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Carbohydrate Counting (Quiz Number: Manatee3032009)
The goal of Carbohydrate Counting is to make clear to you
which foods affect your blood glucose and then to spread these
foods evenly throughout the day (or to match insulin peaks and
durations). This lets you reach your blood glucose goals and
thus, prevent diabetes complications.
What is Carbohydrate Counting?
What is a carbohydrate?
Are some carbs better than others?
How many carbs should I eat?
Reading a food label
What is Carbohydrate counting?
What is Carbohydrate Counting?
Carbohydrate Counting is one method of meal planning for people with diabetes.
Carbohydrate Counting guides you in choosing what and how much to eat.
The advantages of using Carbohydrate Counting are:
Helps to prevent high and low blood glucose fluctuations
Helps with healthy weight loss and maintenance
Gives flexibility for your preferences, or treats
Less guess work for those who take insulin
Eating approximately the same number of carbohydrate choices for each meal and
snack and from day to day helps control blood glucose levels. Carbohydrate Counting
along with an overall healthy eating pattern, including good portion control will promote
general good health.
What is a carbohydrate?
Carbohydrate is one of the six nutrients that make up food (the other five nutrients are
protein, fat, vitamins, minerals and water). Carbohydrates are essential to life because
they are your body’s fuel source. They are a special concern for people with diabetes
because foods high in carbohydrates tend to raise blood sugar. This is not a bad thing
and you do not want to cut carbohydrates out of your diet completely. People with
diabetes need carbohydrates for fuel and energy. The healthy way to eat
carbohydrates it to calculate (more on this later) how many carbohydrates you need at
each meal and snack and then try to stick with this.
In order to start Carbohydrate Counting you must first learn what food groups are high
in carbohydrates. We call these foods, “carbs” for short.
It would be wise to memorize these carbohydrate food groups. This is so you can look
at a buffet table of food and think, “this food or dish will affect my blood glucose,” “this
one won’t” etc. and then make your selections based on this knowledge. If you do not
memorize which food groups are carbs you will either have to carry around a little
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Carbohydrate Counting (Quiz Number: Manatee3032009)
booklet or you will be making guesses. When you guess you will be wrong sometimes and
end up with high or low blood glucose.
Lets go through each of these five groups.
What is a carb?
Fruit
Milk
Starches
Starchy vegetables
Sugar
FRUIT All fruit is healthy. In the old days of diabetes care, people with diabetes were
told to avoid fruit. It was thought to be too sugary. Today, we know this is not true. Fruit
actually makes your blood glucose rise more slowly than grains and grain products such as
rice, crackers, cereal and bread.
MILK This group consists of milk, yogurt and ice cream. Cheese is not in this group, it
is considered a protein instead of a carb.
STARCH
Any food that is a grain or made from grain is in this group. Includes bread,
cereal, rice, pasta, bagels, tortillas, waffles, crackers.
STARCHY VEGETABLES
There are just a few veggies considered to be a carb.
These are: potatoes, corn, peas, beans and sweet potatoes. Peas, beans and sweet
potatoes have less concentrated carbs than potatoes and corn, so they are better choices.
All other vegetables not mentioned above are free. Which means you can eat as much as
you want of these non-starchy vegetables; they do not raise your blood glucose. In fact,
the non-starchy vegetables can help to keep your blood glucose from rising as much if you
do consume a food or meal high in carbs. Just eat a large portion of a non-starchy veggie
or a salad before you eat something high in carbs (pasta, rice or mashed potatoes, pizza
etc) and you will see your blood glucose will not rise as much as if you had eaten the carb
alone.
SWEETS AND SNACKS
Examples of foods in this group are cookies, pudding, candy,
cakes, pastries, regular soda pop, corn chips, cheese puffs, potato chips, popcorn,
chocolate, sugar and honey. People with diabetes can eat sweets, but like any American,
they should not be eaten every day, just occasionally. This is because they have little to no
nutritional value and lots of fat and calories and sometimes sodium, too.
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Carbohydrate Counting (Quiz Number: Manatee3032009)
Are some carbs better than others?
Yes, indeed some carbs are better than others. Your body is smart. It wants to burn
quality fuel, not poor quality fuel. Quality fuel, in the form of healthy carbs, raises your
blood glucose slowly, burns more slowly and lasts longer than poor quality carbs which
raise your blood glucose quickly and quite high, then are gone. Quality carbs will keep
you energized and full. Poor quality carbs will may give you a burst of energy at first, but
this will not last and you may end up feeling low or sleepy. They also will not keep you full
and you may crave more poor quality carbs again in a little while.
Here is a chart to help guide you in choosing mostly high quality carbs. Try to limit the
amount and how often you eat the poor quality carbs.
Quality Carbs
Poor Quality Carbs
Fruit
All fruits
Fruit juices. Tropical fruits (bananas,
pineapple, mango, papaya) are more sugary and should be eaten in smaller quantities.
Milk
Skim or 1% milk, yogurt, light ice
cream or diet ice cream bars
2% or whole milk, regular ice cream,
Starches
Whole grain bread, whole grain cereal (Cheerios, bran flakes, wheat
chex, etc), oatmeal, brown rice,
whole wheat or low carb pasta
White bread, sweet or frosted cereal,
white rice, pasta, bagels
Starchy
veggies
Beans, peas, sweet potatoes,
squash (remember all other veggies
are free)
Triscuits and other whole grain
crackers, whole wheat pretzels, graham crackers, artificial sweetener,
diet syrup
Potatoes (mashed, french fries, baked
(small baked is better than mashed, augratin or fries), corn
Saltines, Ritz, cookies (better cookies are
ginger snaps, vanilla wafers and animal
crackers), candy, cake, donuts, pastries,
potato chips, corn chips, Doritos, cheese
puffs, soda, sugar, honey, syrup
Sweets &
snacks
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Carbohydrate Counting (Quiz Number: Manatee3032009)
How many carbs should I eat?
Carbs are measured in grams (g). The
amount of carbs you should eat depends on
your age, height, weight, activity level and if
you are a male or female.
If you want an individualized Carbohydrate
Counting plan, see your Diabetes Educator
or Registered Dietitian. For this learning
module, we can use an estimate.
Estimate for carb intake
Meal = 30 - 45 grams
Snack = 15 - 30 grams
*Note: If you have any of the following
characteristics you should eat the lower
number of carbs at each meal or snack.
Female, older age, not active, short,
overweight. If you have any of these
following characteristics you should eat the
higher number of carbs at each meal or
snack. Male, young, active, tall, healthy weight.
It needs to be emphasized that this is only an estimate. Individual nutrition and
carb needs vary quite a bit. See your Diabetes Educator or Registered Dietitian.
For those of you taking insulin, the timing of your meals and snacks and how many
carbs you eat should match when your insulin peaks. Please meet with your
Diabetes Educator for help with this as it can be a little complicated.
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Carbohydrate Counting (Quiz Number: Manatee3032009)
With the Carbohydrate Counting system, 15 is our “lucky
number” and we count by 15.
This is because one carb unit/portion/serving consists of 15
grams (g). Thus if we say 45 g for each meal, think “45
divided by 15 is 3.” This means that a 45 g meal could be:
3 units/portions of one carb food or
1 units/portion of 3 different carb foods or
2 units/portions of 1 carb food and 1 unit of another carb
food
Here are examples of this.
3 units/portions of one carb food like 3 slices of bread
1 units/portion of 3 different carb foods such as 1 slice bread, 1 pear and ½ cup lima
beans
2 units/portions of 1 carb food and 1 unit of another carb food like 1 cup lima beans and
1 slice bread
Make an effort to eat about the same amount of carbs at each meal.
Try to have a minimum of 1 carb choice (15 grams) at both breakfast and lunch to keep your
blood glucose from going low and your metabolism going strong).
Don’t skip breakfast! At least eat a piece of fruit if you can’t handle
anything else. In most cases, it is better to have a little less carbs at a
meal than too much.
At dinnertime, it is probably OK to eat zero carbs if you would like or if you are trying to lose
weight. This means just protein and non-starchy vegetables (ex. Chicken and broccoli,
Steak and salad, Fish and tomatoes, Porkchops and green beans). Remember, you can eat
all you want of non-starchy vegetables! Eating zero carbs at dinner is not OK if you take
insulin before dinner or at night.
The total grams of carbohydrate per serving of food are listed on the Nutrition Facts food
label of processed foods and are also in books. You can get a free carbohydrate counting
book by visiting Manatee County’s Diabetes Educator. A book is especially useful when you
are eating combination dishes that contain many ingredients or when you are dining out.
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Carbohydrate Counting (Quiz Number: Manatee3032009)
Reading a food label
You can use the food label to help count carbohydrates.
Remember that 15 g is one carbohydrate serving. However, the carbohydrate
content of food is not always perfectly divisible by 15, which can make it a bit tricky.
Check the food label for the size of the serving and then compare the number of
carbohydrates to the chart below:
Carbohydrate Choice(s)
Range of Carbohydrate Grams (g)
1
8-22 g
2
23-37 g
3
38-52 g
4
53-65 g
Remember that sugar-free foods still often contain
carbohydrate from other sources and may even have more
calories than the regular version. Look carefully at all nutrition
labels before making a purchase, because many are
confusing or even misleading.
What else do I need to know?
Eating meals at the same time every day and not skipping meals is important for
controlling blood glucose levels.
Although you do not need to count protein or fat grams with a carbohydrate
counting plan, you should still try not to eat too much food overall. Eating too much
can affect blood sugar levels in the short term and cause weight gain in the long
term. Overweight individuals can have problems controlling their blood glucose
levels. In addition, people with diabetes are at higher than average risk for
cardiovascular disease (heart attack, stroke, circulatory problems), and eating too
much in general, especially meats high in fat, cheese, fried foods, junk foods and
sweets can increase your risk of heart disease even more.
In short, try to eat more vegetables, more fruits, more lean proteins and less grains,
processed foods, snack foods.
Good luck with your carbohydrate counting! Remember, you can always get an
individual nutrition plan or help with any diabetes care issue just by setting up a
meeting with Manatee County’s Diabetes Educator.