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Counting Carbs: How it Works

separator 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 include

  • Grains (breads, crackers, cereal, pasta, rice)
  • Vegetables
  • Fruits
  • Dried beans
  • Milk and yogurt
  • Sweets
  • 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:

  • Meat
  • Fish
  • Eggs
  • Cheese
  • Bacon
  • Butter
  • Oil

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 carb counting
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 target range

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 snack.

Tools you need
If you’re using carb counting to manage your daily food intake, here are some tools that will help you:

  • 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 spoons

Consistency helps
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.
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