Time To Review Carb Counting (Part 1)

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Hey, why don’t you take some time and reread this article: “Counting Carbohydrates Like a Pro: 
Practical Tips for Accurate Counts.”

OK. Wait. That’s not an imperative. I don’t mean you. No. Wait. Please. Don’t click away. Hold on. Just wait.

Have you started reading that article yet? Stop. Don’t read it. I didn’t intend for you to click away. I’m quite sure this blog entry isn’t about anything that you need help with.

You see, I’m not asking for those of you with diabetes to review how you count the number of carbohydrates in the meals, snacks, drinks, or anything it is you’re about to eat. There’s no lesson to be learned here. I’m not attempting to help you out or teach by example in this blog.

So I guess… well, just go. Go on. Continue to bolus as you’ve been bolusing, eat as you’ve been eating, and maintain the HbA1c you’ve been maintaining. All will be well. You don’t need to read any more of this.

See (for those of you still here), this blog is about me. I’m the one who needs to read the article. Again. As well as other articles like it. All of them: reread. At least one more time.

Why? Because I’m confessing to a new condition I just self-diagnosed, and I’m most definitely infected with it. It’s known as carb-count confidence underestimation creep.


Yes, that’s right. For nearly three years now I’ve lived with Type 1 diabetes, and when I was diagnosed, I spent hours in a diabetes education course learning about how to estimate the amount of carbohydrates in the foods I would eat. I listened to and read about portion sizes, food labels, fiber, carb factors, sugar alcohols, and a whole host of other terms and phrases too numerous to list in one little blog entry. I spent weeks adjusting to the many ways my body would react to its lack of a fully functioning pancreas and the introduction of synthetic insulin by injection (very soon thereafter replaced by insulin infused through an insulin pump). I fine-tuned my insulin-to-carbohydrate ratios by monitoring my blood glucose an hour after a meal — then two, three, four hours later — to see how close I was to 120 mg/dl, my target blood glucose.

After a while — after several months of a steep, steep learning curve — I got the whole thing down. Or, rather, I was pretty sure I’d figured it out and gained a knowledge about counting carbohydrates and bolusing for my meals that would serve me well for the rest of my life.

So I thought.

But time has a way of erasing some of our learning, not to mention inserting some habits that should never have been around to begin with. I realized last week that my initial, early diabetes education session, successful though it was, wasn’t enough to get me through the rest of my days with diabetes. I need recertification.

I need to review, as well as relearn, quite a few things. For the past few years I’ve had pretty good blood glucose averages, hit my bg targets quite often, had decent HbA1c readings at each visit to the endocrinologist, kept up with exercise and healthy diets. All the stuff we responsible persons with diabetes are supposed to do.

However — and there has to be a however, right? — slowly, but very surely, I noticed an increase in my blood glucose averages and my HbA1c.

While there are many factors that can influence an uptick in such numbers (exercise, diet, stress, holidays), last Thursday afternoon (New Year’s Eve) a lightbulb went on and I realized that one of the factors in these higher numbers may well be my own hubris.

In Part 2 Eric will talk more about his hubris and his carb-count confidence underestimation creep.

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