Managing blood glucose (sugar) levels is an important part in caring for your diabetes. One way people with diabetes can help their blood glucose level is through food, more specifically carbohydrates (carb). When someone eats carbs, their body breaks them down into glucose for energy, and this causes blood glucose levels to rise. Usually, insulin will keep these levels from rising too high. However, if you have diabetes, there is not enough insulin produced or used correctly to do this. Because of this, carbohydrate counting is a meal planning strategy that people with diabetes can use to help control their blood glucose levels.

What are carbohydrates?

A carb is one of the three main nutrients found in food. It is made up of glucose and other sugars that the body breaks down for energy. Since carbs contain glucose and the other two major nutrients (protein and fat) do not, carbs have a greater effect on blood glucose levels. There are two types of carbs: simple and complex.

Simple carbs are digested quicker than complex carbs are. If they have been highly processed, they may even contain added sugars. Therefore, they can raise blood glucose levels at a faster rate than complex carbs can. Examples of simple carbs are cookies, potato chips, cake, white rice, and maple syrup. Complex carbs are healthier choices that often contain fiber, are not digested as fast, and slowly raise blood glucose levels. Examples of complex carbs are beans, oats, carrots, whole-grain bread, and apples.

What foods should I choose?

A good rule of thumb is to limit the amount of simple carbs in your diet and choose complex carbs instead. These complex carbs are foods that have not been highly processed. Examples of these include fruits, vegetables, whole grains, and fiber-rich foods. These complex-carb foods are nutrient-dense, meaning they contain more vitamins and mineral per calorie than highly processed carb foods do. Processed foods often consist of simple carbs and have added sugars, salt, preservatives, and fat. They include packaged foods, soda, candy, white bread, and snack foods.

It is important to remember that meals usually consist of all the three main nutrients: protein, fat, and carbs. Foods that have fat and protein in them can slow down how fast the body digests carbs. Therefore, nutrient-mixed meals can help keep blood glucose levels from getting too high right after a meal.

Carbohydrate Counting

Carb counting is a diabetes meal-planning strategy that concentrates on total daily carb intake. It focuses on eating about the same amount of carbs at meal and snack times throughout the day as a way to help blood glucose levels stay within a normal range. A simple way of carb counting is picking carb choices, where one choice is about 15 grams of carbs. Your number of carb choices for the day and at each mealtime may look different than another person’s, depending on what your diabetes care plan team thinks is best. An example of a standard carb choice meal plan may look like three to four carb choices for each of your three meals and one to two choices for two different snack times.

Diabetic Exchange List

The Diabetic Exchange List was developed by the Academy of Nutrition and Dietetics and American Diabetes Association. This list divides foods into similar groups that have about the same amount of carbs, protein, fat, and calories as the other food choices on the list. This can be a useful tool when planning what carb choices to pick. It is important to pay attention to the serving size given for each food on the list, because the amount of carbs, protein, and fat that you are getting for each choice is based on this serving size.

The six different food groups on the Diabetes Exchange List include the following:

• Starches (15 grams of carbs/serving)
  • Includes breads and grains, rice, and starchy vegetables, such as corn and potatoes.
• Meats (0 grams of carbs/serving)
• Vegetables (5 grams of carbs/serving)
  • Nonstarchy vegetables do not count as carb choices (because they are low in carbs) unless you consume three or more servings at one meal that equal more than 15 grams of carbs.
• Fruits (15 grams of carbs/serving)
• Milk (12 grams of carbs/serving)
• Fat (0 grams of carbs/serving)

Next Steps

Carb counting can be a useful tool in helping manage blood glucose levels for diabetes. There is no one-size-fits-all number of carbs everyone with diabetes should eat in a day. Therefore, it is important to talk to your diabetes care plan team to determine the best carb-counting method for you that takes into consideration your lifestyle, body size, medications, etc. A certified diabetes care and education specialist or registered dietitian nutritionist can help you choose a carb plan that works best for you.