Contrary to popular thinking, people with diabetes can enjoy moderate amounts of carbohydrates in their diets. The emphasis is on carbohydrate control NOT carbohydrate avoidance. Actually, carbohydrates are the body's preferred energy source, and roughly half of your daily calorie intake should come from carbohydrate foods. Carbohydrates are the starches and sugars in food. They are found in grains, starchy vegetables, fruit, milk, and sweets.

What is carbohydrate counting?
Carbohydrate counting is a meal planning approach that evenly distributes your carbohydrate calories throughout your day by counting out the right amount of carbohydrate foods for each meal and snack. The emphasis with carbohydrate counting is on how much carbohydrate you eat at any one time, NOT on which type of carbohydrate you choose. Stay away from fad diets that restrict the amount of carbohydrates you can eat.

What about sugar?
Research has shown that sugar does not raise blood sugar levels any more than starches do. This means you can eat sugary foods (cookies, cakes, pies, and candy) as long as you count them as part of your total carbohydrate intake. Keep in mind that foods high in sugar are often high in fat and calories, and if eaten in excess might elevate sugar and triglyceride levels, and can lead to weight gain.

What about sugar substitutes?
A sugar substitute is a sweetener that is used in place of sugar. The sugar substitutes that have been approved by the Food and Drug Administration (FDA) are aspartame (Equal®), saccharin (Sweet 'n Low ®), acesulfame potassium, and sucralose (Splenda ®). All can be safely consumed in moderation. Sugar substitutes do not need to be counted in your meal plan. If they are used as a sweetener in food that contains few calories and no other carbohydrate (such as sugar-free soft drinks or sugar-free gelatin), that food is considered to be a "free food." If, on the other hand, the sugar substitute is used in a food that contains other carbohydrate sources (such as sugar-free pudding or sugar-free cookies), the total carbohydrate content must be counted, and that food is not considered to be a "free food."

What about sugar alcohols?
Sugar alcohols, such as mannitol and sorbitol, are carbohydrates that are absorbed very slowly and therefore affect your blood sugar significantly less than sugars and starches. Because of this, they are often used as sweeteners in sugar-free foods. Sugar alcohols are not "free," and must still be counted as part of the total carbohydrate content of any food.

How do you count carbohydrates?
You can count grams of carbohydrates or carbohydrate choices. A "carbohydrate choice" is a portion of food from one of the carbohydrate food groups (grains/starches, fruits, milk, and sweets) that contains 15 grams of carbohydrate.

1 carbohydrate choice = 15 grams of carbohydrate

Carbohydrate choices can be found by referring to the food servings as listed in the carbohydrate groups of the Food Guide Pyramid.

For example, 1 slice of bread from the starch group, 1 small apple from the fruit group, 1 cup of milk from the milk group, and ½ cup of ice cream from the sweets group are each called a carbohydrate choice and contain 15 grams of carbohydrate. Carbohydrate choices can also be calculated by referring to the total carbohydrate content on a food label. Do not count meats, non-starchy vegetables, or fats as carbohydrate choices.

How do you use the food label to count carbohydrates?
Looking at a food label, find the serving size and the total carbohydrate in that one serving. Note: Total carbohydrate includes sugar, starch, and fiber. Use the grams of total carbohydrate when carbohydrate counting. To calculate the number of carbohydrate choices in that particular serving, simply divide the amount of total carbohydrate by 15.

As an example, let's calculate the number of carbohydrate choices in a serving of Raisin Bran cereal. At the top of the food label, the serving size is listed as one cup. Nearly halfway down the food label, total carbohydrate content is listed as 45 grams. Divide 45 by 15. (Remember, 1 carbohydrate choice = 15 grams.) The answer is 3. So, one cup of Raisin Bran is equal to 3 carbohydrate choices.

 Nutrition Facts

 Serving Size                    1 cup (60g)

 Servings per container          About 11

 Amount Per Serving               Cereal

 Calories   185                         14

 Total Fat   1.5g

          Saturated fat   0g

 Cholesterol   0mg

 Sodium   320mg

 Potassium   350mg

 Total Carbohydrate   45g

          Dietary Fiber   7g

          Sugars   19g

          Other Carbohydrates   19g

 Protein   5g

Refer to the following table to assist with calculating carbohydrate choices.

Grams of Carbohydrate

Count as:

0-5

Do not count

6-10

½ carbohydrate choice

11-20

1 carbohydrate choice

21-25

1½ carbohydrate choices

26-35

2 carbohydrate choices

36-40

2½ carbohydrate choices

41-50

3 carbohydrate choices

51-55

3½ carbohydrate choices

56-65

4 carbohydrate choices

What can I eat that won't raise my blood sugar?
Food with less than 20 calories and 5 grams of carbohydrate are considered "free" foods. These include sugar-free beverages and sodas, spices, and seasonings. A word of caution: "dietetic," "diabetic," "no-sugar-added," and "low-carb" foods are not necessarily carbohydrate-free or low in calories. Please read food labels carefully.

Dietary fiber
Dietary fiber is the indigestible part of plant foods. There are two types of fiber: insoluble and soluble. Together, these two types of fiber can prevent constipation, lower blood cholesterol, and help you to feel fuller after meals. They might also benefit your blood sugar. The recommended fiber intake for people with diabetes is the same as that for the general population - 20 to 35 grams per day. It is important to gradually increase the fiber in your diet to avoid gas and bloating. It is also important to drink adequate fluids.

To increase your fiber intake:

  • Choose whole grain foods.
  • Choose more fruits and vegetables.
  • Do not peel fresh fruits and vegetables.
  • Include dried beans and peas in your meals.

How much carbohydrate do I need?
The amount of carbohydrate needed on a daily basis is different for each of us. As noted before, about half of the calories you eat should come from carbohydrates. This amount can vary from day to day depending on your activity level and other factors. Most women need about three to four carbohydrate choices (45-60 grams) at each meal. Men need about four to five carbohydrate choices (60-75 grams) at each meal. Eat one to two carbohydrate choices (15-30 grams) for a reasonable snack, especially at bedtime. See a registered dietitian to plan your carbohydrate needs.

Sample Menus

Sample menu for three to four carbohydrate choices per meal.

Carbohydrate choices are in bold.

Breakfast
  • ½ cup oatmeal
  • 2 slices whole wheat toast with margarine
  • 2 Tbsp raisins
  • Coffee or tea

OR
  • 1½ cup Cheerios
  • 1 cup fat-free or low-fat milk
  • 1 small banana
  • Coffee or tea

 

Lunch
  • 3 oz turkey on 2 slices of rye bread with lettuce and tomato
  • 1 Tbsp light mayonnaise
  • 2 small tangerines
  • 8 oz. light yogurt
  • Sugar-free iced tea

OR
  • ½ cup tuna salad with 2 Tbsp light mayonnaise on whole grain bun
  • Carrot and celery sticks
  • ½ cup light peaches
  • 1 cup fat-free milk

 

Dinner
  • 3 oz stir-fried chicken
  • 1 cup cooked, non-starchy vegetables
  • 1 cup rice
  • Tossed salad with 2 Tbsp light dressing
  • Sugar-free lemonade

OR
  • 3 oz grilled salmon
  • 1 small baked potato
  • 1 cup cooked broccoli
  • 1 dinner roll
  • ½ cup low-fat ice cream
  • Sugar-free soda

Sample menu for four to five carbohydrate choices per meal.

Carbohydrate choices are in bold.

Breakfast
  • 1 poached egg
  • 2 slices of wheat toast with margarine
  • 1 cup grits
  • 2 strips of turkey bacon
  • ½ cup orange juice or 1 small orange
  • Coffee or tea

OR
  • 1 whole wheat bagel with 1½ tsp peanut butter
  • 1 small banana
  • Coffee or tea

 

Lunch
  • Peanut butter and jelly sandwich made with 2 Tbsp peanut butter, 2 Tbsp jelly on 2 slices whole wheat bread
  • 1 kiwi fruit
  • 1 cup raw carrots
  • Sugar-free iced tea

OR
  • 3 oz grilled chicken on whole grain bun with lettuce and tomato
  • 1 Tbsp light mayonnaise
  • 17 small grapes
  • 3 ginger snaps
  • Sugar-free iced tea

 

Dinner
  • 3 oz baked chicken
  • 1 small sweet potato
  • 1 cup green beans
  • 2 small cornbread muffins
  • ½ cup sugar-free banana pudding
  • Sugar-free lemonade

OR
  • 3 oz broiled lean steak
  • 1 small baked potato
  • 1 ear of corn
  • Salad with 2 Tbsp low-fat dressing
  • 1 small whole wheat dinner roll
  • 1 cup melon cubes

 

My Meal Plan

Breakfast

Snack

Lunch

Snack

Dinner

Snack

Time

 

 

 

 

 

 

Carb choices

 

 

 

 

 

 

Carb grams

 

 

 

 

 

 

Meat

 

 

 

 

 

 

Fat

 

 

 

 

 

 

Vegetables

 

 

 

 

 

 

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