Carbohydrate counting has long been the go-to strategy for people with Type 1 diabetes to match insulin to food. And while it can be helpful, it’s not always enough. Many people still experience highs, lows, or unpredictable results even when they count carbs carefully.

Here’s why carb counting doesn’t always tell the full story and what other factors may need to be considered.

🍽️ Not All Carbs Act the Same

Counting total carbs doesn’t always reflect how quickly or dramatically those carbs will impact blood sugar. For example:

• Simple carbs like juice or white bread spike blood sugar faster than complex carbs like lentils or quinoa

• Liquid carbs digest faster than solid carbs

• High-fiber carbs may have a more gradual effect

Focusing only on the number can miss these important differences in glycemic response.

🥩 Fat and Protein Change the Game

Meals with significant fat and protein can delay glucose spikes. A cheeseburger might contain the same number of carbs as a bowl of pasta, but the mixed nutrients slow digestion, causing blood sugar to rise hours later instead of right after eating.

This delayed effect can:

• Cause a post-meal low followed by a high

• Make standard insulin timing less effective

• Require extended or split boluses if using a pump

🕒 Timing and Activity Matter

Even with accurate carb counts, insulin response can vary based on:

• Exercise: Movement can make insulin work faster or increase sensitivity

• Sleep deprivation: Can cause insulin resistance

• Stress: Triggers hormones like cortisol that raise blood sugar

• Hormonal shifts: Menstrual cycles, puberty, and illness can all impact response

Counting carbs without considering these external factors may lead to dosing mismatches.

📉 Glucose Trends Offer Better Clues

CGM data gives insight that carb counts alone cannot provide. Real-time feedback helps answer:

• Is this meal causing delayed spikes?

• Are corrections working as expected?

• Are you frequently going low after high-fat meals?

Understanding glucose patterns helps fine-tune insulin strategies beyond just matching carbs.

🧠 What Can You Do?

• Track more than just carbs: Log protein, fat, stress levels, and sleep

• Use CGM to identify patterns: Look for post-meal spikes or overnight shifts

• Consider adjusting insulin timing: Pre-bolusing or extending boluses may help

• Work with a provider: A diabetes specialist can help analyze patterns and recommend adjustments

• Stay flexible: Your needs can change with age, activity, and hormones

📋 Ready for a Personalized Insulin Strategy?

📅 Book a consultation to review your food logs, insulin timing, and CGM data together.

Carb counting is just one part of the picture. With the right support, you can move toward steadier numbers and more confidence with every meal.