[UomoNeroNero]

I have been diabetic for 20 years. I have tried every method, app, plan, and tool, including systems falsely marketed as "smart." No method works or delivers decent results except for using a scale and weighing ALL the ingredients. For a diabetic, eating "out" is always a roll of the dice. The "fun" feedback from post-meal blood sugar is always a reminder of how "eyeballing a plate" is utterly useless.

[foxyv]

It doesn't help that food manufacturers intentionally make it hard to measure nutrition from most of their foods. They play around with serving sizes to hide carbohydrates making you have to do math just to keep up.

Sometimes they will round down on grams of macros after setting the serving size so they can claim it has zero sugar when it does in fact have tons of sugar. Tic-tacs are the worst about this. They claim they have zero everything despite just being sugar tablets.

[vanviegen]

In the EU, food manufacturers are required to label macronutrients (and salt) in mg/100mg or mg/100ml for fluids. Easy to compare, works great.

[knifie_spoonie]

It's the same in Australia as well. I'm a bit shocked that the US doesn't have this.

[oniony]

But are you actually?

[foxyv]

This makes so much more sense than the labels in the USA.

[steveBK123]

US food labelling is insane.

For example - lactose-free yogurt is often just regular yogurt with lactase enzyme added.

If that's what I wanted, I'd buy regular yogurt and take a lactaid supplement.

[BoiledCabbage]

What other method would you deem appropriate for removing lactose from milk? A targeted enzyme that removes it seems pretty wise to me.

Since they're not gonna use tweezers, :) are you suggesting instead engineer or breed a special set of cows that don't produce lactase in their milk?

[steveBK123]

A better description would be "lactase treated" milk. In any case, I found consuming it regularly for breakfast still lead me to feel unwell over time.

However I can periodically consume dairy when I take a strong dose of lactase supplements.

From some literature it does appear that manufacturers can use "lactose free" even for non-zero amounts of lactose (10mg per 100g).

This is actually higher lactose density than many cheese varieties, especially considering I would be consuming say 150-200g of yogurt, whereas if I am eating cheese its in small careful quantity.

[barnabyjones]

A2 milk not only exists but is very popular in Asia actually. https://en.wikipedia.org/wiki/The_a2_Milk_Company

[UomoNeroNero]

Yes. I can find everywhere on labels the carb amount. I use 2 app too. And after a lot of errors I acquired a six sense (that try to kill me everyday ;-D)

[BobaFloutist]

My favorite example is that cooking spray advertises 0g of fat, giving a serving size of 0.33 seconds of spray

[krferriter]

I think this is one of the crazier ones. It's just canola oil! It's the same as spreading that much canola oil on the surface, the spray is mainly convenient because it spreads it out evenly for you without you needing to contact the surface. But Pam gets to put "0g fat" and "For Fat Free Cooking" on the side of all their cans.

[bluGill]

That might even be realistic if you are spraying a baking sheet - since you cover the whole thing. But if you are cooking pancakes and spray the pan after each one you get a lot of carbs.

[username135]

Alt tip: dont use any fat on the pan when cooking pancakes. Gives the surface that restaurant quaility, smooth evenness.

[bluGill]

Depends on the pan and pancake. Restaurants use a fair amount of fat in their dough so fat on the griddle isn't needed, if you make your own batter (as opposed to store bought) you can control this and reduce the fat such that you need to add some to the pan. The pancakes will of course taste different. In my case I'm making sourdough on cast iron - I've never figured out the trick to make the first couple not stick (whatever I cooked the night before affects something)

[username135]

True!

[hilux]

Carbs?

[bluGill]

Arrgghhh... Once more I wish I could edit things a day latter to fix all my stupid mistakes. (I blame is on diagnosed dysgraphia).

Oil is not carbs of course. I guess I meant fat.

[pkaye]

The rounding rule is carbs <0.5g can be rounded down to 0 and calories <5 can be rounded down to 0. But I have a feeling even if they properly labeled it without rounding, people would eat the whole pack of tic tac anyway.

https://foodlabelmaker.com/regulatory-hub/fda/rounding-rules...

[foxyv]

So you can just make the serving size so small that everything is less than 0.5g

[tart-lemonade]

The margins the FDA allows for class 2 and third group nutrients are also quite generous. I'm sure they made sense back when they were first introduced, but as food science has improved, the standards have not.

> The Food and Drug Administration (FDA) allows calorie content to exceed label calories by up to 20%

https://pmc.ncbi.nlm.nih.gov/articles/PMC3605747/

> Class I nutrients are those added in fortified or fabricated foods. These nutrients are vitamins, minerals, protein, dietary fiber, or potassium. Class I nutrients must be present at 100% or more of the value declared on the label

> Class II nutrients are vitamins, minerals, protein, total carbohydrate, dietary fiber, other carbohydrate, polyunsaturated and monounsaturated fat, or potassium that occur naturally in a food product. Class II nutrients must be present at 80% or more of the value declared on the label.

> The Third Group nutrients include calories, sugars, total fat, saturated fat, cholesterol, and sodium. [...] For foods with label declarations of Third Group nutrients, the ratio between the amount obtained by laboratory analysis and the amount declared on the product label in the Nutrition Facts panel must be 120% or less, i.e., the label is considered to be out of compliance if the nutrient content of a composite of the product is greater than 20% above the value declared on the label.

https://www.fda.gov/regulatory-information/search-fda-guidan...

Edit: Expanded the quotes to include definitions.

[yellow_lead]

Plus the whole sugar vs. sugar alcohol nonsense, which I still don't completely understand.

[freedomben]

IANA nutritionist or expert at all in this area so take this with a grain of salt, but my understanding from looking into it is that the sugar alcohol doesn't break down in digestion and isn't absorbed, that's why the "carbs" from sugar alcohol "don't count."

I would recommend taking it easy on the sugar alcohols even though they "don't count" because they can cause significant gas ;-)

[foxyv]

It depends on the type. Some are partially digested as carbohydrates. Others are not. You can look up their individual Glycemin Index.

https://cdn.shopify.com/s/files/1/0261/4761/8864/files/Scree...

[rini17]

And some like xylitol are highly toxic to dogs, must be careful around them.

[freedomben]

Indeed. My dog loves the dissolve-on-your-tongue melatonin, but it is super deadly to her because of the Xylitol. I keep it on a high shelf now and am very careful to pick up any pieces that might get dropped. She made it through, but that was a terrifying few days D-:

[MisterTea]

I also hate the games they play with labeling such as "no sugar added." Bought a cherry pie from a local market labeled "no sugar added" thinking it was going to be extra tart only to take it home and taste sugar. Reading the label it listed sugar alcohol which I learned can cause gas and bloating in some people, which I soon found out. Once slice had me doubled over with gas pains a whole night and shit my brains out the next day. I got my money back for that piece of garbage pie. I want to punch whoever thought no sugar added means fuck all...

[Dylan16807]

Sugar alcohols seem simple enough to me. The properties vary but they generally have fewer calories per gram and a low glycemic index, and some of them are much sweeter per calorie.

[interludead]

And I think there's also a psychological angle here, for instance when people see that something claims to be zero sugar or low carb, it can trigger a sense of relief or permission to indulge.

[madrasman]

I worked at Noom and the most successful users weighed the ingredients. Many users were frustrated about not losing weight even with calorie deficit, but the issue was they weren't logging accurately or skipped logging snacks and meals that were clearly not good.

[je42]

What works well is to measure the same food multiple times in a container (every time same volume ).

after a while you can estimate carbs by visually inspecting the contents without scale.

Add to that automatic bolus by a semi closed loop system to correct for errors, you can achieve good results with minimal effort.

[yapyap]

I’m rather unknowledgeable on diabetes, so here’s a question that may seem basic:

does choosing healthier meal, a salad instead of sweet ribs, not suffice for a good blood sugar?

[skyyler]

So, first off, commercial salad dressing almost always has sugar in it. Look at the nutritional facts label next time you're shopping for it. There's a few brands that offer "simple vinegar and oil" style dressings that don't have any sugar in them, but MOST salad dressings Americans come in contact with are full of sugar.

Even low GI foods still cause blood sugar to raise by some amount.

All of the vegetables in the salad have carbohydrates that will raise blood sugar. Carrots, onions, tomatoes, all of that will raise blood sugar. Croutons? Blood sugar.

Obviously selecting a garden salad with no dressing is a healthier choice than "sweet ribs". Most diabetics (that are managing their condition) are not going to be ordering things with refined sugar in them.

Where things get tricky is asking questions like "what's healthier, a honey-miso glazed salmon with brown rice or a salad with croutons and a honey and berry dressing?" or "What's better for you, grilled chicken with a sugary barbeque sauce or fried chicken with no sauce?"

[ryan-richt]

Also watch out for "sugar by another name" ... pineapple puree, white grape juice/concentrate, apple juice/concentrate are very common commercial dressing ingredients to load up on sugar.

Sure always ask for the vinaigrette eating out, but at home make your own salad dressing:

* get a mixing bowl big enough to toss salad in, and a whisk * add 1T dijon mustard, 1T not-balsamic vinegar (balsamic is high sugar! I like sherry or beer vinegar), salt & pepper * drizzle in 1T olive oil while rapidly whisking. * Add 3 oz or more salad, toss, done for 2 servings

[Scoundreller]

I just use old dijon bottles with a bit left in it to get the rest out and shake the heck out of it but I go through a lot of mustard.

The lengths I’ve seen brands go To avoid having sugar as their 1st or 2nd ingredient…

after that you have invert sugar, corn syrup, molasses, brown rice syrup etc. as following ingredients…

[sgerenser]

A few years ago organic/natural products were marketed as containing "Evaporated Cane Juice" (aka Cane Sugar) but my understanding is the FDA put an end to that one.

[reubenswartz]

Making your own salad dressing is really easy and let's you have a salad you really like in a couple of minutes.

My recipe is basically what you have here, although I usually mix some balsamic and other vinegars, and add a bit lemon juice.

I went from feeling sorry for people who were "forced" to eat salads to craving them. (Side benefit of not having the afternoon urge to sleep.)

[barbazoo]

> commercial salad dressing almost always has sugar in it. Look at the nutritional facts label next time you're shopping for it. There's a few brands that offer "simple vinegar and oil" style dressings that don't have any sugar in them, but MOST salad dressings Americans come in contact with are full of sugar.

Making salad dressing is really easy btw in case anyone wants to try. Often all you need is olive oil, vinegar, salt and pepper and you're set for most salads. Even a restaurant should be able to whip that up.

[skyyler]

If you have an immersion blender, making mayonnaise without sugar in it is very easy:

https://www.seriouseats.com/two-minute-mayonnaise

(And it tastes way better than commercial mayo!)

I love this author's recipes; it's the opposite of the normal recipe-preamble-slop. All of the stuff before the actual recipe is relevant information. In more complex recipes, he goes over the testing and process that led to the finished recipe. It's a wonderful view into the world of recipe creation.

[barbazoo]

Awesome, I'll give that a try. What I like about it is that you can use whatever high quality eggs you normally use instead of the cage eggs that mass producers will use. Until now I had to resort to vegan mayo.

[glandium]

"If you have an immersion blender"

You can also make mayonnaise with a whisk.

[skyyler]

Yes, you can make mayonnaise with a whisk.

It's so much easier to do it with a hand blender though. It takes longer to clean up afterwards than it takes to make. And no maintaining a steady thin stream of oil, you just put it all into a container and blitz it.

You can make meringues and cakes with a whisk, too, but most people I know have electric mixers for that.

Mechanical eggbeaters with little flywheels were popular before the electric ones, too!

[nottorp]

> Often all you need is olive oil, vinegar, salt and pepper and you're set for most salads.

Why do you need a "dressing"? In my corner of Europe they put the above by default on every restaurant table and the salad has nothing in it (or maybe a tiny bit of oil and vinegar), you adjust it to taste.

The only places that offer salad "dressings" are american inspired and even those mostly serve it separately so you can ignore it.

[BobaFloutist]

For the same reason you add some spices before cooking, and salt multiple times throughout a recipe.

Plus, it's a little hard to emulsify or even suspend the oil and vinegar right there at the table.

[barbazoo]

> or maybe a tiny bit of oil and vinegar

That's what I mean by "dressing". We're talking about the same thing.

[nottorp]

Ah well, above us they seem to call mayonnaise and other fat and high calorie stuff "dressing"?

[stretchwithme]

I buy a salad kit at Trader Joe's. It has sugar in it. And I buy arugula and make 4 salads out of that one salad. I add a dash of olive oil and pecans. And end up throwing out 1/3 of dressing that came with the salad.

So I get some of the sugar sources in the kit. Just smaller amounts.

Otherwise, I just use olive oil and balsamic vinegar with arugula, pecans.

Arugula is a good source of nitrates, which are good for nitric acid.

[steveBK123]

Not a diabetic but adult later onset lactose intolerant and the problem is you really have NO idea what restaurants put into stuff, even if you ask.

Even a stupid salad, what's in the dressing, what's in the bread/croutons, what was the meat glazed with. Etc.

Restaurant food tastes good because it is generally unhealthy top to bottom, with quantities of salt, butter, etc no sane person would use at home.

One thought experiment - when was the last time you ate out and needed to add salt to anything? Now thing of home cooking how often you might add a little salt while you are eating.

The easiest thing to do is ruling out restaurants entirely, but then that's rather anti-social.. Not to mention family/friends gatherings, etc.

[UomoNeroNero]

Things are changing nonetheless. My wife is celiac (we’re quite a problematic family: I’m diabetic, she’s celiac), but by law, she is guaranteed that a suitable menu must be available wherever she goes, or at least that waitstaff and business owners know how to handle the situation when she informs them. (I know for a fact that managing celiac disease and the most severe and dangerous intolerances is a mandatory requirement for obtaining a business license.)

[steveBK123]

I think in the US, it's basically an intractable problem the way restaurants operate and are staffed. Low margin, high failure rate businesses with many fly by night small operators. Front of house staff is high turnover, while back of house staff is largely non-English speaking of sometimes questionable immigration/work permit status.

And then there is the supply chain since most restaurants are not cooking every single part of every meal from absolute scratch ingredients.

There was a story about a woman near us operating some sort of celiac friendly/gluten free bakery. One day the donuts were delivered and she noticed some D shaped sprinkles and realized her supplier had come up short and just put some random Dunkin Donuts into the delivery. Good on her catching it, but how in good conscience could she operate a bakery advertising itself as celiac friendly/gluten free if she was outsourcing like this?

If I had any sort of food allergy that could result in hospitalization or death, I'd just stop eating out. I'd rather be a little boring than very dead.

[throwway120385]

Why would you run a bakery and not make donuts yourself? They're dead simple if you have a fryer.

[aziaziazi]

I didn’t know their simple and will try. To answer your question, perhaps donuts aren’t her main product, for me it’s more about pastry which is a side bonus for bakeries, thought if I go to a personal shop I expect 95% hand made products but that my differ depending on the culture (I’m not from the US). Also they may be just cheaper (taking into account your time)

[pixl97]

>does choosing healthier meal,

For a type 1 diabetic, no (gets more complex with type 2).

Your body produces insulin at a basal rate.

https://en.wikipedia.org/wiki/Basal_rate

If you're healthy between the pancreas and the liver you maintain homeostasis and things are fine.

As a T1D you don't get that base rate, so your blood sugar will mostly trend up and stay high, even without eating anything. You simply have to get more insulin to avoid burning out all the systems in your body and dying slowly.

[UomoNeroNero]

Is a really complex game. The basic reasoning is that for every X carbohydrates ingested, you need to inject Y insulin (according to a personal ratio).

However, everything is complicated by numerous factors and the technology you use.

Factors: how you feel, stress, exercise, what you ate in previous meals, your blood sugar level at the start of the meal, and the activities you’ll engage in after the meal (physical or mental).

There’s also the issue of how you administer insulin.

In Italy, up until 3-5 years ago, most of us were using the “multiple daily injections” method, which involved taking a dose of “long-acting” insulin (lasting 24 hours) as a “base” and using “rapid or ultra-rapid” insulin at meals. Clearly, this approach provides limited control and requires a VERY habitual lifestyle (you can’t skip a meal; the long-acting insulin keeps working regardless).

Now (at least here in Italy), we are all transitioning to or already using CGM systems, which are more or less intelligent systems that continuously administer insulin at a “medium” rate. Based on input from the patient regarding the predicted amount of carbohydrates (and fats) they will consume, the system calculates the best strategy for what is called the “meal bolus” (using strategies like multi-phase, direct, etc.) and at the same time, it maintains a continuous but adaptable level of injection to achieve a target blood sugar level (day and NIGHT!!)

In essence, it’s a very nerdy way of dying slowly (hopefully as slowly as possible).

È un mondo difficile E vita intensa Felicità a momenti E futuro incerto

[aziaziazi]

> È un mondo difficile E vita intensa Felicità a momenti E futuro incerto

I was curious, for the other curious:

"It's a tough world And intense life Happiness in moments And uncertain future"

[UomoNeroNero]

Diabetes is a complex and mentally demanding disease. It affects you in the short term and has a significant impact in the long term. Everything is in your hands, fully aware that every mistake has immediate consequences but, worse, accumulates over time. That phrase (from this song) perfectly capture the mental state of my 20 years living with the disease. No tragedy (there are worse things), just deep awareness.

https://m.youtube.com/watch?v=cu3K1njbYqs

[Yizahi]

Salad is great for diabetics. The problem is everything else:). Like for instance I've discovered that 99% of all rice is extremely bad, even good pasta is bad, potatoes are poison, bread also bad, and the list goes on. Fruits are bad too.

Cooking at home can be managed, and still heavily limiting. Eating out is a nightmare. First of all there are no "diabetes" places in the similar style to "vegan". And eating in a restaurant with at least some diabetes friendly selection of dishes is hard. For example there are may be 4 soup dishes. But 3 of them or even all will have either potatoes or pasta as ingredient (and leaving out said ingredient makes for a very mall meal, because those are often added to compensate). Salad section - the same issue, too often they have sweet syrup added for flavor. Anything Asian has rice or noodles in large quantities (I often wonder what diabetics in Asia eat). Second course dishes like meat or fish also sometimes contain sweet "surprises". All in all it is very hard task to find something, in a big city even.

[skyyler]

> First of all there are no "diabetes" places in the similar style to "vegan".

AOL keyword: “keto”

low carbohydrate foods are currently trendy but they’re not called “diabetic”

[ksenzee]

This depends on a lot of factors. There are some type II diabetics like this: they might need insulin after a meal with a high glycemic index, but not after a meal with a low glycemic index. There are some type II diabetics with more advanced disease who need insulin after eating anything. Type I diabetics entirely lose their ability to make insulin, which is why the disease was fatal before insulin was discovered, no matter what the kids (it was almost always kids) ate or didn’t eat. As a general rule, it is inaccurate to equate diabetes with unhealthy eating. The Venn diagram only overlaps.

[joseda-hg]

Healthier isn't a good metric, A carb heavy salad will probably be worse than those protein heavy ribs by themselves (Maybe the rib sauce will tip you over, or maybe you will use a salad dressing that put any "healthiness" to the test)

[barbazoo]

That sounds really hard. Is the purpose of determining the amount of food so you can adjust the amount of insulin? Sorry, I don't know about the day to day of living with diabetes.

[lukeschlather]

Yes, diabetics need to precisely adjust their insulin intake in proportion to carbohydrate intake.

[Jarmsy]

Also when figuring out how much insulin is needed for a given amount of carbs you need to factor in the type of carbs, your individual response to that type of carbs, what fats/protein/fiber you eat with it (fats and fiber tend to slow down the BG rise from carbs, protein can cause a rise when eaten on its own but can also slow down the rise from carbs), what time of day it is (I need around double the amount of insulin for the same food first thing in the morning vs in the afternoon), your mood, what else is in your stomach already, the weather (hot weather can greatly increase insulin sensitivity), your current fitness level, what physical activity you have done over the last day or 2 and what you will do over the coming hours, where on your body you inject, if you are fighting any illness…

[not2b]

For my wife (type 1 diabetic), physical activity is the big one that throws off her calculations as a walk in a hilly area makes her blood sugar drop like a rock. Of course she always has something with sugar with her but then she has to figure out how much to consume.

[Jarmsy]

Hill walks are particularly challenging for me too. I can do rowing or weightlifting with my sugars staying fairly stable or rising if it's really intense, but something about walking steadily up a gentle slope makes it drop massively. There was some interesting research a couple of years back on how exercising the calf muscle is particularly effective at lowering BG, perhaps that has something to do with it https://pmc.ncbi.nlm.nih.gov/articles/PMC9404652/

[pixl97]

Yea, as a T1D myself the amount of insulin I need is massively different from days I'm arguing on the internet compared to days I'm up doing physical exercise. Things get concerning really quick when you're a distance from anything and your glucose starts dropping.

[pixl97]

When you eat, depending on the glycemic index of the food you're consuming your blood sugar starts immediately going up and can quickly peak at dangerous numbers if the food is sugary.

A diabetic will want to take dose of insulin a bit before eating in order to send their blood glucose level on a lowering trend. If you dose it right the two waves semi cancel each other out and your blood sugar goes up some, but hopefully not a huge amount.

If you get the dose wrong, it drops dangerously or rockets up and you have take correction doses.