Is Carb Counting a License to Go Crazy?

Last week I talked about my experiences transitioning from the exchange system to the carbohydrate counting system.

As a bit of review, the exchange system was built around having a certain number of portions of each different food group. A meal would have, for example, 2 starch exchanges, 2 protein exchanges, 1 fruit exchange, 1 milk exchange, and 1 fat exchange.

You were supposed to eat your prescribed meals (you'd have a different combination of exchanges for different meals and snacks), and you wouldn't adjust your meal insulin. Can you imagine that? You'd have a sliding correction scale to adjust for highs or lows, but not for the meals.

When they started changing to carb counting, it was way different. The idea was that carbohydrates were the part of the meal that raised blood sugar, so if you counted the amount of carb grams in your meal, and adjusted your insulin accordingly (using what's called an insulin to carb ratio), you would be able to manage your blood sugar pretty well.

The focus was no longer so much on a balanced meal, but more on accurately counting your carb grams. To my young mind, I took it as a license to forget all about a well-balanced meal. All I worried about was blood sugar management.

Years later we know that things are a bit more complicated than simply counting carb grams. We know that fat, protein, and fiber all played a role in helping us manage our blood sugars around mealtime. We know that the carbohydrates have a measure of how fast they raise blood sugar (called the glycemic index), and we know that mixing foods can change that measure.

We gained a lot of freedom with our food, which is great, but at what cost? I think we need to be equally concerned with our total nutrition as we are about blood sugar management, and I'm working on doing just that. Maybe revisiting some of the "old-school" thoughts wouldn't be such a bad thing?