're having let's say chicken fingers
8:46
right sure the chicken is protein it may
8:49
not be counted but if it's breaded then
8:52
you'll look at not only maybe higher fat
8:54
but also looking at carbohydrate because
8:56
of that breading
8:58
milk Alternatives so not all milk is
9:01
created equally so one cup of cow's milk
9:03
for example is not the same thing as one
9:05
cup of oat milk or if you're looking at
9:08
almond milk so looking at the food label
9:10
because that's often um available to you
9:12
when you are purchasing the milk
9:13
Alternatives but be mindful of that as
9:17
well
9:17
and some nuts and seeds so usually when
9:20
we learn about carb counting we say you
9:22
know don't count your nuts and seeds but
9:24
that's not true not all nuts are created
9:26
equally so looking at cashews for
9:28
example those are actually kind of high
9:31
in carbohydrate depending on the amount
9:32
that you're having but I would actually
9:34
count that towards your carb amount if
9:36
you are eating let's say about a third
9:38
of a cup of cashews compared to if
9:41
you're eating peanuts or almonds
9:43
so here are some examples right so
9:46
ketchup for example a quarter of a cup
9:48
of ketchup often very common when we're
9:50
eating especially during the summer time
9:52
right that can add about 15 grams of
9:54
carbohydrate to your meal but often we
9:57
might forget about it because it doesn't
9:58
visually look like a carbohydrate that
10:00
we might usually count for like the
10:02
bread or a fruit example as example
Technology
10:07
so technology so we're lucky today that
10:10
we live in a world where you know we
10:12
have access to lots of things that are
10:13
fingertips in terms of information and
10:15
that includes carb counting not only
10:18
just carbohydrate but all nutrition and
10:20
nutrients found in our Foods so I often
10:23
tell my patients you know start Maybe by
10:25
Googling it so if you don't have access
10:26
to a food label or a food scale or
10:28
really you're just looking at a plate of
10:30
food and you're not sure but you have
10:31
access to it to your phone you could
10:33
Google it you go in your search bar and
10:35
you just type in something like I don't
10:36
know um strawberries right and then you
10:39
can actually choose the amount of
10:40
strawberries that you're going to be
10:41
eating and it will come up with the carb
10:43
count for that amount of food all as
10:46
well as the fiber and all the other
10:48
nutrition for that food
10:50
the other thing I like to teach my
10:52
patients is the fast foods restaurants
10:54
nutrition information so if you actually
10:56
go on Google and do a quick search I can
10:59
actually do a live demonstration here to
11:01
show you how easy it is so let me just
11:03
stop sharing my screen
11:06
if I go to Google and let's say I'm
11:08
going to Subway for lunch
11:11
okay and then I'm going to click on
11:14
subway
11:24
let's see if I can find it somewhere
11:26
else here
11:28
um
11:31
okay
11:34
so nutrition
11:39
I go down to nutrition data tables
11:41
it's a PDF so you can actually print
11:43
this if you're often going to Subway uh
11:46
you can print this keep this handy ready
11:47
to go you can actually find this in your
11:49
phone as well okay so PDF comes up and
11:52
in the PDF I'll make this a bit bigger
11:54
here you see here the carbohydrate and
11:57
the dietary fiber
11:58
so you can do the math
12:00
okay so if I'm looking at perhaps
12:05
the turkey
12:06
43 minus five so I'm looking at about 38
12:10
grams of carbs first my six inch
12:13
sandwich okay so you can literally like
12:15
I said like I said print this off have
12:17
it handy uh take a picture with your
12:20
phone uh but again keeping track of the
12:22
things that you're often ordering can be
12:24
very helpful and maybe it's once or
12:25
twice a need to look it up and then
12:27
after that you'll know it by heart so
12:29
that's just an information how easy it
12:31
is to find nutrition information your
12:33
carb counting online
12:36
so let me just reshare my screen
12:44
okay perfect the other thing that we can
12:46
do as well is if you again look online
12:48
are Canadian nutrient file has a huge
12:51
array of different foods that we've come
12:53
up with over the years in terms of the
12:54
nutrition available to us so again just
12:57
looking up a certain food you'll find
12:59
all the nutrients related to that food
13:01
including the carb count
13:04
another thing that we all use these days
13:05
for multiple reasons are apps on our
13:08
phone so for example carbs and cows carb
13:11
manager MyFitnessPal Calorie King these
13:14
are examples of carb counting apps so
13:16
you might be already using a diabetes
13:18
app or um not for anything right so
13:21
downloading another app on your phone to
13:23
help with this it's not that you need to
13:25
use it every time that you need to card
13:26
count I mean you can but it could be for
13:29
those things that you're just really not
13:30
sure about there's often big databases
13:32
of different types of foods ethnicities
13:34
all types of foods available to you
13:36
different restaurants even if you travel
13:39
to a different country you'd be
13:40
surprised what you can see there or
13:42
different chains so again using these
13:44
apps uh when you want can really help
13:46
and like I said if you often visit these
13:49
restaurants or have these meals over and
13:52
over again you might need to look it up
13:53
once or twice a few times and then
13:56
you'll know it off by heart after after
13:58
a few times of looking it up
14:00
so these are some of many apps available
14:02
to you these are the most popular that I
14:04
see but certainly looking on your phone
14:06
and looking either in your app store to
14:09
see what's available to you when you
14:10
type in carbohydrate counting you'd be
14:12
surprised what you can see there so take
14:14
a look
Strategies
14:17
so of course when we're carb counting
14:19
we're often doing that to take our
14:20
insulin with our carb ratio or perhaps
14:23
just looking at learning more about
14:24
carbohydrates so we can come up with the
14:26
carb ratio for you so here are some
14:29
strategies to help you with your insulin
14:31
but also to help your insulin work
14:33
better especially when there's a
14:34
situation where you're not sure about
14:35
the carb count
14:36
so consider taking your correction if
14:38
you're a little high before eating so at
14:41
least get some insulin circulating in
14:43
your system if you're really not sure if
14:45
you can't pre-bull this for your meal
14:46
making sure that you have at least a
14:48
correction going in so that you can be
14:50
maybe less above Target when you're
14:53
eating your food again if you can and
14:55
you can remember
14:57
if you're at a restaurant don't pre-bull
14:59
this at a restaurant you don't know
15:00
what's happening in the kitchen there
15:02
might be a fire there someone might be
15:04
delayed whatever it is so really make
15:06
sure that you're only bullisting when
15:08
your plate of food arrives at your table
15:09
then you can take a look at it do some
15:11
calculation maybe looking at your hands
15:14
to see if it mimics the plate method or
15:15
whatever it is and then bolus when you
15:18
have a better understanding of your card
15:19
count and again when it's in front of
15:21
you
15:22
use your extend Bulls feature on your
15:24
pump like we talked about in terms of
15:26
high fat high protein certainly a
15:28
situation that would happen more often
15:29
in a restaurant and if there's something
15:31
that you're often eating in a restaurant
15:33
that you really want to get correct in
15:35
terms of bolusing maybe discussing this
15:37
with your diabetes team taking notes so
15:40
maybe the first time you're not actually
15:42
using extendable list you just take a
15:43
you take your insulin as you usually
15:45
would and see what happens to your sugar
15:47
and then maybe you'll see that maybe in
15:49
four hours or six hours you need more
15:51
insulin well we can use the extend Bulls
15:53
feature to help you with that
15:56
be careful it's better to underestimate
15:59
than to overestimate when we're looking
16:00
at our carb count I would say if you're
16:02
really not sure give it a guess but try
16:05
to guess a little lower than maybe what
16:07
you think is actually in your plate
16:09
um so better to do that than to overdo
16:11
it and then have too much insulin on
16:12
board and cause a low
16:15
if you're really not sure bullets for
16:17
some right or half if you think of an
16:19
idea of how much it is Monitor and
16:22
adjust as needed we can always give
16:24
Corrections later on but certainly you
16:26
want to give it enough time you don't
16:27
want to give a correction half an hour
16:29
after eating you want to at least wait
16:31
two three four hours to give your
16:33
correction
16:34
um so just keep that in mind just give
16:36
some before if you can
16:39
um and if you have no idea you can eat
16:42
your plate of food think of how much you
16:44
ate and go from there right some insulin
16:46
is better than no insulin
Summary
16:50
so I hope that today we learned about a
16:53
few things ultimately we know carb
16:55
counting is hard work we never expect
16:56
Perfection you shouldn't as well right
16:59
that is a lot of work to just do that
17:01
um so be mindful of that skill use your
17:04
hands or visuals to help you understand
17:06
your portions like we talked about those
17:08
household items if you have them around
17:09
but certainly using your hand is good
17:11
enough
17:12
model the plate method at a restaurant
17:14
when possible so if you're at a
17:16
restaurant and you want to order
17:18
something if you can see if it fits more
17:20
into that plate method versus a mixed
17:22
dish certainly you know it might
17:24
increase your chances of getting a more
17:26
accurate carb counting but don't make
17:27
that your deciding factor for what
17:29
you're going to order but it could be a
17:31
helpful strategy for sure
17:33
look out for those hidden sources of
17:35
carbohydrate like we said in those
17:37
sauces and the condiments pay attention
17:39
to how high fat and high protein meals
17:42
affect your sugars and discuss with your
17:44
team so maybe you won't use the extended
17:46
bolus or give insulin a different way
17:48
you'll just see how your sugar reacts to
17:50
a certain food take note of that and see
17:52
what happens and you can discuss that
17:54
with your diabetes team
17:56
a best guess is better than no guests
17:58
and use technology to help with your
18:00
carb Counting
18:02
I hope today's presentation helped you a
18:04
little more with your curb counting
18:05
skills and like I said please reach out
18:07
to your diabetes team if you need more
18:09
uh review or skills or practical
18:11
knowledge on learning how to carb count
18:13
thank you so much
Outro
18:16
thank you so much for joining us to dive
18:18
deeper into how card counting can help
18:20
support your diabetes management please
18:22
take the opportunity to let us know what
18:24
you learned what you liked and how we
18:26
can do better
18:27
you can do that by posting a comment in
18:29
the comments section below or by
18:31
clicking the link to the feedback survey
18:33
in the description box
18:35
if you have ideas for other topics you'd
18:37
like to learn more about you can include
18:39
that in the comments or feedback survey
18:41
as well
18:43
you can also find the website linked to
18:45
the Canadian nutrient file mentioned in
18:47
the video in the description box as well
18:49
as some additional helpful resources on
18:52
this topic from diabetes Canada
18:54
if you are looking for more resources
18:56
about diabetes management please visit
18:58
our website at diabetes.ca you can also
19:01
email us at info diabetes.ca or call our
19:05
info line at 1-800banting that's
19:10
1-800-226-8464 and speak to one of our
19:12
information and support Specialists who
19:14
can address your needs thanks again for
19:17
joining us and see you next time
19:19
foreign
19:21
[Music]