Gabrielle Schmid, a registered dietitian and certified diabetes educator who lives with Type 1 herself, offers her practical advice on navigating counting carbs when enjoying your meals with different ingredients all mixed together.
Speaker: Gabrielle Schmid, RD, CDE
Speaker: Gabrielle Schmid, RD, CDE
0:00
foreign0:08
I'm so pleased that you're joining us0:11
today0:12
diabetes deep Dives is a series of0:14
videos designed to dive deeper and0:16
Beyond the surface of different areas of0:18
diabetes management we are exploring0:20
those burning questions that you may0:22
have by featuring Dynamic and engaging0:24
guests with knowledge or lived0:26
experience on the topic our goal is to0:29
share information in ways that will0:30
spark continued interest and learning0:32
and leave you with practical tips and0:35
tools that you can easily use0:37
we'll be dropping a new video every0:39
month so subscribe to our YouTube0:41
channel and click on the notification0:42
Bell to be notified about new content0:44
you can also check us out on social0:47
media to find out when the next one will0:49
be posted to our YouTube channel0:51
just a reminder that the information0:53
shared in these videos in no way0:55
replaces the advice and direction from0:57
your Healthcare team if you have0:59
questions about your care please speak1:01
to your healthcare provider and team to1:03
make sure that you are getting the best1:04
advice1:06
in this episode our guest speaker1:08
Gabrielle Schmid will offer her1:10
practical advice on navigating the1:12
complex world of counting carbs when1:14
enjoying your meals with different1:16
ingredients all mixed together1:18
Gabrielle will walk us through the key1:19
learnings that we hope you will get from1:21
this video1:23
Gabrielle is a registered dietitian1:25
certified educator and pump trainer she1:28
currently works at LMC Healthcare as a1:31
diabetes educator and clinical1:33
coordinator for the diabetes education1:35
program1:36
she has been living with type 1 diabetes1:38
for 25 years and ultimately she is1:40
passionate about driving change in the1:42
healthcare provider approach to help1:44
Empower all people living with diabetes1:49
we hope that you will find this video1:50
informative and that it will support you1:52
in managing your blood sugar while1:54
enjoying your favorite mixed dishes and1:56
now over to GabrielleWelcome1:59
hi everyone and welcome to diabetes2:01
Canada deep Dives today's topic is tips2:03
and tricks on carb counting my name is2:06
Gabrielle Schmid I'm a registered2:07
dietitian and certified diabetes2:10
educator in Ottawa2:11
so let me first start by saying that2:13
curb counting is a very difficult skill2:15
to learn you may have learned this early2:17
on in your diagnosis or maybe you're2:19
learning this for the first time but2:21
when we learn crowd counting we learn2:22
about food labels looking at the grams2:24
of carbs subtracting our fiber for a2:26
total amount of carbs or maybe learning2:29
how to use a food scale but what if our2:31
environment changes right we don't have2:32
access to these food scales and food2:34
labels in a restaurant out with friends2:36
Etc so today I want to help teach you2:39
some tips and tricks to help you learn2:41
more about practical skills so we're2:43
going to learn practical carb counting2:45
methods how fat protein and the glycemic2:47
affects carb Counting hidden sources of2:50
carbs how to make a best guess when carb2:53
counting using technology to help and2:56
Insulin strategiesPractical Methods2:58
so here we're looking at practical3:00
methods so you'll see on the left hand3:02
side actually two in one so we're3:04
looking at both the plate method and3:06
also a visual like using your hand so if3:09
you're looking at the plate method here3:11
you'll see that in the plate you're3:13
divided in three you have your grains3:15
and starches in one quart of the plate3:17
protein in the other quarter of your3:19
plate and half your plate is vegetables3:21
although this might not be new to you3:24
you can actually use this method let's3:26
say in a restaurant right you can order3:27
a dish that might mimic this and it3:29
might help you look at it and understand3:31
more about your3:32
carbohydrate portions3:34
um so looking at your corner of your3:36
plate now maybe the restaurant plate is3:37
much bigger but at least you have a3:39
better understanding of how much3:41
carbohydrate is in your plate versus a3:43
mixed dish or something like that3:45
at the same time you can see the hand so3:48
beside the graves and starches you have3:50
a fist so that once this tier you're3:52
looking about a cup of food so if you3:54
have a big plate at the restaurant and3:56
you think you have about two fifths of3:58
food that's approximately two cups so4:00
then you can do the math in terms of4:01
what you think the carb count is4:04
another practical method that I like to4:06
use is actually using a dry measuring4:08
cup to actually serve the food on4:10
someone's plate or my own plate so4:12
instead of using like a ladle or a big4:14
spoon I don't know how much that later4:16
that spoon is actually going to give me4:17
in terms of the amount of food but if I4:20
actually use4:21
um a one cup measuring cup I know that4:23
I'll be serving myself one cup of food4:25
and I can do my curb counting a little4:27
easier that way so using a dry measuring4:29
cup is actually quite useful for4:31
actually serving the food on someone's4:32
plate same thing for liquids if you4:35
actually want to measure the amount of4:38
liquid going into a smoothie for example4:39
maybe pouring it up in a measuring cup4:42
to see how much milk you're getting or4:44
fruit Etc to give you a better sense of4:47
the amount of carbohydrateHand Visuals4:51
here's another document to show you more4:54
visuals so just understanding more4:56
household objects versus your hand but4:59
certainly you may not have access to5:00
these things if you're at a restaurant5:01
but you have your hand right so looking5:04
in at your fist was again one cup the5:07
palm of your hand is about a quart or5:09
half a cup sorry5:11
um the Palm here5:13
is about three ounces a handful another5:17
ounce so looking at different ways to5:18
use your hand to look at you know uh how5:21
much I may be eating in my plate of food5:23
you could even maybe print this off and5:25
have it handy for the first couple of5:26
times just because you may not be sure5:29
um but you'll get used to it so if you5:30
start using this now even at home when5:32
you're in a restaurant or someone else's5:34
house to eat it might get easier over5:36
time5:37
so looking at both household objects and5:39
also your hands could be another5:40
practical tip to help you with your carb5:42
counting a little more accuratelyNon Carbs5:46
so what about non-carbs so we know that5:48
when we eat carbohydrate if we just eat5:50
the carbohydrate alone it's pretty5:52
predictable how it might act in the body5:54
but if I have something that's high fat5:56
and high protein with the carb food it's5:59
actually going to slow down the6:00
absorption of the carb so if I take6:02
insulin for my carb counting and I think6:05
you know when I eat it alone and I think6:07
that it's going to work within two hours6:09
Etc it might not be the same thing when6:12
we're actually adding something like6:13
cheese or something that's deep fried or6:15
something of that sort you may have that6:17
experience yourself when you in6:19
something like pizza or nachos right the6:22
spaghetti or the noodle itself or the6:24
chip itself uh maybe the chip because6:26
it's higher in fat but let's say the6:28
noodle itself is pretty predictable in6:30
terms of how it affects your sugar but6:32
when you add a lot of that cheese or a6:34
lot of that meat sauce it might change6:36
the way that it works so looking at6:38
strategies to help you with that could6:39
be either using the extend bolts feature6:42
if you're using an insulin pump if6:44
you're on injections you might want to6:45
split urine injection in two and of6:48
course discussing this with your6:49
diabetes team to help you learn more6:51
about those features and understanding6:53
how to split your injection6:55
but just understanding the fact that you6:57
know if I have a plate of food and it6:59
seems to be quite high fat high protein7:01
the outcome is going to be different7:02
than if you're just having a7:04
carbohydrate with more predictable food7:05
on the plate like a side salad and a7:08
small piece of fish or something like7:10
thatGlycemic Index7:12
and what about the glycemic index so the7:15
glycemic index is a way to look at how7:17
carbohydrate is going to impact the7:19
sugar just the carbohydrate alone so an7:21
example would be let's say bread if I'm7:24
eating a white uh bread or one slice of7:26
white bread my blood sugar might Spike7:28
fast versus if I have something like7:31
sourdough bread or rye bread7:33
surprisingly even though they are still7:35
white by visually looking at it the way7:38
that it's made and fermented actually7:40
it's quite different and so the outcome7:42
or the absorption of the carbohydrate7:44
may look differently than just having7:45
that white bread so if I have to7:48
pre-bull this let's say for my sandwich7:49
with white bread I may not need to7:51
pre-bull this if I'm having something7:53
with sourdough bread or rye bread7:55
because the carb even though the carb7:57
count might be similar it's how the7:58
carbohydrate is actually behaving in my8:00
body once I've eaten it so again it's8:03
not all about carb counting learning the8:05
grams of carbohydrate but understanding8:07
kind of what foods do what and when we8:09
pair it on top of fat and protein again8:11
right understanding of that there might8:13
be a change in the outcome of your sugarHidden Carbs8:18
and what about those hidden sources of8:20
carbohydrate so certainly if you're at a8:22
restaurant right this is my this might8:24
be where you might come to face this8:26
challenge just because if you're at home8:28
you have more control in terms of what8:30
you're putting into your recipes8:32
Etc so if I'm at a restaurant remember8:34
to look at the sauces the salad8:36
dressings the condiments the breaded or8:40
crispy options right those are going to8:41
be more or higher in carbohydrates so if8:45
you're having let's say chicken fingers8:46
right sure the chicken is protein it may8:49
not be counted but if it's breaded then8:52
you'll look at not only maybe higher fat8:54
but also looking at carbohydrate because8:56
of that breading8:58
milk Alternatives so not all milk is9:01
created equally so one cup of cow's milk9:03
for example is not the same thing as one9:05
cup of oat milk or if you're looking at9:08
almond milk so looking at the food label9:10
because that's often um available to you9:12
when you are purchasing the milk9:13
Alternatives but be mindful of that as9:17
well9:17
and some nuts and seeds so usually when9:20
we learn about carb counting we say you9:22
know don't count your nuts and seeds but9:24
that's not true not all nuts are created9:26
equally so looking at cashews for9:28
example those are actually kind of high9:31
in carbohydrate depending on the amount9:32
that you're having but I would actually9:34
count that towards your carb amount if9:36
you are eating let's say about a third9:38
of a cup of cashews compared to if9:41
you're eating peanuts or almonds9:43
so here are some examples right so9:46
ketchup for example a quarter of a cup9:48
of ketchup often very common when we're9:50
eating especially during the summer time9:52
right that can add about 15 grams of9:54
carbohydrate to your meal but often we9:57
might forget about it because it doesn't9:58
visually look like a carbohydrate that10:00
we might usually count for like the10:02
bread or a fruit example as exampleTechnology10:07
so technology so we're lucky today that10:10
we live in a world where you know we10:12
have access to lots of things that are10:13
fingertips in terms of information and10:15
that includes carb counting not only10:18
just carbohydrate but all nutrition and10:20
nutrients found in our Foods so I often10:23
tell my patients you know start Maybe by10:25
Googling it so if you don't have access10:26
to a food label or a food scale or10:28
really you're just looking at a plate of10:30
food and you're not sure but you have10:31
access to it to your phone you could10:33
Google it you go in your search bar and10:35
you just type in something like I don't10:36
know um strawberries right and then you10:39
can actually choose the amount of10:40
strawberries that you're going to be10:41
eating and it will come up with the carb10:43
count for that amount of food all as10:46
well as the fiber and all the other10:48
nutrition for that food10:50
the other thing I like to teach my10:52
patients is the fast foods restaurants10:54
nutrition information so if you actually10:56
go on Google and do a quick search I can10:59
actually do a live demonstration here to11:01
show you how easy it is so let me just11:03
stop sharing my screen11:06
if I go to Google and let's say I'm11:08
going to Subway for lunch11:11
okay and then I'm going to click on11:14
subway11:24
let's see if I can find it somewhere11:26
else here11:28
um11:31
okay11:34
so nutrition11:39
I go down to nutrition data tables11:41
it's a PDF so you can actually print11:43
this if you're often going to Subway uh11:46
you can print this keep this handy ready11:47
to go you can actually find this in your11:49
phone as well okay so PDF comes up and11:52
in the PDF I'll make this a bit bigger11:54
here you see here the carbohydrate and11:57
the dietary fiber11:58
so you can do the math12:00
okay so if I'm looking at perhaps12:05
the turkey12:06
43 minus five so I'm looking at about 3812:10
grams of carbs first my six inch12:13
sandwich okay so you can literally like12:15
I said like I said print this off have12:17
it handy uh take a picture with your12:20
phone uh but again keeping track of the12:22
things that you're often ordering can be12:24
very helpful and maybe it's once or12:25
twice a need to look it up and then12:27
after that you'll know it by heart so12:29
that's just an information how easy it12:31
is to find nutrition information your12:33
carb counting online12:36
so let me just reshare my screen12:44
okay perfect the other thing that we can12:46
do as well is if you again look online12:48
are Canadian nutrient file has a huge12:51
array of different foods that we've come12:53
up with over the years in terms of the12:54
nutrition available to us so again just12:57
looking up a certain food you'll find12:59
all the nutrients related to that food13:01
including the carb count13:04
another thing that we all use these days13:05
for multiple reasons are apps on our13:08
phone so for example carbs and cows carb13:11
manager MyFitnessPal Calorie King these13:14
are examples of carb counting apps so13:16
you might be already using a diabetes13:18
app or um not for anything right so13:21
downloading another app on your phone to13:23
help with this it's not that you need to13:25
use it every time that you need to card13:26
count I mean you can but it could be for13:29
those things that you're just really not13:30
sure about there's often big databases13:32
of different types of foods ethnicities13:34
all types of foods available to you13:36
different restaurants even if you travel13:39
to a different country you'd be13:40
surprised what you can see there or13:42
different chains so again using these13:44
apps uh when you want can really help13:46
and like I said if you often visit these13:49
restaurants or have these meals over and13:52
over again you might need to look it up13:53
once or twice a few times and then13:56
you'll know it off by heart after after13:58
a few times of looking it up14:00
so these are some of many apps available14:02
to you these are the most popular that I14:04
see but certainly looking on your phone14:06
and looking either in your app store to14:09
see what's available to you when you14:10
type in carbohydrate counting you'd be14:12
surprised what you can see there so take14:14
a lookStrategies14:17
so of course when we're carb counting14:19
we're often doing that to take our14:20
insulin with our carb ratio or perhaps14:23
just looking at learning more about14:24
carbohydrates so we can come up with the14:26
carb ratio for you so here are some14:29
strategies to help you with your insulin14:31
but also to help your insulin work14:33
better especially when there's a14:34
situation where you're not sure about14:35
the carb count14:36
so consider taking your correction if14:38
you're a little high before eating so at14:41
least get some insulin circulating in14:43
your system if you're really not sure if14:45
you can't pre-bull this for your meal14:46
making sure that you have at least a14:48
correction going in so that you can be14:50
maybe less above Target when you're14:53
eating your food again if you can and14:55
you can remember14:57
if you're at a restaurant don't pre-bull14:59
this at a restaurant you don't know15:00
what's happening in the kitchen there15:02
might be a fire there someone might be15:04
delayed whatever it is so really make15:06
sure that you're only bullisting when15:08
your plate of food arrives at your table15:09
then you can take a look at it do some15:11
calculation maybe looking at your hands15:14
to see if it mimics the plate method or15:15
whatever it is and then bolus when you15:18
have a better understanding of your card15:19
count and again when it's in front of15:21
you15:22
use your extend Bulls feature on your15:24
pump like we talked about in terms of15:26
high fat high protein certainly a15:28
situation that would happen more often15:29
in a restaurant and if there's something15:31
that you're often eating in a restaurant15:33
that you really want to get correct in15:35
terms of bolusing maybe discussing this15:37
with your diabetes team taking notes so15:40
maybe the first time you're not actually15:42
using extendable list you just take a15:43
you take your insulin as you usually15:45
would and see what happens to your sugar15:47
and then maybe you'll see that maybe in15:49
four hours or six hours you need more15:51
insulin well we can use the extend Bulls15:53
feature to help you with that15:56
be careful it's better to underestimate15:59
than to overestimate when we're looking16:00
at our carb count I would say if you're16:02
really not sure give it a guess but try16:05
to guess a little lower than maybe what16:07
you think is actually in your plate16:09
um so better to do that than to overdo16:11
it and then have too much insulin on16:12
board and cause a low16:15
if you're really not sure bullets for16:17
some right or half if you think of an16:19
idea of how much it is Monitor and16:22
adjust as needed we can always give16:24
Corrections later on but certainly you16:26
want to give it enough time you don't16:27
want to give a correction half an hour16:29
after eating you want to at least wait16:31
two three four hours to give your16:33
correction16:34
um so just keep that in mind just give16:36
some before if you can16:39
um and if you have no idea you can eat16:42
your plate of food think of how much you16:44
ate and go from there right some insulin16:46
is better than no insulinSummary16:50
so I hope that today we learned about a16:53
few things ultimately we know carb16:55
counting is hard work we never expect16:56
Perfection you shouldn't as well right16:59
that is a lot of work to just do that17:01
um so be mindful of that skill use your17:04
hands or visuals to help you understand17:06
your portions like we talked about those17:08
household items if you have them around17:09
but certainly using your hand is good17:11
enough17:12
model the plate method at a restaurant17:14
when possible so if you're at a17:16
restaurant and you want to order17:18
something if you can see if it fits more17:20
into that plate method versus a mixed17:22
dish certainly you know it might17:24
increase your chances of getting a more17:26
accurate carb counting but don't make17:27
that your deciding factor for what17:29
you're going to order but it could be a17:31
helpful strategy for sure17:33
look out for those hidden sources of17:35
carbohydrate like we said in those17:37
sauces and the condiments pay attention17:39
to how high fat and high protein meals17:42
affect your sugars and discuss with your17:44
team so maybe you won't use the extended17:46
bolus or give insulin a different way17:48
you'll just see how your sugar reacts to17:50
a certain food take note of that and see17:52
what happens and you can discuss that17:54
with your diabetes team17:56
a best guess is better than no guests17:58
and use technology to help with your18:00
carb Counting18:02
I hope today's presentation helped you a18:04
little more with your curb counting18:05
skills and like I said please reach out18:07
to your diabetes team if you need more18:09
uh review or skills or practical18:11
knowledge on learning how to carb count18:13
thank you so muchOutro18:16
thank you so much for joining us to dive18:18
deeper into how card counting can help18:20
support your diabetes management please18:22
take the opportunity to let us know what18:24
you learned what you liked and how we18:26
can do better18:27
you can do that by posting a comment in18:29
the comments section below or by18:31
clicking the link to the feedback survey18:33
in the description box18:35
if you have ideas for other topics you'd18:37
like to learn more about you can include18:39
that in the comments or feedback survey18:41
as well18:43
you can also find the website linked to18:45
the Canadian nutrient file mentioned in18:47
the video in the description box as well18:49
as some additional helpful resources on18:52
this topic from diabetes Canada18:54
if you are looking for more resources18:56
about diabetes management please visit18:58
our website at diabetes.ca you can also19:01
email us at info diabetes.ca or call our19:05
info line at 1-800banting that's19:10
1-800-226-8464 and speak to one of our19:12
information and support Specialists who19:14
can address your needs thanks again for19:17
joining us and see you next time19:19
foreign19:21
[Music]
foreign0:08
I'm so pleased that you're joining us0:11
today0:12
diabetes deep Dives is a series of0:14
videos designed to dive deeper and0:16
Beyond the surface of different areas of0:18
diabetes management we are exploring0:20
those burning questions that you may0:22
have by featuring Dynamic and engaging0:24
guests with knowledge or lived0:26
experience on the topic our goal is to0:29
share information in ways that will0:30
spark continued interest and learning0:32
and leave you with practical tips and0:35
tools that you can easily use0:37
we'll be dropping a new video every0:39
month so subscribe to our YouTube0:41
channel and click on the notification0:42
Bell to be notified about new content0:44
you can also check us out on social0:47
media to find out when the next one will0:49
be posted to our YouTube channel0:51
just a reminder that the information0:53
shared in these videos in no way0:55
replaces the advice and direction from0:57
your Healthcare team if you have0:59
questions about your care please speak1:01
to your healthcare provider and team to1:03
make sure that you are getting the best1:04
advice1:06
in this episode our guest speaker1:08
Gabrielle Schmid will offer her1:10
practical advice on navigating the1:12
complex world of counting carbs when1:14
enjoying your meals with different1:16
ingredients all mixed together1:18
Gabrielle will walk us through the key1:19
learnings that we hope you will get from1:21
this video1:23
Gabrielle is a registered dietitian1:25
certified educator and pump trainer she1:28
currently works at LMC Healthcare as a1:31
diabetes educator and clinical1:33
coordinator for the diabetes education1:35
program1:36
she has been living with type 1 diabetes1:38
for 25 years and ultimately she is1:40
passionate about driving change in the1:42
healthcare provider approach to help1:44
Empower all people living with diabetes1:49
we hope that you will find this video1:50
informative and that it will support you1:52
in managing your blood sugar while1:54
enjoying your favorite mixed dishes and1:56
now over to GabrielleWelcome1:59
hi everyone and welcome to diabetes2:01
Canada deep Dives today's topic is tips2:03
and tricks on carb counting my name is2:06
Gabrielle Schmid I'm a registered2:07
dietitian and certified diabetes2:10
educator in Ottawa2:11
so let me first start by saying that2:13
curb counting is a very difficult skill2:15
to learn you may have learned this early2:17
on in your diagnosis or maybe you're2:19
learning this for the first time but2:21
when we learn crowd counting we learn2:22
about food labels looking at the grams2:24
of carbs subtracting our fiber for a2:26
total amount of carbs or maybe learning2:29
how to use a food scale but what if our2:31
environment changes right we don't have2:32
access to these food scales and food2:34
labels in a restaurant out with friends2:36
Etc so today I want to help teach you2:39
some tips and tricks to help you learn2:41
more about practical skills so we're2:43
going to learn practical carb counting2:45
methods how fat protein and the glycemic2:47
affects carb Counting hidden sources of2:50
carbs how to make a best guess when carb2:53
counting using technology to help and2:56
Insulin strategiesPractical Methods2:58
so here we're looking at practical3:00
methods so you'll see on the left hand3:02
side actually two in one so we're3:04
looking at both the plate method and3:06
also a visual like using your hand so if3:09
you're looking at the plate method here3:11
you'll see that in the plate you're3:13
divided in three you have your grains3:15
and starches in one quart of the plate3:17
protein in the other quarter of your3:19
plate and half your plate is vegetables3:21
although this might not be new to you3:24
you can actually use this method let's3:26
say in a restaurant right you can order3:27
a dish that might mimic this and it3:29
might help you look at it and understand3:31
more about your3:32
carbohydrate portions3:34
um so looking at your corner of your3:36
plate now maybe the restaurant plate is3:37
much bigger but at least you have a3:39
better understanding of how much3:41
carbohydrate is in your plate versus a3:43
mixed dish or something like that3:45
at the same time you can see the hand so3:48
beside the graves and starches you have3:50
a fist so that once this tier you're3:52
looking about a cup of food so if you3:54
have a big plate at the restaurant and3:56
you think you have about two fifths of3:58
food that's approximately two cups so4:00
then you can do the math in terms of4:01
what you think the carb count is4:04
another practical method that I like to4:06
use is actually using a dry measuring4:08
cup to actually serve the food on4:10
someone's plate or my own plate so4:12
instead of using like a ladle or a big4:14
spoon I don't know how much that later4:16
that spoon is actually going to give me4:17
in terms of the amount of food but if I4:20
actually use4:21
um a one cup measuring cup I know that4:23
I'll be serving myself one cup of food4:25
and I can do my curb counting a little4:27
easier that way so using a dry measuring4:29
cup is actually quite useful for4:31
actually serving the food on someone's4:32
plate same thing for liquids if you4:35
actually want to measure the amount of4:38
liquid going into a smoothie for example4:39
maybe pouring it up in a measuring cup4:42
to see how much milk you're getting or4:44
fruit Etc to give you a better sense of4:47
the amount of carbohydrateHand Visuals4:51
here's another document to show you more4:54
visuals so just understanding more4:56
household objects versus your hand but4:59
certainly you may not have access to5:00
these things if you're at a restaurant5:01
but you have your hand right so looking5:04
in at your fist was again one cup the5:07
palm of your hand is about a quart or5:09
half a cup sorry5:11
um the Palm here5:13
is about three ounces a handful another5:17
ounce so looking at different ways to5:18
use your hand to look at you know uh how5:21
much I may be eating in my plate of food5:23
you could even maybe print this off and5:25
have it handy for the first couple of5:26
times just because you may not be sure5:29
um but you'll get used to it so if you5:30
start using this now even at home when5:32
you're in a restaurant or someone else's5:34
house to eat it might get easier over5:36
time5:37
so looking at both household objects and5:39
also your hands could be another5:40
practical tip to help you with your carb5:42
counting a little more accuratelyNon Carbs5:46
so what about non-carbs so we know that5:48
when we eat carbohydrate if we just eat5:50
the carbohydrate alone it's pretty5:52
predictable how it might act in the body5:54
but if I have something that's high fat5:56
and high protein with the carb food it's5:59
actually going to slow down the6:00
absorption of the carb so if I take6:02
insulin for my carb counting and I think6:05
you know when I eat it alone and I think6:07
that it's going to work within two hours6:09
Etc it might not be the same thing when6:12
we're actually adding something like6:13
cheese or something that's deep fried or6:15
something of that sort you may have that6:17
experience yourself when you in6:19
something like pizza or nachos right the6:22
spaghetti or the noodle itself or the6:24
chip itself uh maybe the chip because6:26
it's higher in fat but let's say the6:28
noodle itself is pretty predictable in6:30
terms of how it affects your sugar but6:32
when you add a lot of that cheese or a6:34
lot of that meat sauce it might change6:36
the way that it works so looking at6:38
strategies to help you with that could6:39
be either using the extend bolts feature6:42
if you're using an insulin pump if6:44
you're on injections you might want to6:45
split urine injection in two and of6:48
course discussing this with your6:49
diabetes team to help you learn more6:51
about those features and understanding6:53
how to split your injection6:55
but just understanding the fact that you6:57
know if I have a plate of food and it6:59
seems to be quite high fat high protein7:01
the outcome is going to be different7:02
than if you're just having a7:04
carbohydrate with more predictable food7:05
on the plate like a side salad and a7:08
small piece of fish or something like7:10
thatGlycemic Index7:12
and what about the glycemic index so the7:15
glycemic index is a way to look at how7:17
carbohydrate is going to impact the7:19
sugar just the carbohydrate alone so an7:21
example would be let's say bread if I'm7:24
eating a white uh bread or one slice of7:26
white bread my blood sugar might Spike7:28
fast versus if I have something like7:31
sourdough bread or rye bread7:33
surprisingly even though they are still7:35
white by visually looking at it the way7:38
that it's made and fermented actually7:40
it's quite different and so the outcome7:42
or the absorption of the carbohydrate7:44
may look differently than just having7:45
that white bread so if I have to7:48
pre-bull this let's say for my sandwich7:49
with white bread I may not need to7:51
pre-bull this if I'm having something7:53
with sourdough bread or rye bread7:55
because the carb even though the carb7:57
count might be similar it's how the7:58
carbohydrate is actually behaving in my8:00
body once I've eaten it so again it's8:03
not all about carb counting learning the8:05
grams of carbohydrate but understanding8:07
kind of what foods do what and when we8:09
pair it on top of fat and protein again8:11
right understanding of that there might8:13
be a change in the outcome of your sugarHidden Carbs8:18
and what about those hidden sources of8:20
carbohydrate so certainly if you're at a8:22
restaurant right this is my this might8:24
be where you might come to face this8:26
challenge just because if you're at home8:28
you have more control in terms of what8:30
you're putting into your recipes8:32
Etc so if I'm at a restaurant remember8:34
to look at the sauces the salad8:36
dressings the condiments the breaded or8:40
crispy options right those are going to8:41
be more or higher in carbohydrates so if8:45
you're having let's say chicken fingers8:46
right sure the chicken is protein it may8:49
not be counted but if it's breaded then8:52
you'll look at not only maybe higher fat8:54
but also looking at carbohydrate because8:56
of that breading8:58
milk Alternatives so not all milk is9:01
created equally so one cup of cow's milk9:03
for example is not the same thing as one9:05
cup of oat milk or if you're looking at9:08
almond milk so looking at the food label9:10
because that's often um available to you9:12
when you are purchasing the milk9:13
Alternatives but be mindful of that as9:17
well9:17
and some nuts and seeds so usually when9:20
we learn about carb counting we say you9:22
know don't count your nuts and seeds but9:24
that's not true not all nuts are created9:26
equally so looking at cashews for9:28
example those are actually kind of high9:31
in carbohydrate depending on the amount9:32
that you're having but I would actually9:34
count that towards your carb amount if9:36
you are eating let's say about a third9:38
of a cup of cashews compared to if9:41
you're eating peanuts or almonds9:43
so here are some examples right so9:46
ketchup for example a quarter of a cup9:48
of ketchup often very common when we're9:50
eating especially during the summer time9:52
right that can add about 15 grams of9:54
carbohydrate to your meal but often we9:57
might forget about it because it doesn't9:58
visually look like a carbohydrate that10:00
we might usually count for like the10:02
bread or a fruit example as exampleTechnology10:07
so technology so we're lucky today that10:10
we live in a world where you know we10:12
have access to lots of things that are10:13
fingertips in terms of information and10:15
that includes carb counting not only10:18
just carbohydrate but all nutrition and10:20
nutrients found in our Foods so I often10:23
tell my patients you know start Maybe by10:25
Googling it so if you don't have access10:26
to a food label or a food scale or10:28
really you're just looking at a plate of10:30
food and you're not sure but you have10:31
access to it to your phone you could10:33
Google it you go in your search bar and10:35
you just type in something like I don't10:36
know um strawberries right and then you10:39
can actually choose the amount of10:40
strawberries that you're going to be10:41
eating and it will come up with the carb10:43
count for that amount of food all as10:46
well as the fiber and all the other10:48
nutrition for that food10:50
the other thing I like to teach my10:52
patients is the fast foods restaurants10:54
nutrition information so if you actually10:56
go on Google and do a quick search I can10:59
actually do a live demonstration here to11:01
show you how easy it is so let me just11:03
stop sharing my screen11:06
if I go to Google and let's say I'm11:08
going to Subway for lunch11:11
okay and then I'm going to click on11:14
subway11:24
let's see if I can find it somewhere11:26
else here11:28
um11:31
okay11:34
so nutrition11:39
I go down to nutrition data tables11:41
it's a PDF so you can actually print11:43
this if you're often going to Subway uh11:46
you can print this keep this handy ready11:47
to go you can actually find this in your11:49
phone as well okay so PDF comes up and11:52
in the PDF I'll make this a bit bigger11:54
here you see here the carbohydrate and11:57
the dietary fiber11:58
so you can do the math12:00
okay so if I'm looking at perhaps12:05
the turkey12:06
43 minus five so I'm looking at about 3812:10
grams of carbs first my six inch12:13
sandwich okay so you can literally like12:15
I said like I said print this off have12:17
it handy uh take a picture with your12:20
phone uh but again keeping track of the12:22
things that you're often ordering can be12:24
very helpful and maybe it's once or12:25
twice a need to look it up and then12:27
after that you'll know it by heart so12:29
that's just an information how easy it12:31
is to find nutrition information your12:33
carb counting online12:36
so let me just reshare my screen12:44
okay perfect the other thing that we can12:46
do as well is if you again look online12:48
are Canadian nutrient file has a huge12:51
array of different foods that we've come12:53
up with over the years in terms of the12:54
nutrition available to us so again just12:57
looking up a certain food you'll find12:59
all the nutrients related to that food13:01
including the carb count13:04
another thing that we all use these days13:05
for multiple reasons are apps on our13:08
phone so for example carbs and cows carb13:11
manager MyFitnessPal Calorie King these13:14
are examples of carb counting apps so13:16
you might be already using a diabetes13:18
app or um not for anything right so13:21
downloading another app on your phone to13:23
help with this it's not that you need to13:25
use it every time that you need to card13:26
count I mean you can but it could be for13:29
those things that you're just really not13:30
sure about there's often big databases13:32
of different types of foods ethnicities13:34
all types of foods available to you13:36
different restaurants even if you travel13:39
to a different country you'd be13:40
surprised what you can see there or13:42
different chains so again using these13:44
apps uh when you want can really help13:46
and like I said if you often visit these13:49
restaurants or have these meals over and13:52
over again you might need to look it up13:53
once or twice a few times and then13:56
you'll know it off by heart after after13:58
a few times of looking it up14:00
so these are some of many apps available14:02
to you these are the most popular that I14:04
see but certainly looking on your phone14:06
and looking either in your app store to14:09
see what's available to you when you14:10
type in carbohydrate counting you'd be14:12
surprised what you can see there so take14:14
a lookStrategies14:17
so of course when we're carb counting14:19
we're often doing that to take our14:20
insulin with our carb ratio or perhaps14:23
just looking at learning more about14:24
carbohydrates so we can come up with the14:26
carb ratio for you so here are some14:29
strategies to help you with your insulin14:31
but also to help your insulin work14:33
better especially when there's a14:34
situation where you're not sure about14:35
the carb count14:36
so consider taking your correction if14:38
you're a little high before eating so at14:41
least get some insulin circulating in14:43
your system if you're really not sure if14:45
you can't pre-bull this for your meal14:46
making sure that you have at least a14:48
correction going in so that you can be14:50
maybe less above Target when you're14:53
eating your food again if you can and14:55
you can remember14:57
if you're at a restaurant don't pre-bull14:59
this at a restaurant you don't know15:00
what's happening in the kitchen there15:02
might be a fire there someone might be15:04
delayed whatever it is so really make15:06
sure that you're only bullisting when15:08
your plate of food arrives at your table15:09
then you can take a look at it do some15:11
calculation maybe looking at your hands15:14
to see if it mimics the plate method or15:15
whatever it is and then bolus when you15:18
have a better understanding of your card15:19
count and again when it's in front of15:21
you15:22
use your extend Bulls feature on your15:24
pump like we talked about in terms of15:26
high fat high protein certainly a15:28
situation that would happen more often15:29
in a restaurant and if there's something15:31
that you're often eating in a restaurant15:33
that you really want to get correct in15:35
terms of bolusing maybe discussing this15:37
with your diabetes team taking notes so15:40
maybe the first time you're not actually15:42
using extendable list you just take a15:43
you take your insulin as you usually15:45
would and see what happens to your sugar15:47
and then maybe you'll see that maybe in15:49
four hours or six hours you need more15:51
insulin well we can use the extend Bulls15:53
feature to help you with that15:56
be careful it's better to underestimate15:59
than to overestimate when we're looking16:00
at our carb count I would say if you're16:02
really not sure give it a guess but try16:05
to guess a little lower than maybe what16:07
you think is actually in your plate16:09
um so better to do that than to overdo16:11
it and then have too much insulin on16:12
board and cause a low16:15
if you're really not sure bullets for16:17
some right or half if you think of an16:19
idea of how much it is Monitor and16:22
adjust as needed we can always give16:24
Corrections later on but certainly you16:26
want to give it enough time you don't16:27
want to give a correction half an hour16:29
after eating you want to at least wait16:31
two three four hours to give your16:33
correction16:34
um so just keep that in mind just give16:36
some before if you can16:39
um and if you have no idea you can eat16:42
your plate of food think of how much you16:44
ate and go from there right some insulin16:46
is better than no insulinSummary16:50
so I hope that today we learned about a16:53
few things ultimately we know carb16:55
counting is hard work we never expect16:56
Perfection you shouldn't as well right16:59
that is a lot of work to just do that17:01
um so be mindful of that skill use your17:04
hands or visuals to help you understand17:06
your portions like we talked about those17:08
household items if you have them around17:09
but certainly using your hand is good17:11
enough17:12
model the plate method at a restaurant17:14
when possible so if you're at a17:16
restaurant and you want to order17:18
something if you can see if it fits more17:20
into that plate method versus a mixed17:22
dish certainly you know it might17:24
increase your chances of getting a more17:26
accurate carb counting but don't make17:27
that your deciding factor for what17:29
you're going to order but it could be a17:31
helpful strategy for sure17:33
look out for those hidden sources of17:35
carbohydrate like we said in those17:37
sauces and the condiments pay attention17:39
to how high fat and high protein meals17:42
affect your sugars and discuss with your17:44
team so maybe you won't use the extended17:46
bolus or give insulin a different way17:48
you'll just see how your sugar reacts to17:50
a certain food take note of that and see17:52
what happens and you can discuss that17:54
with your diabetes team17:56
a best guess is better than no guests17:58
and use technology to help with your18:00
carb Counting18:02
I hope today's presentation helped you a18:04
little more with your curb counting18:05
skills and like I said please reach out18:07
to your diabetes team if you need more18:09
uh review or skills or practical18:11
knowledge on learning how to carb count18:13
thank you so muchOutro18:16
thank you so much for joining us to dive18:18
deeper into how card counting can help18:20
support your diabetes management please18:22
take the opportunity to let us know what18:24
you learned what you liked and how we18:26
can do better18:27
you can do that by posting a comment in18:29
the comments section below or by18:31
clicking the link to the feedback survey18:33
in the description box18:35
if you have ideas for other topics you'd18:37
like to learn more about you can include18:39
that in the comments or feedback survey18:41
as well18:43
you can also find the website linked to18:45
the Canadian nutrient file mentioned in18:47
the video in the description box as well18:49
as some additional helpful resources on18:52
this topic from diabetes Canada18:54
if you are looking for more resources18:56
about diabetes management please visit18:58
our website at diabetes.ca you can also19:01
email us at info diabetes.ca or call our19:05
info line at 1-800banting that's19:10
1-800-226-8464 and speak to one of our19:12
information and support Specialists who19:14
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Category Tags: Diet & Nutrition, Management, Healthy Living;