Diabetes Canada recommends learning how to count carbohydrates, as the quantity of carbs eaten at one time affects diabetes management. Counting carbohydrates and eating a healthy, diabetes-friendly diet can improve your health. These two activities can reduce the risk of developing heart and blood vessel disease for those with type 1 or type 2 diabetes.
Advanced carb counting can also help manage blood glucose levels. It works by matching the type and amount of carbohydrates to your medications. If you use insulin, your diabetes care team can help you to establish an insulin to carb ratio. Your self-monitored blood glucose values can be used to match the amount of carbohydrate covered by one unit of insulin.
Apps can help you track carbohydrate, protein, fat, insulin dose, activity, blood glucose, and A1C. Choose only one or two apps, and be consistent in using them. Since an app that is mob-sourced may not be accurate, use your common sense.
Reliable apps include:
Apps on some meters, such as the OneTouch Reveal, Accu-Chek Connect, and Contour Diabetes metres, allow you to track carbs electronically without using a standard pen and paper log book.
Carbohydrates, protein, and fat are the three main macronutrients that make up our food. They include starch, sugar and fibre. Carbs are found in grains, root and sweet vegetables, all fruits, milk and milk alternatives, legumes, sugar and high-sugar foods like candy, jam and baked goods. Most carbohydrate is converted to glucose, the body’s main source of energy.
Protein is found in all meat, poultry, fish, cheese and legumes. Protein breaks down into amino acids that are used as an immediate energy source and to build and repair tissues. Excess protein is stored as fat. When protein is consumed in appropriate amounts, it has minimal impact on blood glucose.
Fat is found in higher-fat meat and dairy products, as well as in oils, nuts, seeds, butter, margarines, and commercial baked products. It is stored as a source of energy, provides insulation, and transports certain nutrients in the body. A high-fat meal may affect blood glucose, as fat can delay the time it takes for food to move from your stomach. This in turn delays the absorption of glucose, resulting in higher glucose readings later on. A high-fat meal may also cause the body to be less responsive to insulin, either your own or injected. Instead, choose a low-fat meal with a focus on mono and poly-unsaturated fats, including omega-3 fats. Eating this way is better for your heart and can help reduce high blood glucose after meals.
Of the three macronutrients, carbs have the largest impact on your blood glucose. The starch and sugar in carbs break down into glucose during digestion, directly affecting your blood glucose level. The fibre in carbohydrate is not digested, does not break down into glucose, and is not used for energy.
Keep in mind that in order to function, your brain needs the glucose in carbohydrate. For this reason, minimum amounts of carbohydrate are specified in dietary recommendations. Adults require no less than 130 grams of carbohydrate each day.
The glycemic index is a system that assigns values of high (70 or more), medium (56 to 69), or low (55 or less) to food. The value indicates how rapidly carbohydrate foods are digested and absorbed in the two hours after it is consumed. A food with a low glycemic index value, such as parboiled rice, causes a smaller rise in blood glucose than a high glycemic index food like instant rice. Diabetes Canada reports that many reliable studies confirm that low glycemic diets help to control blood glucose and blood lipids in people with diabetes.
To manage your blood glucose levels, design your meals to include low glycemic index foods, an appropriate amount of protein and healthy fat.
You can determine the amount of carbohydrate in your food in several ways:
Carb counting involves several steps:
Measure food using nesting measuring cups for dry and cooked foods. Other foods need to be measured by volume with a graduated measuring cup. Learning to measure portions accurately takes time. Be patient and become familiar with what your typical portions look like on your plate. For instance, if you typically eat one cup of cereal with half a cup of milk, measure these amounts in your favourite bowl repeatedly until you can ‘eye-estimate’ the amount.
If your blood glucose control changes, get the measuring tools out again.
A weigh scale can help you to figure out the amount of carbohydrate available in one gram of a given food. Some digital nutrition scales have a built-in carb/fibre and available carb tracker.
Example: One 10-inch tortilla contains 38 grams of available carbohydrate.
|Weight||X||Carb Factor||Available Carb|
|74 grams||x||.52||Available Carb|
To count the total number of carbohydrates in a recipe, consider the number of servings it makes.
It can really help to work with a dietitian who can assess your nutritional requirements, including carbohydrate needs, based on your age, gender, weight, activity, and weight goals. Set carbohydrate goals for each meal and snack that meet your overall goals for managing blood glucose, weight, and lifestyle interventions.
Advanced carbohydrate counting can help establish insulin to carb ratios for each meal you eat, as well as for insulin pump therapy. This counting includes increased monitoring of blood glucose before meals and two hours after meals. Work with your diabetes care team to determine insulin to carb ratios along with insulin correction factors. Advanced carb counting can allow additional freedom with the type of food and amount you eat, timing of meals, and the basal and bolus balance of an insulin regimen. However, healthy eating remains the cornerstone of diabetes management.
Whether you are using carbohydrate counting to gain awareness about the amount and type of food eaten, or for matching medication or insulin to the amount of carbohydrate eaten, use the same simple principle.
Be consistent about the spacing and intake of carbohydrate, as well as with the spacing and regularity of your meals. This consistency may help control blood glucose and weight.
Your nutrition therapy should be specific to you. It should be regularly evaluated by a registered dietitian along with your diabetes education team. Choose a strategy that works for you, such as Eating Well with Canada’s Food Guide, the plate method, or carbohydrate counting. The best option for you, and the one that will be easiest to maintain, is the one that fits with your values, preferences and treatment goals.
Counting Carbs in a Sample Lunch
This lunch includes a chicken sandwich, fruit and veggies, and two beverages.
|Food||Portion Size||Grams of Carbohydrate||Carbohydrate Choices|
|Whole wheat bread||2 slices||30 g||2|
|Chicken breast||2 oz/60 g||0||0|
|Margarine||1 tsp/5 mL||0||0|
|Carrot sticks||1/2 cup/125 mL||0||0|
|Green grapes||1/2 cup/125 mL||15 g||1|
|Milk||1 cup/250 mL||15 g||1|
|Tea/coffee||1 cup/250 mL||0||0|
|TOTAL||60 g||4 choices|
|SOURCE: * diabetes.ca (search carbohydrate counting)|
Using the Nutrition Facts Label
|% Daily Value (% DV)||
|SOURCE: * Diabetes Canada - Understanding the nutrition label|