Question about carb counting

Okay I am type 1 on a pump and have been doing carb counting for yrs on end and now I was just recently hospitalized for a low low bg under 20 mg/dl and was passed out thank God for my diabetes tattoo it really helped them help me. but while speaking to the doc and diabetes educator I found that I was sopposed to be subtracting half my sugar aclcohol from my carbs along with fiber which with the fiber I do but not the sugar A. so I got home and looked at all the foods I eat and no box shows sugar A. just sugar so how do I know the sugar A if it is not listed? or what type of foods would have this in it? this of course was not the sole reason for the low as I had two kidney stones and a kidney infection and nausea and vomiting so that all was a big factor but when we went over my knowledge of foods and carbs and everything assoc. with my pump I was amazed that I didn’t know this about sugar but she was suprised I knew everything else to the T but I am very OCD about being healthy so it was no wonder to my doc. so help me out here guys where is the info i seek and besides fiber and sugar alcohol does anything else need to be subtracted? I do take into account fat content and protien due to the longer amount of time it takes to raise my sugar so I alway square wave bolus for those but other then that I am stumpped I did not know this

Foods with sugar alcohols show on the label as sugar alcohols, so the packaged foods you’re eating don’t have sugar alcohols. Sugar alcohols can be in any sugar-free food, but mostly they’re in chocolate, ice cream, candies, gum & some baked goods. Anything ending in a “tol” is a sugar alcohol–sorbitol, maltitol, xylitol, etc.

Some people actually metabolize sugar alcohols just like sugar. In others, they pass right through without being metabolized. Excess sugar alcohols can cause gas, bloating, diarrhea.

Other than sugar alcohols & a portion of fiber, there’s nothing else to subtract. Unless the grams of fiber is close to the number of carbs, I don’t subtract it. Most nutritional labels aren’t accurate to begin with. I’ve not found that subtracting fiber makes any difference unless it’s super high fiber. Some people say to only subtract 1/2 the fiber if it’s over 7 grams & not to bother subtracting at all if it’s under 7 grams.

You taught me about sugar alcohol. Thanks.
In Think Like a Pancreas, Gary Schindler says you subtract fiber if it is above 3 grams. I am not sure who is right. Just food for thought, or discussion. = )

Basic carb counting crudely ignores both sugar alcohol and fiber. In fact, it ignores the glycemic index. I have Gary Scheiner’s book “The Ultimate Guide to Accurate Carb Counting” which goes into a lot of detail on this subject. The unfortunate situation is that carb counting is like religion, every has their own method. Dr. B tells you to not subtract fiber for instance. As Gerri explained, there are various sugar alcohols, if you know which kind you have, you can “guesstimate” from the glycemic index the effective net carbs. Schiener also has a method that lets you use total calories, subtracting calories from listed nutrients to estimate hidden carbs from things like sugar alchohol.

In the end, once you get down to that level of detail, it becomes just as important to understand your own personal response to different foods. Some people react to sugar alcohols as though they had a glycemic index of 100 (just like sugar), while others could eat a cup of the stuff and not ave their sugar budge. So you might find it useful to just buy a bunch of different sugar alcohols and see how you react. Remember, as Gerri notes, for some, sugar alcohols are a gastric disaster.

dude you and me both I have had them for yrs no matter what diet changes I do or how much cran juice or water I drink they never seem to stay away! I will say I apperently didn’t care too much about my BG since I passed out and all! and even when I woke up all I could do was fight the nurse so I could ball up but no she wanted me stright but the doc has had stones before so he hooked up on the pain meds and I was a happy camper till they broke the stones up for me. I so wanted to die! I swear I really debate having a kid now I tell my husband there are kids without homes lets help them.

OMG. We have been dealing with T1 since 2003 and not one CDE as ever gone into that much detail about counting carbs. Tyler is very lazy and does not even bother to count the carbs half the time he eats. He just guesses and puts in what he thinks is right. I am still working with him on this, but when his is away, it is all him. The reason for his hi’s and lows are because he waits till the pump is empty before he changes his site or will go all day without checking himself. Nothing like coming home and finding his meter sitting on the counter while he is at school! Is it really that complicated? There has to be an easier way.

It really depends. If you are working on a very low carb diet, then those details will matter. Did you know that there is 0.5 g of carb in an egg?

You know I was much like your son when I was his age I felt like if others didn’t have to do it then why should I. It got to the point where my parents took over my care and the school nurse did while at school and I missed out on lots of things since I could not go anywhere without a parent and it became evident to me real fast that either I start taking care or I am really going to miss out.