Update:
So I wrote this post a while back and I feel that it’s not nearly the catastrophe that I was initially shocked by. True, some things are a bit off par to what I have learned, but time has allowed me to see that the things I have learned in US help me survive as a diabetic.
Now, I’m more concerned about spreading what I have learned in the US with other Japanese type ones. I think that through this avenue, I can hopefully reach out and help other type one that might be stuck in an monolithic view of T1D treatment.
Anyway, on to the main post from last month…
So I asked a bunch of people last month about carb counting here (Carb Counting Insight - #17 by Terry4) and I got a lot of responses. I did this mostly to prep myself for an upcoming meeting with Endo in Japan. I did a bunch of digging before hand and learned how diabetes treatment in Japan is so very different from the US. I get a bit unnerved when I heard that this country is behind the 8 ball, and I can only wonder what people with diabetes in Japan deal with on a day to day basis.
This was the first time to be seen by a doctor in Japan for diabetes, and I really wanted some sort of informal consensus on what carb counting was to those of us in West.
I found it really strange coming out of the nutritionists’ office, getting an explanation of what carb counting was contrary to what I learned in the US. I was basically told that carb counting is ‘diabetic exchanges’ in disguise (and they told me the only difference between the US and Japan is that the exchange in Japan is 10g carbs = 1 carb exchange whereas 15g carbs = 1 carb exchange in the US).
Some surprising highlights from the carb counting class was that all vegetables, sans squash and a few others are ‘free’. That pasta raises blood sugar slowly, and that a serving of beer is always one carb (10g carbs…). The ‘classroom’ included a table filled with wax fruit and vegetables… portion sizes of the vegetables were surprisingly small… I knew the answer I was about to get when I asked about broccoli- that I typically eat 100-150g of broccoli. I was told that it is still ‘free’ (and not count it…)
When I asked about dietary fiber, I had this feeling that I was going to be told to subtract thing like fiber when carb counting… Never once have I heard not to subtract fiber from a carb count. never… until last month. It’s not like Japan uses ‘net carbs’- they just don’t subtract fiber completely. What doesn’t help is that most food labels do not include dietary fiber in Japan. This includes foods high in fiber, such as peanut butter, beans, etc…
So, as for myself, I’m sticking to what I learned in the US (and on this forum), but I’m wondering if anyone has experienced anything quite like this. Are there any other -developed- countries that seem to be faltering T1D care?