Have you given up on your favorite marinades because you couldn’t figure out how to count the carbs for your type 1er? After all… how the @$%! can you figure out a carb count with a marinade? How many carbs were absorbed
into the meat? How much was left in the pan? How much will be left when it is done cooking? I had abandoned them for a long time, opting instead to use spice rubs while cooking and then only add sauces to the food as it was being served in order to be able
to accurately count the carbs on the plate.
The Never Ending Quest
Trying to find new, mouth watering recipes to keep him wanting to eat healthy foods is a never ending quest, because after a few times, any recipe loses its novelty. He’s
happiest when I keep him guessing about what’s going to be on his plate, especially when he’s not really sure if he’s going to like the flavor combinations, only to be blown away and wind up asking for a second helping (a couple of good examples of this are
the chocolate mayan jungle bird and
strawberry BBQ sauce, both are a nice example of satisfying the sweet & spicy cravings without going overboard).
Until recently, that is, when my son’s love of salmon and a comment from another user on this site sparked an epiphany.
Let’s look at the minor recipe rework:
The original recipe
Margarita Salmon calls for 2 salmon fillets (no carbs in salmon) to be marinated in:
3 TBSP fresh lime juice (~3 carbs)
3 TBSP honey (41 carbs)
a pinch of brown sugar (~1 carb) [I omitted this, the honey was sweet enough]
2 TBSP EVOO (no carbs)
for a total of 45 carbs.
First, mix the marinade in a small bowl, as instructed. Then, instead of marinading them both together, split the marinade in half (23 carbs), and marinade them separately.
Then, before placing in the pan, make a foil packet for each of them to have its own home to cook in, being careful to form them so the marinade doesn’t escape. When finished cooking, serve over a bed of rice and veggies, dumping the remaining marinade over
the top to be absorbed in. Then just add the 23 carb count to that of the rice & veggies for the total count of the whole meal. A whole lime only adds about 7 carbs, so the addition of the two slices for garnish is negligible. Converted rice and broccoli were
chosen for their low glycemic index and ability to soak up the marinade.
Carb counting & insulin requirements, continued…
We touched on the importance of matching carb counts to insulin briefly in my earlier post “Let’s Get It Started! Sweet Dessert Egg Rolls”. To go into a little further
detail, for those who are interested… accurate carb counting is an imperative for a type 1er. Everyone has their own individual insulin:carb ratio (i:c), which means for a certain quantity of carbohydrates, that person needs to take a single unit of insulin
in order to be able to keep their blood sugar from rising. It’s not necessarily a constant, and can change at different hours of the day with a person’s biorhythms, with different environments, activity levels or illness. The easiest way, by
far, is to let the scale do the counting for you as much as possible to take the guesswork out of it.
Few things feel worse than realizing you’ve calculated or drawn up a dosage incorrectly and your type 1er has suffered some ill effects from hyper- or hypo- glycemia as
a result. In the hospital, a trained RN isn’t even allowed to deliver a dose without having another set of eyes double check prior to injection. The picture of the syringe gauge next to the ruler gives an indication of how tiny and annoying it is to deal with
If you’re predominantly a solitary caregiver, you may experience a certain, special kind of joy in knowing that if anything goes wrong, there’s no one to blame but yourself.
Stop it. It doesn’t help. You’re human, and are going to make mistakes. Does this mean that you don’t try your best? No, it just means that when you do mess up, forgive yourself as quickly as possible and move on. If you make the same mistake twice, it’s a
wake up call to find another way of doing things that eliminates more of the chances for errors. Don’t be ashamed or afraid to ask for help or some support. Find your local
JDRF support group leader if you haven’t already, even if you just need a shoulder to cry on. That’s what they’re there for.
The perils of being not average
To share some of our personal challenges, my type 1er is fairly insulin sensitive, with a single unit capable of dropping his blood sugar by 70 points at rest (twice that
when he’s exercising), and his i:c right now is varying from 1:60 to 1:35 depending on time of day. Before we started eating for autoimmunity, his disease had progressed as predicted, with increasing insulin needs over time. The highest was 50-60 units per
day. The dosages are actually lower today than they were when he was first diagnosed, averaging 15-20 units per day. It's my firm belief that this is in great part due to the dietary changes we've made, which is what made me want to start this blog and share
this info with others.
This is a part of our individual experience, it is not the same for everyone. There are some diabetics who require as little as one unit of insulin a day, some who require
50 or more. In case you’re curious (I’m guessing since you’re reading this that you are!) the statistical average dosage is between .5 and 1 unit of insulin per kg of the person’s weight per day, but it really all comes down to what will keep the BG in range.
Since my type 1er is below average, we had to make some adjustments to the recommended calculation method and here’s why: When in the hospital here in ATL, they teach you to do the calculations rounding to the nearest unit and using the multiple daily injections
(MDI) regimen. So say my type 1er was going to eat 35 carbs at a time of day when his ratio is 1:60. 35 divided by 60 equals .58 units, so we would have rounded to nearest unit, or 1. Say his before meal blood sugar was 90, we’d smile, and breathe a sigh of
relief that it was well within range. Give him his meal and his insulin, and go happily about our business. 2 hours after dinner, he’s suddenly having a hypoglycemic reaction, even though he wasn’t running around, and his blood sugar is down to 60. What happened?
When we rounded to the nearest unit he would have been given an additional .42 units of insulin above and beyond covering what he was eating. Given that a single unit will drop his blood sugar 70 points, that additional .42 units drops it another 30 points
from 90 to 60. For this reason we decided to start rounding to nearest half unit for greater accuracy and more stable results. It worked really well and we continued with that until we switched to the pump which is capable of delivering a dose in increments
of .05 units. That was a major influencing factor in our decision since dealing in such teenie tiny amounts is so nerve wracking. It’s been really successful for us so far.
My happy dance
Had the annual checkup @ the endocrinologist today & got to do my happy dance when his A1c came back at 5.7 (the best it’s ever been).
What’s an A1c? It’s a measure of average blood sugars for the last 90 days (actually, technically it’s measure of the glycated hemoglobin in the red blood cells, from which the average 90 day blood sugar can be estimated). A 5.7 works out to an average
blood sugar of 117, which is awesome for a type 1er!
Bottom line: Don’t give up until you find what works best for you, and if you really love a certain food, find a healthy way to keep it in your meal plan.