Diabetes: Counting carbs if you don't use insulin

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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.

Key points

  • Carbohydrate is the nutrient that most affects your blood sugar.
  • Carbohydrate counting helps you maintain 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 the recommended method of meal planning for people who have diabetes. Carbohydrate counting involves adding up the amount of carbohydrate in your food. Spreading carbohydrate throughout the day helps prevent high blood sugar after eating, 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 yogourt.
  • Starchy foods (such as breads, cereals, dry beans, and vegetables such as potatoes and corn).
  • Sugary foods (such as candy and cakes).

Foods that contain sugar usually have more total carbohydrate in a serving than foods that contain starch. Contrary to what you may have heard, you can eat foods that contain sugar in your diet when you have diabetes. However, if foods that are high in sugar make up a large part of your diet, you are probably not eating enough of other, more nutritious foods.

You can use artificial sweeteners (such as Splenda or NutraSweet) that do not contain sugar and that contain no calories. You also may eat foods that contain sugar alcohols, a type of sweetener sometimes used in foods labelled "sugar-free," such as candies, cookies, and soft drinks. Sugar alcohols are thought of as carbohydrates when meal planning. But they do not affect blood sugar very much. They do contain some calories, but less than sugar. Eating more than 20 grams (g) a day of mannitol or 50 g a day of sorbitol may 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. You also can count carbohydrate grams if you take insulin. For more information on carbohydrate counting when you use insulin, see:

Click here to view an Actionset. Diabetes: Counting carbs if you use insulin.

Spreading carbohydrate throughout the day 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.

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?

 

Here are some ways to help you count the carbohydrate content of your food and spread the amount throughout the day.

Eat regularly

Eat 4 to 6 smaller meals and snacks throughout the day to spread your intake of food, especially high-carbohydrate food, throughout the day. Plan several meals at a time. Plan to double some recipes and freeze the leftovers for other meals. Reuse menu plans.

Count carbohydrate

Count carbohydrate and eat a balanced diet by:

  • Talking with a registered dietitian. A registered dietitian can help you plan the amount of carbohydrate to include in each meal and snack.
  • Eating standard portions of carbohydrate foods. Each serving size or standard portion contains about 15 grams of carbohydrate. You don't have to weigh and measure your food but that may be helpful when you are first learning what makes up a standard portion.
  • Counting either grams or servings of carbohydrate. A dietitian or certified diabetes educator will help you plan how much carbohydrate to include in each meal and snacks, including sweets.
  • Eating standard portions of foods that contain protein. Foods that contain protein (meat and cheese) are an important part of a balanced diet.
  • Limiting saturated fat. A balanced diet includes a limited amount of 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. Be careful to consider the serving size 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.
  • Record what you eat and your blood sugar results in a food record. 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 (What is a PDF document?).
  • Get more help. The Canadian Diabetes Association offers booklets to help you learn how to count carbohydrate, measure and weigh food, and read food labels. But you will still need to talk with a registered dietitian or a certified diabetes educator to establish a plan that fits your needs.

Test Your Knowledge

Calculate the carbohydrate content in the following breakfast. Use the information in the carbohydrate foods and foods that contain protein links. The breakfast includes 2 eggs, 1 cup (250 mL) milk, 1 slice of toast, and 2 teaspoons (10 mL) 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 (250 mL) milk, 1 slice of toast, and 2 teaspoons (10 mL) margarine] contains less than 36 grams of carbohydrate. The correct answer is a. It 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 [2 eggs, 1 cup (250 mL) milk, 1 slice of toast, and 2 teaspoons (10 mL) margarine] contains more than 22 grams of carbohydrate. The correct answer is a. It 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.

  • 15 grams of carbohydrate
    This answer is incorrect.

    The breakfast [2 eggs, 1 cup (250 mL) milk, 1 slice of toast, and 2 teaspoons (10 mL) margarine] contains more than 15 grams of carbohydrate. The correct answer is a. It 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.

  •  

Calculate the carbohydrate content in the following lunch. Use the information in the carbohydrate foods and foods that contain protein links. The lunch includes 1 cup (250 mL) macaroni, ½ cup (125 mL) grated cheese, 1 cup (250 mL) milk, ½ cup carrots, and one apple.

  • 50 grams of carbohydrate
    This answer is incorrect.

    This lunch [1 cup (250 mL) macaroni, ½ cup (125 mL) grated cheese, 1 cup (250 mL) milk, ½ cup (125 mL) carrots, one apple] has more than 50 grams of carbohydrate. The correct answer is c. It contains 80 grams of carbohydrate. There are 45 grams in 1 cup (250 mL) macaroni, 0 grams in ½ cup (125 mL) grated cheese, 15 in 1 cup (250 mL) of milk, 5 in ½ cup (125 mL) 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 [1 cup (250 mL) macaroni, ½ cup (125 mL) grated cheese, 1 cup (250 mL)milk, ½ cup (125 mL) carrots, one apple] has more than 40 grams of carbohydrate. The correct answer is c. It contains 80 grams of carbohydrate. There are 45 grams in 1 cup (250 mL) macaroni, 0 grams in ½ cup (125 mL) grated cheese, 15 in 1 cup (250 mL) of milk, 5 in ½ cup (125 mL) 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.

    This lunch [1 cup (250 mL) macaroni, ½ cup (125 mL) grated cheese, 1 cup (250 mL) milk, ½ cup (125 mL] carrots, one apple) contains 80 grams of carbohydrate. There are 45 grams in 1 cup (250 mL) macaroni, 0 grams in ½ cup (125 mL) grated cheese, 15 in 1 cup (250 mL) of milk, 5 in ½ cup (125 mL) 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.

  •  

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 doctor, registered dietitian, or certified diabetes educator.

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 mark areas or make notes in the margins of the pages where you have questions.

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

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

Organization

Canadian Diabetes Association
National Life Building
1400-522 University Avenue
Toronto, ON  M5G 2R5
Phone: (416) 363-0177
1-800-BANTING (1-800-226-8464)
Fax: (416) 408-7117
Email: info@diabetes.ca
Web Address: http://www.diabetes.ca
 

The Canadian Diabetes Association (CDA) is devoted to meeting the needs of people with diabetes in Canada. This organization provides general information about diabetes and its care. It organizes summer camps for young people with diabetes and conducts educational seminars to help people manage their diabetes. The CDA also sells a range of products, including cookbooks, in its stores.


More information about diabetes can be found in these topics:

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Credits

By Healthwise Staff
Primary Medical Reviewer Caroline S. Rhoads, MD - Internal Medicine
Primary Medical Reviewer Anne C. Poinier, MD - Internal Medicine
Specialist Medical Reviewer David C.W. Lau, MD, PhD, FRCPC - Endocrinology
Last Revised December 29, 2009

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.