Bread as my benchmark

Clearly, this image has 75 grams of carbohydrate
Image Credit: SliceOfChic | Flickr, used under Creative Commons license

I stink at counting carbs.

When the Big D first shot it’s arrow through my pancreas in 1981, I left the hospital with a strict exchange diet.  Most meals were two or three bread exchanges (depending on the meal), one or two meat exchanges, and one fruit exchange.  There were some vegetable exchanges and fat exchanges in the plan too, which I never really counted too closely.  The Exchange Diet was kind of like the Richard Simmons Deal-a-Meal plan.

The fruit exchange was a fast-acting and sweet-tasting part of the meal, put there so my blood sugar wouldn’t crash after an injection before the meal had time to work.  In hindsight, that reason wasn’t very credible, considering I ate the fruit at the end of the meal as dessert, and that the Regular insulin took forever to work to begin with.  But that was the conventional wisdom at the time.  (1 Fruit Exchange = a small apple, an orange, twelve grapes, two plums, or half a banana)

But the most interesting and challenging of all was a bread exchange.  Quite simply it was, a slice of bread (or if anyone was counting, 15 carbohydrates) – or to complicate things, something equivalent to a slice of bread: like some measurable amount (which I can’t remember) of mashed potatoes, ½ cup of Cheerios (or something like that), or exactly twelve potato chips.

Yes, I was the seven-year-old moron in the school cafeteria counting his potato chips before eating them.  Not only that, but I would try to mentally reassemble the broken ones to figure out how many full chips was eating.  And those old habits die hard.

When I finally gave up the exchange diet and went to carb-counting, nothing changed.  Yes, I wasn’t trying to comply with an allocation of food exchanges, but I would still think and eat carbs in increments of 15 – adding or subtracting from my meal to get to that nice, round number.  Not until months after I began pumping did I realize that I didn’t need to measure my carbs in quarter-hour intervals.

But even today, when I guess at carbs, I always go back the slice of bread.  I don’t eat as many slices of bread anymore, but I’ve still got a pretty good idea of how big it is.  So if I’m having a tortilla wrap, some corn, a hamburger bun, or even a pizza crust, in my mind I morph it into the shape of a slice of bread, and figure out – in volume – how many slices it equates to.  If it takes as much space as 1 ½ slices of bread, it’s about 23 carbs.  For dense stuff, like potatoes, I round up a little.  For sweet stuff, like cake, I double or triple it.

It’s a pretty lousy way at carb-counting (don’t try this at home), but it’s what I do.  There are better ways, I know.  I’ve read that you should visualize something practical for comparison: something like the size of your fist, the palm of your hand, or maybe your big toe, and that equates to … umm… something.  As hard as I try, I can’t quite remember what it equates to.    While I no-longer bolus relative to 15-carb increments, I still measure relative to that known quantity  (except for breakfast cereal.  I use a measuring cup for the cereal and milk, which my wife finds a bit ridiculous considering how I guess at everything else).

Some people are great at carb-counting.  I wish there were some sort of scanner-machine that could analyze a piece of food and determine its carb-count.  Next to an artificial pancreas, an automatic carb-counter would be the biggest breakthrough in diabetes machinery that I could imagine.

Yesterday, Elizabeth blogged about carb-counting and going back to basics on Diabetes 24-7.  That’s what prompted me to write this article.  It’s one of those ideas that’s been floating in my head for awhile as a possible blog post, but never made it into words.  I’m thankful that Elizabeth posted what she did – it’s a bit of a refresher for me on what I should be doing, and at the same time, tells me that I’m not the only one whose estimates have grown more inaccurate over time.  Knowing there’s someone else who, like me, struggles to count carbs, is indeed comforting.

I think it’s time for me to re-calibrate my mental visualizations as they equate to carbs.  I’ll try to convince myself that all carbs are not equal, and that they can’t be measured in volume.  But I don’t think I’ll ever be able to stop mentally reassembles salty snack-food crumbs.  That’s burned in my mind forever.