Time To Review Carb Counting (Part 1)

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.

  • Deb

    Eric, I know where you’re coming from! I not only have carb-count confidence underestimation creep, but also Dove-chocolate-count confidence underestimation creep, as well as carb-count denial for high fructose corn syrup containing sodas. I was blaming my rising numbers on the HCFS, but after I stopped drinking it, the numbers kept on their upward climb. Now I’m on Metformin and measuring my food, and eating 3 Dove morsels a day instead of 10-20. Finally I’m seeing 120 or less in AM, and hoping that tomorrow’s A1C is not too bad.

    You’re in my thoughts every day and will be especially on Thursday.

  • Jeny-Lynn

    That’s not fair that you start this and not finish ii in one blog, or whatever you call it. Some of us really need to know how you solve the problem, since we are going through the same thing. My A1c dropped almost 2 percent after I started on the pump, which, by the way, no one would let me use one for over two years, because they didn’t think I could do it. College grad, very smart person, had done the research, long acting insulin didn’t work for me, etc., etc. Had diabetes for over 32 years!! Duh!! No wonder a lot of us are suffering complications and dying from the disease!!!!!! I have been on the pump for over a year, now, and it’s incredible how well I can deal with this disease now!!

    I need to know, NOW, what you have found out, since I’m having a harder time keeping my blood glucose levels down from when I first started on the pump. I use a continuous glucose monitor, and take care of my blood sugars 24/7. My Dad and many more of my relatives died of horrible complications of diabetes, and I’m determined not to be one of them!!

  • violet

    I have looked up “bolusing ” in every dictionary I could find and it must be a new NET word. So please explain what that mean?