When people think of diabetes, they usually think of that old rule against eating sweets. But today's dietary guidelines have no forbidden foods and make controlling your blood sugar much easier. The new guidelines are:
- Eat a variety of healthful foods
- Eat smaller amounts of protein foods and fewer high fat foods
- Balance the carbohydrate you eat with insulin and exercise
The first two guidelines are for long-term health. The third guideline is for blood sugar control. Many people are familiar with Diabetic Exchanges or the Point System for meal planning. A newer method, called Carbohydrate Counting, makes meal planning much simpler.
What is Carbohydrate Counting?
Calories in food come from three sources: carbohydrate, protein, and fat. Each affects blood sugar differently. Carbohydrate, which includes both sugar and starch, has the biggest effect on blood sugar. Carbohydrate counting is based on two ideas:
- Eating equal amounts of sugar (such as fruit or, on occasion, candy) or starch (such as bread or pasta) will raise blood sugar about the same amount.
- Carbohydrate is the main nutrient that effects blood sugar. Within one to two hours after eating carbohydrate, most of it is changed to blood sugar. Protein and fat have much less effect on blood sugar.
The key to remember is that the amount of carbohydrate you eat (whether sugar or starch) will determine how high your blood sugar level will be after a meal or snack.
Why Use Carbohydrate Counting?
- It is easier to learn than Exchanges or the Point System.
- It offers more variety in choices.
- It provides a more accurate guess of how blood sugar will rise after a meal or snack.
- Carbohydrate information on food labels makes meal planning easier.
- You can swap an occasional high sugar food (even though it may contain fewer nutrients) for other carbohydrate-containing foods.
How Does Carbohydrate Counting Work?
There are two methods of carbohydrate counting -- simple and advanced.
Simple Carbohydrate Counting
With the simple method, you work with your dietitian to plan how many grams of carbohydrate to eat at meals and snacks. One serving from the Bread/Starch, Fruit, or Milk group each contains between 12 and 15 grams of carbohydrate. Vegetables contribute little carbohydrate and are not counted. When you know how many grams of carbohydrate you need each meal, you can choose foods from any of the three carbohydrate-containing food groups to meet your allowance. For example, if you need 75 grams of carbohydrate for breakfast each day, you might have dry cereal, fruit, and yogurt when you are not rushed. On a more hectic day, you could get the same amount of carbohydrate by eating a bagel, low sugar jelly, and a glass of milk as you rush out the door. Knowing portions is important. For example, a bagel from a bakery is usually 4-5 ounces and contains 60-75 grams of carbohydrate while a frozen grocery store bagel is about 2 ounces and has about 30 grams of carbohydrate.
Breakfast Options Example Breakfast #1 Food Amount Grams of
Cereal, dry flakes 1 1/2 cups 30 Milk, skim 1 cup 12 Blueberries 3/4 cup 15 Yogurt, light, with fruit 1 cup 15 Total Grams: 72 Breakfast #2 Food Amount Grams of
Bagel 1 bagel (4 oz.) 60 Low sugar jelly 1 Tbsp. 6 Milk, skim 1 cup 12 Total Grams: 78
Advanced Carbohydrate Counting
The advanced method of carbohydrate counting matches your short-acting insulin dose to the amount of carbohydrate grams to be eaten. People who use this method usually take three to four insulin injections daily, or use an insulin pump. If you choose this method, you must understand how to use food labels, use measuring cups and spoons to measure your food portions, and be skilled at estimating carbohydrate content of restaurant foods. Records of your food intake and blood sugars will be used to determine the amount of insulin to take for the amount of carbohydrate you wish to eat. This is called a carbohydrate to insulin ratio. It's important to work with a professional diabetes team to help you determine your individual carbohydrate to insulin ratio.
What About Protein and Fat?
Protein and fat do not raise blood sugar levels as high or as quickly as carbohydrate does. Furthermore, when protein and fat are eaten at the same time as carbohydrate, blood sugar may not rise as quickly. But most people consume more protein and fat than they actually need for good health. Foods high in protein include meat, cheese, nuts, and eggs. Teenage boys need 6-7 ounces daily; teenage girls should eat about 5-6 ounces per day, and children require 3-4 ounces daily. Too many servings of foods high in fat can increase risk of heart disease and cancer, and can cause weight gain. Limit your intake of foods such as cream sauce, gravy, butter and regular stick margarine, salad dressing, and fried foods.
And the Bottom Line Is ...
Sitting on the fence about carb counting? Consider these points:
- Focus is on carbohydrates, but protein and fat are still important
- Food and insulin match better
- Increased variety of food choices
- More flexibility in meal/snack times with advanced carb counting
- Better blood sugar control
- You'll enjoy a greater feeling of control over diabetes
For Additional Information
Original post 25 November 1998 by Betty Brackenridge, MS, RD, CDE
- NutritionData's Nutrition Facts Calorie Counter is an excellent tool that you can use to calculate food values for home made foods
- Carbohydrate Counting Works Regardless of Amount of Carbohydrate Eaten
- Carb Up and GO!, published by the LSU Ag Center, offers lessons and information about carbohydrates.
Updated August 14, 2005
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