Carb Counting Isn't Just for Newbies: A No-Judgment Refresh for Veteran T1Ds

Madi Cheever, MPH, RD, LDN, CHES - Registered Dietitian Nutritionist & Type 1 Diabetes Expert Coach

You’d think that after a decade (or two, or three, or four) with Type 1 diabetes, you’d have carb counting down to a science. You should be able to eyeball a plate of food like a boss, confidently whip out a bolus, and glide through meals without a blood sugar blip… right?

But here’s the thing I see all the time AND something I’ve gone through myself:

Veteran T1Ds who know “enough” about carb counting to survive… but not necessarily to thrive.

If you’ve been diagnosed for years and feel like your carb counting is more “instinct” than “intentional,” you’re not alone, and it varies. This blog is your no-shame, totally realistic refresh — because your body has changed, your food has changed, and frankly, nutrition science has too.

Let’s do a dive into the common gaps, outdated habits, and small shifts that can make your carb counting actually work again.

You’re Not Failing — You’ve Just Been Eyeballing It for a Long Time

Let’s start with a reality check: there is no award for “most intuitive boluser.” (If there were, I’d nominate myself circa 2016.)

When you’ve had diabetes for years, it’s normal to develop a rhythm where you stop actively looking up carb counts. You think you remember what that wrap has. You think you know the portion you usually eat. And maybe you do… kind of… probably…

But subtle drift adds up.

Portions get bigger. Formulas change. Your favorite go-to foods from ten years ago have been reformulated three times and now have 6g more sugar per serving. That’s not your fault — but it is your problem if your blood sugar is spiking.

Why the Carb Count You Think You Know Might Be Wrong

Carb counts aren’t carved in stone. And sometimes, the counts we learned years ago are… well, strategies of the past.

Here are a few reasons your “default numbers” might be off:

• Food companies tweak their recipes — even something like a granola bar may vary in grams of sugar or added fiber, or protein supplementation in the year 2025.
• You’ve changed your portions — what was once “1/2 cup rice” may have become “¾ cup.”
• Cooking methods matter — roasted vs. steamed sweet potatoes, al dente vs. mushy pasta couldddd have an impact.
• Food labeling laws have evolved — and the net carbs vs. total carbs conversation still confuses people. (HINT: read the nutrition label, not the nutrition marketing). 

I’ve had clients swear they were counting accurately — but a quick audit can reveal hidden carbs, especially for mixed meals.

The Restaurant & Homemade Meal Struggle Is REAL

Let’s talk restaurants — because no matter how confident you are, unless you’re eating at the same 3 spots and measuring your sauce on a digital scale you brought from home (yeah right), carb counting here gets weird fast.

• That burger looked small… until you got a 220 spike 30min later.
• That “gluten-free, grain-free” bowl had honey in the dressing.

Same goes for home-cooked meals. If you’re not measuring the pasta or tracking the hidden sugars in that sauce you love, it adds up (2 carbs is “free” for many of us, but 2+2+2+2+2 is where issues can occur).

BUT, we don’t need to become obsessive (at least that isn’t the goal). We DO need to get real about uncertainty and build a better strategy, or at least a better buffer.

Hidden Carbs You Forgot to Count

Let’s make a quick list:

• Cooking oils with added sugar (yes, they exist)
• Marinades and sauces (teriyaki is notorious for this)
• Fruit in savory dishes (I’m talking to you, cranberry & candied walnut salad)
• Milks or alt-milks in your caffeinated beverage of choice 
• Gum, breath mints, or “sugar-free” sweets that still spike blood sugar

These might seem minor, but for those of us with sensitive insulin needs or low thresholds for correction, 10g here and 7g there becomes a huge blood sugar ordeal. 

How to Audit Your Go-To Meals WITHOUT Losing Your Mind (hopefully)

Let’s make it as simple as possible.

Step one: pick your most frequently eaten meals — not the fancy ones. I’m talking your 3-5 repeat meals per week. Then:

1. Log them for 2-3 days with full carb counts (yes, measure as accurately as you can).
2. Compare your usual bolus with the true carb value.
3. Track your BG response for the 1-5 hours after.

Most people find that either:

• They’ve been undercounting,
• Their ratios are outdated, or
• Timing (hello, prebolus) is the real issue.

An audit like this can save you months of confusion. And it applies to more situations than your mom’s spaghetti (if you see this, I love you, ma! Your spaghetti is the best!).

Tools Worth Reintroducing (Even If You’ve Ditched Them)

Yes, I know you probably ditched the scale years ago. That’s fine. But these tools don’t have to scream “diet culture.” They’re just data sources to help you recalibrate:

• Measuring cups (even as a professional diabetic, I have to check myself. Using measuring  cups is not a statement on your worth)
• Food scale (try it for 2 weeks, not forever)
• Carb counting apps like Cronometer (<- this is an affiliate link meaning I could make a small commission at no additional cost to you), CalorieKing, or MyFitnessPal
• Visual portion guides (for when you can’t measure (or eventually when you just don’t want to measure))
• Nutrition scanners– yep, double check that barcode again. Things change.

Rebuilding Consistency (Without Getting Obsessive)

Carb counting doesn’t have to run your life.

I teach my clients to aim for accuracy, not perfection. That might look like:

• Double checking 1-2 meals per day or per week,
• Reviewing labels for new packaged foods,
• Reassessing old “trusted” recipes OR portions every few months or years.

Think of carb counting like brushing your teeth — unless you're a dental professional, you don’t have to make it your whole personality, but doing it regularly prevents a lot of pain later.

Wins From Clients Who Got a Carb Count Refresh

🗣 “I was shocked how far off I was on my taco bowl”

🗣 “I thought my dad’s meatball recipe was a carb-less option, but I didn’t even realize there were breadcrumbs. No wonder I went super high every time”

🗣 “I realized my favorite salad had almost 20g of carbs in the dressing. The spikes make sense now.”

Sometimes just making one or two small updates can stabilize your numbers in ways you’ve been chasing for years.

When to Adjust Your Carb Ratios (and When NOT to)

If your go-to meals are consistent, your carb counts are solid, and you’re still seeing spikes — then it MIGHT be time to tweak your carb ratio…. 

But only after you’ve ruled out:

• Miscounted carbs
• Delayed digestion
• Missed prebolus windows
• Hormonal shifts (cycle, stress, illness)

A lot of people jump to adjusting their ratio when the real culprit is hidden carbs or undercounted portions.

Need help sorting that out? (double check with your doctor or diabetes educator before making changes). OR, That’s exactly what I coach on — because your numbers are telling a story. You just need the right translator. Send me a message on any social media platform at Type One Type Fun. 

Final Thoughts: You’re Not Behind — You’re Evolving

Revisiting carb counting after years with diabetes doesn’t mean you failed. It means you’re being intentional and taking back control— and that’s powerful.

Bodies change. Life changes. And your diabetes strategies deserve to evolve with them.

Whether it’s a tiny shift in your breakfast bolus or a full refresh of your evening meal plan, you’re taking steps toward more confident, consistent blood sugars — and that’s the kind of energy I’m always here for.

If you found this helpful and want to go deeper, I have a full module that walks you through advanced carb counting, including what to do when your numbers still don’t make sense.

You're not supposed to have all the answers — you're supposed to have support.

And that’s what I’m here for.

Madi Cheever, MPH, RD, LDN, CHES
Type One Type Fun

‼️DISCLAIMER: although I am a healthcare professional, this post is not intended to be medical advice. This is simply me sharing some of what I know, but your body may not respond in this way so please make sure you are chatting with your diabetes educator and/or doctor first ‼️ or bring me onto your care team 😘