Counting Carbs: How it Works
Foods are made up of three
basic elements: carbohydrates, protein and fat. Foods that contain
carbohydrates, or “carbs,” are the ones that affect your blood glucose, or
sugar, the most. About 90 percent of the carbohydrate you eat appears in your
blood as glucose about two hours after you eat it.
We all need carbohydrates.
They’re our main source of energy. When you have diabetes, getting the
carbohydrates you need while keeping your blood sugar under control is one of
the first things you learn to do.
Foods that are mainly carbs
- Grains (breads, crackers,
cereal, pasta, rice)
- Dried beans
- Milk and yogurt
- Sweeteners such as sugar,
honey, syrup and molasses
From this list above, you
can see that both starches and sugars are in the carbohydrate group. In the
past, many people believed that sugary foods had a bigger impact on blood sugar
than starchy foods. But researchers have learned that whether a food is a
starch, such as bread, rice or pasta, or a sugar, such as a cookie, it affects
your blood glucose in the same way.
Foods that contain no carbs,
or very few, include fats and proteins:
At first, you might ask
yourself why you can’t simply leave out the carbs and eat just the fats and
proteins. But the fact is that you need a balanced diet. You need carbohydrates
because they are an important source of energy, fiber, vitamins and minerals.
You need the fat and protein as well, but too much of those foods can contribute
to obesity, heart disease and other serious health problems.
The basic idea behind
Many people who have
diabetes manage their food plan by counting carbohydrates, or “carb counting.”
Carbohydrates are measured in grams. They’re listed on food labels along with
protein counts, fat counts, calorie counts, etc.
An important part of taking
care of yourself when you have diabetes is learning to control your blood sugar.
You learn how to keep your blood sugar in the healthy range. When you count
carbs, you work with a dietitian or diabetes educator to:
- Determine what the target
range of your blood sugar level should be
- What your total amount of
carbohydrate should be at each meal and snack to keep your sugar level in that
If you take insulin, you can
figure out what your dose should be based on the amount of carbs you eat.
Additionally, the amount of exercise you get has an effect on the amount of
carbs you’ll be able to eat.
Remember—your dietitian or
diabetes educator are there to help you figure all of this out. You need to tell
them what kinds of foods you enjoy, what your lifestyle and school or work
schedule are like and what kind of exercise you do. Together, you and your
diabetes care team member will figure out all of the details about your blood
sugar numbers and the amount of carbohydrates you should have at each meal and
Tools you need
If you’re using carb
counting to manage your daily food intake, here are some tools that will help
- A gram scale so that you
can weigh food. This is particularly helpful with foods that don’t have
labels, such as fresh produce.
- A book that lists the
carb counts of all foods (ask a member of your healthcare team to recommend a
good resource for you)
- Measuring cups and
For the most part, you’ll
have an easier time managing your blood glucose if you stick to the same basic
schedule on most days. This includes:
- Eating about the same
amounts of foods each day
- Eating at around the
same times each day
- Taking your medications
at about the same time each day
- Exercising at about the
same time each day
Keeping a record can help
Like anything else that’s
new to you, carb counting takes practice. The more experience you have with it,
the better you get and the easier the process seems.
In the beginning, you might
find it helpful to keep a written record of the foods you had in each meal and
the amount of carbs you had. You could also include information about your blood
sugar levels and exercise. This information can help you see a trend in the way
your body digests food, how much difference the exercise makes to your blood
sugar levels, etc.
Over time, these written
records and your increased experience will help carb counting to seem almost
like second nature. Eventually, you’ll probably get to the point that you’ll be
able to look at a piece of fruit and know how many carbs it has, or you’ll be
able to tell at a glance the carb count of a restaurant meal.
Patience and practice are
they keys. The reward? A meal management plan that allows for high flexibility
in food selection.
The American Diabetes Association; P. Geil, L.A.
Holzmeister, Diabetes Nutrition A to Z. The American Diabetes Association,
2001; The National Institutes of Diabetes
and Digestive and Kidney Disorders.