Carbohydrate(carb)
counting
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Overview
Too many carbohydrates
(carbs) can raise blood
sugar levels. Ninety percent
of the carbs we eat turn to
sugar within 1-2 hours. The
more carbs you eat, the
higher your blood sugar
levels rise. Too many carbs
can overload the body’s
insulin supply. However,
we still need some carbs.
Carbs provide energy and
are found in many healthy
foods. The answer is to eat
them as part of a balanced
meal plan.
OBJECTIVE: Define carbohydrates and
benefits of carb counting.
How does carb counting work?
When using carb counting, you count your carb intake at each meal
and snack. It is best to work with a dietitian or diabetes educator
to learn the right amount of carbs for your lifestyle, personal
choices and medical history.
How do you count carbs?
There are two ways to count carbohydrates. The first method uses
the Exchange Lists for Diabetes. The exchange lists are available
by calling the American Diabetes Association or looking on their
website. The starch, fruit, milk and other carbohydrate groups
are the main sources of carbs. One serving of food from each list
contains about 15 grams of carbs, also known as a “carbohydrate”
choice. If your goal is to have 60 grams of carbs at a meal, you can
eat 4 carbohydrate servings. This would consist of two servings
of starch, one serving of fruit and one serving of milk. The second
method for counting carbs is to count carbohydrate grams. In this
method, you use food labels and food composition tables to look
up the amount of carbohydrates in each food eaten. You will then
need to total the entire amount of carbs for each meal or snack. At
fi st,
r this method takes more time and eff ort. It is more precise than
the exchange system because the exchange system uses averages
for the carb contents of foods. Both methods are good for people
with type 1 diabetes and those on intensive insulin therapy or
fixed insulin doses.1
What are the benefits of carb counting?
Carb counting has become more popular than the exchange lists.
It focuses on the foods that are most likely to raise blood sugar
levels. It is also more flexible. It allows you to have different types
of foods at meals and snacks. It is important that your total
carbohydrate intake stays nearly the same at each meal. For
example, the two lunches on the next page are very different.
However, they still contain the same amount of carbs and are
equal.
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Menu #1
Menu #2
2 slices of bread
(30 grams carbs)
1 c. chicken noodle soup
(15 grams carbs)
2 oz. turkey
(zero grams carbs)
6 saltine crackers
(15 grams carbs)
1 tsp. Mayonnaise
(zero grams carbs)
1/2 c. tuna salad
(zero grams carbs)
1 small apple
(15 grams carbs)
1 c. cubed cantaloupe
(15 grams carbs)
Total: 45 grams carbs
Total: 45 grams carbs
Finally, in carb counting, you can have sugar. Occasional
sweets are okay as long as you account for their
carbohydrate content. Keep in mind that sweets are
not a healthy choice. Eat small amounts and only if the
blood sugar levels are under good control.
Important steps to take
•
•
•
Work with a dietitian or diabetes educator to
develop a carb counting meal plan that works for
you.
Learn what foods contain carbs. Eat carbs in the
proper portion sizes at meals and snacks.
It is possible to eat the right amount of carbs and
still eat too much food. This can happen when you
eat large portions of meat and too much fat. These
foods do not contain carbohydrates but are high in
fat and calories. Keep an eye on your portion sizes of
ALL foods and weigh yourself regularly.
How can your doctor help you?
If you think that carb counting is a meal planning
method that would work for you, your doctor can
refer you to a dietitian. The dietitian can instruct you
on your carb goals. Your doctor can also explain how
your diabetes medicines affect your blood sugar levels
throughout the day. Finally, your doctor can inform you
of any other dietary needs that you might have (such as
low sodium to control blood pressure).
QUIz
QUESTIONS
1. True or False: The more carbs
you eat, the higher the blood
sugar levels will rise.
2. In addition to using the
Exchange Lists for Diabetes for
carbohydrate counting, what
other method can be used?
3. Which of the following are
benefits of carb counting?
a) It is more flexible than other
meal planning methods.
b) Sugar is not forbidden.
c) It focuses attention on the
foods which are most
likely to make blood
sugar levels go up.
d) All of the above.
e) None of the above.
ANSWERS
1. True
2. count carbohydrate grams
3. d