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  • Diabetes: Counting Carbs if You Don't Use Insulin

Diabetes: Counting Carbs if You Don't Use Insulin

Introduction

Carbohydrate counting is a skill that can help you plan your diet to manage type 2 diabetes and control your blood sugar. This technique helps you determine the amount of sugar and starch (carbohydrate) in the foods you eat so you can spread carbohydrate throughout the day, preventing high blood sugar after meals. Carbohydrate counting gives you the flexibility to eat what you want and increases your sense of control and confidence in managing your diabetes.

  • Carbohydrate is the nutrient that most affects your blood sugar.
  • Carbohydrate counting helps you keep your blood sugar at your target level.
  • You should consult a registered dietitian or certified diabetes educator to help you master carbohydrate counting and plan meals.
 

Carbohydrate counting is one method of meal planning for people who have diabetes. Carbohydrate counting means adding up the amount of carbohydrate in your food. Limiting carbohydrates when you eat helps prevent high blood sugar, because carbohydrate affects your blood sugar more than other nutrients. All forms of carbohydrate increase your blood sugar. Foods that contain carbohydrate include:

  • Fruits and vegetables.
  • Milk and yogurt.
  • Starchy foods (such as breads, cereals, dry beans, and vegetables such as potatoes and corn).
  • Sugary foods (such as candy and cakes).

Foods that have sugar usually have more total carbohydrate per serving than foods that have starch. You can eat foods that have sugar when you have diabetes, but if you eat a lot of them, you are probably not eating enough of other more nutritious foods.

You can use low-calorie artificial sweeteners that don't have sugar (such as Splenda or NutraSweet). You can eat foods that have sugar alcohols (mannitol, sorbitol, xylitol), a sweetener sometimes used in "sugar-free" processed foods like candies, cookies, and soft drinks. Treat sugar alcohols as carbohydrates, but for many people they don't affect blood sugar that much. They do contain some calories but less than sugar. Be careful using sugar alcohols, especially with children, because sugar alcohols sometimes cause diarrhea.

Test Your Knowledge

Carbohydrate counting helps you know how much carbohydrate you are eating during a meal.

  • True
    This answer is correct.

    Carbohydrate counting helps you know how much carbohydrate you are eating during a meal. Carbohydrate is the nutrient that most affects your blood sugar. Carbohydrate counting allows you to spread the amount you eat throughout the day to prevent high blood sugar after meals.

  • False
    This answer is incorrect.

    Carbohydrate counting does help you know how much carbohydrate you are eating during a meal. Carbohydrate is the nutrient that most affects your blood sugar. Carbohydrate counting allows you to spread the amount you eat throughout the day to prevent high blood sugar after meals.

  •  

Which of these foods contain carbohydrate?

  • Wheat bread, rice, peas, and oatmeal
    Both answers are correct.

    Wheat bread, rice, peas, and oatmeal all contain starch, a form of carbohydrate. Carbohydrate is an essential nutrient that comes in two forms: starch and sugar. Starch is found in foods such as bread, cereal, grains, and vegetables. Sugar is found in fruit, milk, desserts, and candy. Both answers are correct.

  • Cheesecake, skim milk, and pears
    Both answers are correct.

    Cheesecake, skim milk, and pears all contain sugar, a form of carbohydrate. Carbohydrate is an essential nutrient that comes in two forms: starch and sugar. Starch is found in foods such as bread, cereal, grains, and vegetables. Sugar is found in fruit, milk, desserts, and candy. Both answers are correct.

  •  

Continue to Why?

 

Carbohydrate counting helps you know how much carbohydrate you are eating. The more carbohydrate you eat at one time, the higher your blood sugar level will rise. Eating less carbohydrate at one time can help keep your blood sugar levels within your target range, preventing low or high blood sugar.

Both low and high blood sugar levels can cause emergencies. Over time, high blood sugar levels can damage many body tissues and organs. If you have gestational diabetes, high blood sugar levels can increase your risk for complications that can affect your health as well as your baby's health.

You also can count carbohydrate grams if you take insulin.

Test Your Knowledge

Counting carbohydrate helps me know how much fat and protein I am eating.

  • True
    This answer is incorrect.

    Counting carbohydrate grams does not help you know how much fat and protein you are eating. Carbohydrate counting helps you know how much starch and sugar you are eating. The more carbohydrate you eat at one meal, the higher your blood sugar level will rise after the meal.

  • False
    This answer is correct.

    Carbohydrate counting grams does not help you know how much fat and protein you are eating. Carbohydrate counting helps you know how much starch and sugar you are eating. The more carbohydrate you eat at one meal, the higher your blood sugar level will rise.

  •  

Continue to How?

 

Count carbohydrate and eat a balanced diet by:

  • Working with a registered dietitian or certified diabetes educator. They can help you plan the amount of carbohydrate to include in each meal and snack, counting either grams or servings of carbohydrate.
  • Eating standard portions of carbohydrate foods. Each serving size or standard portion contains about 15 grams of carbohydrate. It might be helpful to weigh your food when you are first learning what makes up a standard portion.
  • Eating standard portions of foods that contain protein. Foods that contain protein (meat and cheese) are an important part of a balanced diet.
  • Eating less saturated fat and trans fat. A balanced diet includes healthy fat. Talk with a registered dietitian about how much fat you need in your diet.

Other helpful suggestions

Here are some other suggestions that will help you count carbohydrate:

  • Read food labels for carbohydrate content. Notice the serving size shown on the package.
  • Check your blood sugar level. If you do this before and 1 hour after eating, you will be able to see how food affects your blood sugar level.
  • Use a food recordfood record(What is a PDF document?) to keep track of what you eat and your blood sugar results. At each regular visit with your dietitian or certified diabetes educator, or whenever you think your meal plan needs adjusting, you can review your food record.
  • Get more help. The American Diabetes Association offers booklets to help people learn how to count carbohydrate, measure and weigh food, and read food labels. Also, you will need to talk with a registered dietitian or a certified diabetes educator to build a plan that fits your needs.

Test Your Knowledge

Calculate the carbohydrate content in the following breakfast: 2 eggs, 1 cup milk, 1 slice toast, and 2 teaspoons margarine.

  • 30 grams of carbohydrate
    This answer is correct.

    There are 30 grams of carbohydrate in this breakfast. There are 0 in the eggs, 15 in the milk, 15 in the toast, and 0 in the margarine. If you had problems with this exercise, take the question with you to your next visit with your diabetes educator. Have him or her help you learn how to calculate the carbohydrate content in food.

  • 36 grams of carbohydrate
    This answer is incorrect.

    The breakfast (2 eggs, 1 cup milk, 1 slice of toast, and 2 teaspoons margarine) contains 30 grams of carbohydrate. There are 0 in the eggs, 15 in the milk, 15 in the toast, and 0 in the margarine. If you had problems with this exercise, take the question with you to your next visit with your diabetes educator. Have him or her help you learn how to calculate the carbohydrate content in food.

  • 22 grams of carbohydrate
    This answer is incorrect.

    The breakfast contains more than 22 grams of carbohydrate. The 2 eggs, 1 cup of milk, 1 slice of toast, and 2 teaspoons of margarine contain a total of 30 grams of carbohydrate. There are 0 in the eggs, 15 in the milk, 15 in the toast, and 0 in the margarine. If you had problems with this exercise, take the question with you to your next visit with your diabetes educator. Have him or her help you learn how to calculate the carbohydrate content in food.

  • 15 grams of carbohydrate
    This answer is incorrect.

    The breakfast (2 eggs, 1 cup milk, 1 slice of toast, and 2 teaspoons margarine) contains more than 15 grams of carbohydrate. There are 0 in the eggs, 15 in the milk, 15 in the toast, and 0 in the margarine for a total of 30 grams of carbohydrate in the breakfast. If you had problems with this exercise, take the question with you to your next visit with your diabetes educator. Have him or her help you learn how to calculate the carbohydrate content in food.

  •  

Calculate the carbohydrate content in the following lunch: 1 cup macaroni, ½ cup grated cheese, 1 cup milk, ½ cup carrots, and one apple.

  • 50 grams of carbohydrate
    This answer is incorrect.

    This lunch (1 cup macaroni, ½ cup grated cheese, 1 cup milk, ½ cup carrots, one apple) has more than 50 grams of carbohydrate. It contains 80 grams of carbohydrate. There are 45 grams in 1 cup macaroni, 0 grams in ½ cup grated cheese, 15 in 1 cup of milk, 5 in ½ cup carrots, and 15 in one apple. If you had problems with this exercise, take the question with you to your next visit with your diabetes educator. Have him or her help you learn how to calculate the carbohydrate content in food.

  • 40 grams of carbohydrate
    This answer is incorrect.

    This lunch contains 80 grams of carbohydrate. There are 45 grams in 1 cup macaroni, 0 grams in ½ cup grated cheese, 15 in 1 cup of milk, 5 in ½ cup carrots, and 15 in one apple. If you had problems with this exercise, take the question with you to your next visit with your diabetes educator. Have him or her help you learn how to calculate the carbohydrate content in food.

  • 80 grams of carbohydrate
    This answer is correct.

    There are 45 grams in 1 cup of macaroni, 0 grams in ½ cup of grated cheese, 15 in 1 cup of milk, 5 in ½ cup of carrots, and 15 in one apple, for a total of 80 grams of carbohydrate in this lunch. If you had problems with this exercise, take the question with you to your next visit with your diabetes educator. Have him or her help you learn how to calculate the carbohydrate content in food.

  •  

Continue to Where?

 

Now that you have read this information, you are ready to plan regular meals and snacks and calculate the amount of carbohydrate in your diet.

Talk with your health professional

If you have questions about this information, take it with you when you visit your registered dietitian or certified diabetes educator. You may want to write down any questions you have.

If you need help with carbohydrate counting or meal planning, ask to speak with a registered dietitian. If you have been writing in a food record, take it with you.

If you would like more information on meal planning for people who have diabetes, the following resources are available:

Organization

American Diabetes Association (ADA)
1701 North Beauregard Street
Alexandria, VA  22311
Phone: 1-800-DIABETES (1-800-342-2383)
Email: AskADA@diabetes.org
Web Address: www.diabetes.org
 

The American Diabetes Association (ADA) is a national organization for health professionals and consumers. Almost every state has a local office. ADA sets the standards for the care of people with diabetes. Its focus is on research for the prevention and treatment of all types of diabetes. ADA provides patient and professional education mainly through its publications, which include the monthly magazine Diabetes Forecast, books, brochures, cookbooks and meal planning guides, and pamphlets. ADA also provides information for parents about caring for a child with diabetes.


More information about diabetes can be found in these topics:

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References

Other Works Consulted

  • American Diabetes Association (2013). Standards of medical care in diabetes—2013. Diabetes Care, 36(Suppl 1): S11–S66.

Credits

By Healthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer John Pope, MD - Pediatrics
Last Revised July 1, 2011

Last Revised: July 1, 2011

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