I can't remember a time when I didn't worry about my dad's diabetes. My father, Carl Payne, 67, was diagnosed with type 2 diabetes nearly 40 years ago, and despite continuous treatment since then, his blood glucose, or blood sugar, was always too high whenever doctors checked his A1C levels. That changed about a year ago, when he discovered how counting carbohydrates helps to control his blood sugar. That realization came as he was undergoing training to get fitted for a medical device called an insulin pump.
My dad, who has had to take regular insulin injections since the mid-1980s, said he remembers being sent to a diabetes education class in 1970, when he was first diagnosed. At that time, carb counting wasn't as heavily recommended as it is now. After he started counting carbs last year, he discovered what diabetes experts have long known: The more carbs you eat, the higher your blood sugar reading is, and the more you need insulin. My dad recently had his A1C level checked again, and the doctor said it was much improved.
What my dad has learned is that he can eat foods he enjoys—within reason. And that should be the general rule of thumb for diabetics. "There are no good or bad foods. It's a matter of learning how to count" carbohydrates, says Martha M. Funnell, a research investigator in the University of Michigan's medical education department and director for administration in the school's Center for the Study of Complications in Diabetes. "If it's something you love, we can help you learn how to count that and how to fit it in" with your diet.
Diabetes experts told me that it's not unusual for diabetics to be unfamiliar with the best approaches to managing their condition. Access to dietitians who can help them plan a diabetes diet can be tremendously helpful.
But some diabetics are more knowledgeable than others. Michael Weiss, a 60-year-old Pittsburgh attorney who has had type 1 diabetes for 25 years, didn't have to work with a dietitian to learn how to count carbs when he was fitted with an insulin pump five years ago. That's because he had worked with the American Diabetes Association's board of directors from 2002 to 2003 and already knew what was involved. Still, he says, it took time to get comfortable with how his body responds to carbohydrates. "There's no book that you can sit down and read to learn how to do this, and your healthcare providers can't do it for you either," he says. "Only the patient is going to be able to ultimately learn the effects that carbohydrates are going to have on his or her body."