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Nutrition and Carbohydrate Counting

Insulin pump therapy allows you to be flexible with your food choices. Since there is no long-acting insulin dictating when, what or how much you eat, there is no reason to be rigid concerning your diet. By understanding the nutritional content of the food you eat, you will be able to take insulin accordingly and maintain blood glucose control.

Carbohydrates have the greatest effect on blood glucose, especially within a few hours of being eaten. Counting carbohydrates allows you to match your insulin dose to the food you are eating. Although fat and protein can affect your blood glucose when eaten in large amounts, it is the carbohydrates that affect blood glucose the most.

Carbohydrate Counting

With insulin pump therapy you must take a bolus for the carbohydrates you eat. To determine how much insulin to take for any given meal or snack, you need to count the carbohydrates in that meal.

Foods containing carbohydrates include:
• Starches - Starchy Vegetables - Fruits & Fruit Juices
• Milk & Milk Products - Sugars & Foods With Sugar

The information on the nutrition labels on packaged food will help you to determine how much carbohydrate is in a particular food. There are several paperback books available that list the grams of carbohydrates in many foods. These books are particularly helpful when you are eating foods without labels or eating out. Also, if you are familiar with the exchange system, you can count carbohydrate exchanges.

Your Endocrinologist, GP, or Diabetes Educator will give you an insulin to carbohydrate ratio to begin carbohydrate counting. This will be a starting place and may need to be adjusted based on the results of your blood glucose readings after you eat.

NOTE: As you begin to learn carbohydrate counting, try to estimate the carbohydrates in the food you are eating and then look at the food labels to see how close you are.

The Effect of Fat on Blood Glucose

Although fat does not contain carbohydrate, it may very well affect your blood glucose level. You may find that 2 hours after a meal containing a lot of fried food, cheese or a large portion of fatty meat, your blood glucose is normal, but 4-6 hours later it's high. That is because the fat slowed down the absorption of the carbohydrates in that meal.

As you become aware of how meals with certain foods containing fat affect your blood glucose, you can adjust your insulin accordingly. When you eat certain high-fat foods like pizza or french fries, you may find that using the variable bolus feature on your pump allows you to better match the insulin delivery to the blood glucose rise from the meal.

Foods containing fat include:
• Margarine - Oils - Mayonnaise
• Salad Dressing
• Nuts - Fried Foods

Foods containing saturated fat include:
• Butter - Sour Cream - Whole Milk
• Cream Cheese - Bacon - High Fat Meats

Doctors and health experts recommend that all people, with or without diabetes, eat less total fat, and especially less saturated fat. If you have high cholesterol or are trying to lose weight, it is important to limit the amount of fat you eat per day.

The Effect of Protein on Blood Glucose

Protein has little effect on blood glucose when eaten in moderate amounts.

Sources of protein include:
• Meat - Fish - Poultry - Eggs - Cheese
• Peanut Butter - Tofu - Dried Beans
• Dried Peas

Protein needs are the same for people with and without diabetes, unless kidney disease is present. Most people eat more protein than they need. Protein does not need to be included in every meal. If you have high cholesterol or are trying to lose weight, eat leaner proteins such as chicken and fish.

Other Nutrients that Effect Blood Glucose and Overall Health

FIBRE may slow down the rise in blood glucose after a meal. Fibre is an important part of a healthy diet. Recommendations for fibre intake are the same as for the general population.

SODIUM (salt) has no effect on blood glucose. Moderate sodium intake is recommended for people with or without diabetes. If you have high blood pressure or are sensitive to sodium, you should limit the amount of sodium in your diet.

ALCOHOL can cause low blood glucose and should always be consumed with food. The carbohydrate content of different types of alcohol can be found in carbohydrate counting books.

VITAMINS & MINERALS have no effect on blood glucose. As long as you eat balanced, healthy meals, there is no need to take vitamin and mineral supplements unless your Endocrinologist, GP, or Diabetes Educator recommends it.

SUGAR-CONTAINING FOODS may be included in your food choices as long as they are part of a healthy diet and do not compromise blood glucose control.

Healthy Eating Habits and Carbohydrate Counting

Insulin pump therapy gives you the choice of when, what and how much to eat without compromising blood glucose control. This flexibility allows you to sleep-in, postpone or skip meals and eat snacks, the same as people who do not have diabetes. Be careful not to take advantage of this freedom and compromise your nutritional health. Even people without diabetes need to make healthy food choices to be mentally and physically healthy.

Determining your meal bolus based on carbohydrate counting is not an exact science. Sometimes it takes trial and error to determine the correct meal bolus for certain foods. If you are unsure of how certain foods will affect your blood glucose, test your blood glucose 2 hours after you eat. If your reading is too high or too low, adjust your meal bolus the next time you make that food choice.