Carbohydrate counting 101 joslin diabetes center gas bike alley


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.

· 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.

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.

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.

Most of the carbohydrates we eat come from three food groups: starch, fruit and milk. Vegetables also contain some carbohydrates, but foods in the meat and fat groups contain very little carbohydrates. This list shows the average amount of carbohydrates in each food group per serving:

To make things easy, many people begin carbohydrate counting by rounding the carbohydrate values of milk up to 15. In other words, one serving of starch, fruit or milk all contain 15 grams of carbohydrates or one carbohydrate serving. Three servings of vegetable also contain 15 grams. One or two servings of vegetables do not need to be counted. Each meal and snack will contain a total number of 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).

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.

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.