Low-carb lamentations.

Since my last CDE appointment and A1c check in, I’ve been trying harder to “control the controllables” in my life – especially diet and exercise. With so many other variables in our lives, I’ve been trying to impact things where I can, and the easiest place to start is the food choices I make every day.

I’m a fairly devoted low-carb eater already. I don’t like how I feel after carb-heavy meals like pastas, cereals, or rice, so I do my best to avoid them (special occasions aside). I’ve long believed in the rule of small numbers: large amounts of carbs mean you have to take large amounts of insulin which can create large mistakes. Small amounts of carbs have the opposite effect. The idea is to narrow the margin of error so that there’s less clean up to do later. In terms of food choices, that means that I often spring for things that have few carbs listed on the nutrition label. Things like cheese, cream-based soups and sauces, and lots of proteins – chicken, fish, and red meat.

These foods seem like easy, diabetic-friendly choices in the short term. But as I strive to truly self-reflect on my diabetes management these days, I’ve taken a closer and more honest look at my food choices. The fact of the matter is that many low-carb foods are very high in fat – and saturated fat. Not only can these foods negatively affect cholesterol and lipid levels, but they don’t always translate into good blood sugars either. That’s because foods high in fat – even the good kinds of fat – take longer to break down, and can cause BGs to rise hours after eating. In fact, I’ve been experiencing this issue for years, but wasn’t fully aware of it until going on a CGM. I used to think salmon was a perfect dinner – I’d have a great postprandial BG and wake up with a normal fasting. Once I started wearing a CGM though, I realized that salmon often caused a sustained high overnight as the polyunsaturated and monounsaturated fats broke down over several hours.

This is not to say that salmon should be eliminated – it’s a nutrient-packed food that has incredible health benefits. But it helps prove the point that eating low-carb doesn’t always yield better blood sugars. And foods like cheese and steak can pack tons of calories, which is a concern for all of us. The challenge is about finding a balance between low-carb and healthy, and also learning to control the downstream effects of latent digestion with higher-fat foods. For me, that means changing my outlook on some of my go-to snacks. I tend to view cheese and eggs as foods that I don’t need to limit much. In reality, measuring out a portion of grated cheddar onto egg whites instead of whole eggs could save me hundreds of calories and fat grams, not to mention the hours of annoyance combating a high from too much fat later.

It’s all about balance, but it’s hard not to feel deprived when even the low-carb choices can work against you. If anyone out there has some other good low-carb, not-to-high-in-fat choices, I’m always up for suggestions!

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I try to control carbs (obviously), but I don´t eat sooo low carb.
I´ve been eating nuts – almonds, pistachios, peanuts – when I need a low carb snack. But in limited portions too…
I tend to think it´s better than cheese at least.

But I do eat fruits and wholewheat bread too.

I needed to read this today. I’m a low carber too and avoid breads, cereals, pasta, potatoes, and most fruit. I really don’t even miss all that stuff. But I guess I don’t watch the calories on the low carb stuff that I eat. Good reminder.

Have you heard of fat-protein units yet?
Here’s some info I found without a lot of research: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2901033/
The basic idea and rule of thumb for me is to give 1 unit of insulin for every 100 calories gained from fat and proteins, if your I:C ratio is 1:12. (If it’s 1:8, that would result in 12/8=1.5 units of insulin.) The bolus needs to be extended for 3 hours for 100 calories, 4 hours for 200, 5 for 300, and so on. (There’s a calculator here: http://www.grennis-welt.de/hobbies/web-a-co/74-fpe
It’s in German, but here’s how it works: In 2nd tab: KH=10g of carbs, KH-Faktor: how much insulin you give for 10g of carbs, FPE is usually the same. In 3rd tab, enter the nutritional values for 100g of food, than verzehrte Menge=how much you intend to eat. 4th tab gives you in blue the units for carbs and in red the units for fat & protein and in the last line in blue the total units and in front of the red how long to extend the bolus of the red units for fat-protein. The example that’s filled in is for a convenience-food pizza with tuna.)
I only do this when I have low-carb meals, but up to now it works out quite well and I’d recommend it. But YDMV, of course. Sorry for overfilling the comment.

Vera this is a cool idea and I’m going to look into it. I always feel like I’m guessing a bit when I use my extended bolus feature for high fat meals. Thanks for this tip!

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