5 Myths about Diabetes and Nutrition (2 Part Series)

Clint-Cullins,-RDBy Clint Cullins, RDN, LDN, Licensed & Registered, Dietitian Nutritionist

Part II

4) I need to count carbs

Managing diabetes often feels overwhelming—especially when it comes to food. One of the most common recommendations people hear is: “You need to count your carbs.” But is carbohydrate counting truly necessary for everyone with diabetes? The answer depends on the type of diabetes, treatment plan, and individual goals.

Carbohydrates have the most direct impact on blood glucose levels. When you eat foods containing carbs—like bread, rice, fruit, milk, or sweets—your body breaks them down into glucose. For people with diabetes, managing that rise in blood sugar is critical.

Carb Counting for Type 1 Diabetes

For people with Type 1 diabetes, carb counting is often essential. Since the body produces little to no insulin, individuals typically use insulin injections or an insulin pump.

To dose insulin accurately:

  • They calculate the grams of carbohydrates in a meal.
  • They apply an insulin-to-carb ratio (for example, 1 unit of insulin per 10 grams of carbs).
  • They adjust for current blood glucose levels.

Without carb counting, matching insulin to food intake becomes much harder and can increase the risk of high or low blood sugar. For this group, carb counting is usually not optional—it’s a core tool.

Carb Counting for Type 2 Diabetes

For people with Type 2 diabetes, carb counting may be helpful—but it isn’t always necessary.

Many individuals with Type 2 diabetes:

  • Still produce insulin.
  • Manage their condition with lifestyle changes and/or oral medications.
  • May not require precise insulin dosing.

In these cases, strict carb counting may not be required. Instead, approaches such as:

  • Portion control
  • The plate method (half vegetables, quarter protein, quarter whole grains)
  • Reducing refined carbohydrates
  • Focusing on fiber-rich foods

can effectively improve blood sugar control without detailed tracking.

However, for people with Type 2 diabetes who use mealtime insulin, carb counting often becomes more important. For those who choose to manage their diabetes without medications, carb counting is often helpful at ensuring that specific carb goals are achieved throughout the day.

 

5) I can’t have my favorite foods

Many people think that having diabetes means you must stop eating all your favorite foods. I am here to set the record straight by saying “That is not true!”.

People with diabetes can still enjoy foods they love. The key is balance, not giving up everything.

Diabetes means your body has trouble using sugar. Because of this, it is important to watch how much and how often you eat certain foods. But no food is completely “off limits.”

For example, you can still have a cookie, a slice of pizza, or a small dessert. You just may need to:

  • Eat smaller portions
  • Not eat these foods every day
  • Balance them with healthier foods like vegetables and protein
  • Try alternative recipes that are more diabetes friendly

It is also helpful to pair “treat” foods with healthier choices. For example, if you want a slice of birthday cake, you can have a small serving with your meal instead of after. Try to make sure the meal is lower in high carb foods and choose fiber or protein-rich options to help your body handle the sugar better.

Living with diabetes does not mean life without joy. Food is part of our culture, can be comforting, used to express love, a source of bonding, and overall should be enjoyed. With mindful choices and thoughtful decision making, people with diabetes can still enjoy a wide variety of foods.

Remember: You don’t have to give up your favorite foods. You just might need to enjoy them in a more healthful way.

Living with diabetes can feel overwhelming, but support and connection make a real difference. By learning, sharing experiences, and staying informed, you can build confidence and take control of your health.

Join our upcoming diabetes support group meetings to ask questions, share tips, and connect with others who understand. Whether you’re newly diagnosed or experienced, your voice matters.

Our next meetings at the Orofino clinic are April 6 and May 4 at 4pm—we hope to see you there!