There are several different ways people with diabetes can manage their food intake to keep their blood glucose (sugar) within their target range and one such method is 'carbohydrate counting'. Carbohydrate, or carb counting is a method of calculating grams of carbohydrate consumed at meals and snacks. Foods that contain carb have the greatest effect on blood glucose compared to foods that contain protein or fat. Before starting any new treatment or meal plan, you should always consult with your diabetes care professional.

What are the benefits of counting carbs?

 Counting carbohydrates is a good solution for many people with diabetes. Once you learn how to count carbs, you’ll find it easier to fit a wide variety of foods into your meal plan, including combination foods such as those in frozen dinners. For example, by checking the grams of total carbohydrate on the Nutrition Facts label  on a frozen dinner, you can figure out how to fit the dinner into your carb allotment for a particular meal.  Many people find carb counting to be much easier than using a more traditional exchange meal plan.

Another benefit of counting carbohydrates is that it can bring tighter control over your glucose readings. Being as precise as possible with your carb intake and medication will help you better manage your blood glucose after meals. 

Lastly, if you take mealtime insulin, counting carbohydrates allows you to decide how much carb you want to eat at a meal, rather than having to eat a certain amount of carbohydrates, even if you do not want to.

Who can use carbohydrate counting?

Carbohydrate counting can be used by anyone with diabetes, not just people taking insulin.

This method is also useful for people who are using more intensive methods of adjusting insulin to control diabetes. The amount of meal and snack carbohydrate is adjusted based on the pre-meal blood glucose reading. Depending on the reading, more or less carbohydrate may be eaten. Likewise, insulin may be adjusted based on what the person wants to eat. For example, if you want to eat a much larger meal than usual, carb counting can help you determine how much extra insulin to take.

The following is an explanation of how to use carbohydrate counting. Print these pages and discuss them with your nurse educator, dietitian or physician at your next visit.

Tools of the Trade

1.      The first step in carb counting is to have a meal plan.  A meal plan is a guide that helps you figure out how much carb, protein and fat to eat at meals and snacks each day.  If you don’t have a meal plan, meet with a registered dietitian.

2.      Step two involves learning which foods contain carbohydrate. Most people know that starchy foods, such as bread, pasta and cereal contain carbs.  But other food   groups, such as fruit, milk and desserts and sweets, have carbs, too.

There are three main ways to learn about carbs in foods:

     Ask for a food choice list from your dietitian

      Learn how to read the Nutrition Facts Label

     Purchase a food counts book that provides the number of grams of carb in various foods

3.      Measuring tools.  In order to accurately count carbs, you’ll need to be accurate with the portion sizes of foods that you eat.  Invest in a food scale to weigh foods such as fruit and bread.  Use measuring cups to measure cereal, pasta and rice, and use liquid measuring cups for carb-containing beverages such as milk, juice and energy drinks.

Resources

Fortunately, there are many resources available to help you with carb counting  Below are a few to consider:

      Staying Healthy with Diabetes:  Nutrition & Meal Planning (Joslin Diabetes Center)

     Choose Your Foods:  Exchange Lists for Diabetes (American Diabetes Association)

     Complete Guide to Carb Counting (American Diabetes Association)

    The Calorie King Calorie Fat & Carbohydrate Counter (Alan Borushek)

   The Diabetes Carbohydrate & Fat Gram Guide (Lea Ann Holzmeister)

Step 1: Know your meal plan

Indicate on the chart below the number of servings from each food group planned as part of your meal plan. The last row will be completed in Step 2.

 1 cup oatmeal with 1 cup milk = ______grams of carbohydrates

Look back at your meal plan in Step 1. Total up the number of grams of carbohydrate for each meal and snack and write the totals in the last row. It is more important to know your carbohydrate allowance for each meal and snack than it is to know your total for the day. The amount of carbohydrates eaten at each meal should remain consistent (unless you learn to adjust your insulin for a change in the amount of carbohydrates eaten).

Step 3: Using carbohydrate counting in meal planning

Here is an example to show how carbohydrate counting can make meal planning easier. Let's say your dinner meal plan contains 5 carbohydrate servings or 75 grams of carbohydrates. (This is based on a meal plan of 3 starch servings, 4 protein, 1 vegetable, 1 fruit, 1 milk and 3 fat.) The label on a frozen dinner of beef enchiladas says it contains 62 grams of carbohydrate. Instead of calculating how many exchanges that converts to, just figure out how many more grams of carbohydrates you need to meet your 75 gram total. Add about 15 more grams of carbohydrates (one serving of fruit or milk, for example) and you have almost matched your total.

The final word on carbohydrate counting

Counting carbohydrates allows flexibility in your meal plan, but you can't abandon your meal plan and eat as many carbohydrates as you desire. Keep in mind your overall goals--to keep your carb intake at a certain amount each day, and keep your glucose as close to normal as possible--and you'll do well. Remember to consult your healthcare team before making any of the changes discussed here.