Carb Counting

This is the most common method for helping people with diabetes plan and manage their diets.

Since the 1990s, carbohydrate counting has been the most common method taught to people with diabetes to manage their blood glucose. It is the method you will most likely be discussing if you work with a diabetes educator or dietitian. (It is not the only method, however. Another program, called the Food Exchange System, was once more commonly taught. Many people still use it, especially for weight loss.)

The basics

In carb counting, you define a total quantity of carbs to include in your diet for a typical day, and then portion out that total among the various meals and snacks. Once the pattern is set, you seek to follow it each day. For example, you may decide that each day you will eat approximately 190-200 grams of carbs. You may decide to allocate 30 to your breakfast, 45 to your lunch, 60 to your dinner, and another 60 divided into two 30-gram snacks, one at mid-morning and one in the afternoon.

What’s a serving?

You draw these from the higher-carb food groups, such as grains and starchy vegetables, milk, and fruits. A sample serving might be a half a cup of potatoes or beans, a cup of milk, or a small piece of fruit.

Keep in mind that most guides for carb counting help you define foods in 15-gram portions, which is why it helps to think in term of units of 15 grams of carbs. (They are usually called carbohydrate “choices.”) Another way to view the above plan would be to say - 4 carb choices for breakfast, 3 for lunch, 4 for dinner, and 2 one-choice snacks per day.

Putting carb counting to work

Here’s an example: A 30-grams-of-carbs or 2-choice breakfast could be made up of ½ cup of oatmeal (one choice) and a small orange (also one choice.). Or, in place of either the oatmeal or the orange, instead have a 6 oz. Serving of sugar-free yogurt (also one choice). Add some plain tea or black coffee, which have no calories or carbs, and you have a satisfying way to start the day.

The real advantage of the carb counting system is that it gives you a great deal of freedom to plan your meals and mix and match foods. It does take some willingness to learn the carbohydrate content of various foods - as well as to estimate portion size - but once you’ve developed these skills, you can find the carb counting system very flexible. It can also give you the confidence to experiment with new foods. For example, let’s say that your typical afternoon snack is peanut butter on crackers, and that you know the carb count for your usual portion. One day, for variety, you decide to have some granola instead. If you have a portion with the same carb count as your usual crackers, then you could expect a similar impact on your glucose.

To check your ability to estimate, it can help to test your glucose before and after the meal. If your post-meal glucose goes up no more than 30-40 mg/dL, then you got the carb count right.

Another factor, if you are on insulin, is knowing how to adjust your insulin dosages to accommodate your food choices. In addition to carb counting and portion estimating, you’ll also need to learn how to plan your insulin needs. Look to your diabetes educator or physician for assistance.

Don’t forget that what you drink is just as important as what you eat. If you choose beverages that have calories and carbs, include them in your planning. These can include anything with added sweeteners, or those that are naturally sweet, such as fruit juices. Be aware that such drinks can be surprisingly high in carbs! For this reason, it is often recommended that people with diabetes stick with “no calorie” drinks, such as diet sodas, black coffee, plain tea, and water.