Carbs vs. Calories: Don’t Be Out to Lunch!

This video throwback was recorded in 2015, but Dr. E’s advice still holds. It’s important to consider both carbs and calories when making food choices to support diabetes management, and here he shares some of his favorite foods and meal ideas that are filling, easy to prep, and check both boxes of low carb/low cal.

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    Give us suggestions for vegetarians while balancing the calories from fat

    • Hi Indira, one of the dietitians we work with suggested that you may want to visit with an RD (registered dietitian) or nutritionist so they can offer examples and resources for your individual tastes and dietary restrictions. Even one appointment can be very helpful and many dietitians are doing virtual visits these days. If you would like a referral, Janice Baker is an RD we have worked with for years. You can reach out to her directly at

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    I had great numbers until I had to go off Metformin. Now I am really watching my diet. I was having diarrhea really bad recently so went to the gastroenterologist who asked if I was on Metformin and I was. He asked me to stop for 10 days and the diarrhea stopped. He said the makers of Metformin changed the ingredients so he is seeing a lot of folks with Metformin diarrhea. My endocrinologist doesn’t believe Metformin can cause diarrhea so he said stop it for 2 months then go back on and all will be fine.
    Please advise me re Metformin

    • Metformin commonly causes diarrhea. There are so many other good medications you could use instead that you should speak to your caregiver about. Some examples are: DPP-4 inhibitors, SGLT inhibitors, and GLP-1 RAs. Some people who experience diarrhea on metformin are changed to the long-acting metformin which sometimes helps, but not always. I have seen many patients who are extremely sensitive to any dose of metformin in terms of developing diarrhea. With these new medication options though there’s no need for you to suffer.

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    Thanks! Good to remind self..I was told 4 yrs ago when diagnosed to count carbs (30 a meal) and would have this…fast forward to this past year and I discovered the keto marketing and bought into all the low carb treats…and have put on 15 lbs. Holy Moly! What a dummy…lessons learned, another sucker born!

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    I just found this site a couple of days ago and not only do I love this site so far; but, everyone here is really funny. An old and wise friend of mine, when dealing with the many stresses of getting older (she was taking care of her husband who had developed Alzheimers) just said, “You have to laugh. It’s as simple as that.” I have found that to be so true. I do the same with my diabetes. Sure, I take it seriously, but I also laugh.

    In the first weeks of using the pump; my wife and I learned to painstakingly measure the carbs. We are both amateur foodie chefs (cooks) and a lot of our dishes are well… complicated. Initially we made many mistakes, many mistakes.. mostly forgetting what we learned about counting carbs at first. Forgetting to Tare the weight, you name it. We had to laugh. One meal, we don’t know what we did wrong; but, when we had the total carbs for the meal; I just looked at it overall, and intuitively I said, that is *way* too high. So, she fretted, but, I laughed, after all we couldn’t break it down to measure the carbs.. but, I am fortunate, as a science guy, to have this intuitive gut feeling about measurements. I said, I’m only claiming half the carbs… and I’ll adjust. It was a good call; I wasn’t off by much. She is now learning to laugh along with me.

    Perhaps not the place; but, the one thing she had a hard time grasping, when cooking, was, for each dish… we don’t need to know the weight of anything. We just need to know the carbs for each ingredient. For the tiny stuff, like most seasoning that’s very low… I’ll just add in a carb now and then for every 2 or 3 things. In the end, all we had was a total carb for reach dish.

    I’m not sure why that was difficult for her; but, we… with a lot of love, and a bit of laughter.. she trusted me; and it all worked out. Some people seem to get hung up on the process, which is complicated, and trying to figure out how many carbs are in it. The two are unrelated. Get the total carbs for the dish, then weigh it afterward. What we realy needed is carbs/gram for anything we cook. Of course, this also depends on how evenly things get mixed; but.. and one has to laugh. No matter how hard one tries to determine the exact carbs; often it’s going to be either neigh impossible, or so complicated it will take out all the joy. Like many, I’ve learned to adjust. When in doubt, I’ll bolus on the low side, and adjust when needed. I think this might be called stacking; and, well, ok; but, I don’t just do it willy nilly. I Usually know, how conservative I have been, and since my pump will try to auto correct for me… it’s not a big deal to figure out a value that will work. It feels like cheating, telling it I have eaten something (carbs) when I have not; but, it’s just the carbs I didn’t enter, minus the carbs the pump corrected already… and again, I will add on the conservative side. I can always adjust again. Just remember to laugh along the way.

    We don’t really worry much about calories, yet. So far, I’m actually losing weight. Which right now is OK. If the dish is filling, and enjoyable, that’s what’s important. Since I needed to lose weight, it has been working out. Of course, we eat foods healthy for us; and except for a bit of flavor, we trim or don’t use any fat… within reason. I eat a moderate portion, and for me the guide is… if I’m still hungry 20 minutes later… I can have seconds. So far, it works well on losing weight side; but, now I’m getting close to my desired weight; I’m just increasing the portion sizes a little, till I find the tipping point.

    I want to add, that I think the reason this works for us is really because we do choose to eat in a healthful way. A well balanced meal is important to us, as well as taste, the right spices will fix almost anything. But, the most important factor is to enjoy, and laugh along the way. For the rest, make minor adjustments; learn what works and what doesn’t; and live accordingly.

    I’m 67 years old, not very active due to injuries of the past. I once weighted 380+ pounds, and now weight 240 lbs. and… I like to laugh!

    Thank you all for this fine site; and thanks to your viewers for their often funny anecdotes. 🙂

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