Anyone can benefit from carbohydrate counting, says Linda Yerardi, M.S., R.D., LDN, CDE, director of diabetes education at the Diabetes Center at Mercy in Baltimore. "Everyone with diabetes has to monitor their carbohydrates."
After you eat any type of carbohydrate, it breaks down into glucose and enters the bloodstream. This is why blood glucose rises after eating carbs.
"Protein and fat will not have as big of an impact on blood sugar as carbohydrate, so carbs are what we look at," Yerardi says.
"The purpose of carb counting is to more consistently control the amount of glucose going into the bloodstream to stabilize blood sugar levels," says Michelle Bravo, R.D., LDN, CDE, a dietitian at Johns Hopkins Comprehensive Diabetes Center in Baltimore.
Carb counting ranges from basic to advanced. Everyone starts with basic carb counting, no matter how long they've had diabetes or what their ultimate carb counting goal is.
With basic carb counting, you try to eat the same amount of carbohydrate at the same time each day. For example, if you eat 60 grams of carbohydrate (4 carb choices) for breakfast, you should eat that amount at breakfast every day.
"By keeping carbohydrate consistent, we can keep blood sugars on track," says nutritionist Linda Yerardi. "That does not mean you have to eat the same thing at every meal every day." You can choose from many different foods that have similar carbohydrate amounts.
Carbohydrates can be counted two ways: by grams or by carb choices. Your dietitian or certified diabetes educator (CDE) will likely let you choose which method you prefer. When working with carb choices, remember:
Everyone needs different amounts of carbohydrate, depending on factors such as height, weight, age, activity level, medications, and weight loss goals. A general guideline is:
While these guidelines help to determine the amount of carbohydrate to include in your meals, a dietitian or CDE can make a plan specific to your needs.
The nutrition facts label on food packaging tells you all you need to know to count carbohydrates. Look at two things:
Serving size is important because all the values on the nutrition label are based on one serving, not the entire package. Multiply the number of servings you will eat by the total grams of carbohydrate, and you will know how many carbs you're eating.
Don't worry about sugar on the food label. Sugar is included in the total carbohydrate.
"Sugar is just a kind of carb; you want to look at all carbs," says nutritionist Linda Yerardi. "Once it gets past the mouth, your body doesn't know what kind of carb it is." All carbohydrate sources raise your blood glucose similarly.
The best way to evaluate portion size is by measuring your food with measuring cups or a food scale. If the serving size is 1 cup, measure 1 cup to be sure that's how much you're eating. If the portion you plan to eat is more or less than the serving size on the label, then you need to figure out how many grams of carbohydrate you will actually be consuming. It's a good idea to measure or weigh your food until you get a good sense of serving sizes. Then periodically measure to be sure your carb counting is accurate.
For carb counting to be effective in blood glucose control, you have to keep good glucose records and food diaries. After a while, you'll get a sense of how certain foods affect your blood glucose levels so you can anticipate and avoid highs and lows, says nutritionist Linda Yerardi.
"Even though it can seem like a big pain, the extra couple of minutes you spend each day writing down and reviewing these records will give huge rewards in the long run," she says.
Knowledge is key, Yerardi says. Carb counting teaches you how the foods you eat affect your blood glucose. It will help to minimize your risk of complications, the scariest part of diabetes.
Be predictable when it comes to your grocery shopping and buy the same products -- at least at first. "You'll learn their carb counts and the ways they affect your blood glucose," says Joan Wilson, 66, PWD type 2.
When you start basic carb counting, you try to eat the same amount of carbohydrate at the same times each day. Buying the same products is a great way to control your carb amounts at each meal. Once you get the hang of how much carbohydrate is in each item, start mixing it up!
Good foods to have in your shopping cart are:
When eating out, checking portion sizes isn't always easy. Before heading to the restaurant, look at its web site for nutrition information on menu items you might order. Some restaurants include serving sizes for you to base the calories, fat, and carbs you get in the meal. "When I'm eating pizza, I pick the most moderate slice because it's most likely to be equal to the carb count on the label or provided by the restaurant," says Rainey Edwards, 27, PWD type 1.
When ordering, ask your server for a to-go box along with your meal and pack up half of the food before you begin eating -- that way you know you're eating fewer carbs before taking the first bite.
The American Diabetes Association considers one serving of several condiments, such as fat-free mayonnaise, mustard, and ketchup, as "free" foods. But not all toppers are free. For example, gravy and marinara sauce don't make the cut. Neither do sauces added to Asian dishes like sweet-and-sour chicken, because they likely contain more than a 2-teaspoon serving. If the toppers aren't fat free or you didn't add the sauces to the dish yourself, you may consume extra carbs.
When you eat a dish with a sauce that likely contains cornstarch, flour, or another carb-base thickener, add 5-10 grams to the meal's carb count to more accurately measure the amount of carbohydrate in your meal.
Meat, vegetables, grains, beans, and cream can all be thrown together to make a delicious and hearty meal. But when you don't know how much of each you're getting in one serving of your mixed dish, counting carbs can be tricky. To avoid the fuss, dietitian Marion Franz, R.D., CDE, recommends estimating 30 grams of carbohydrate for a 1-cup serving of a starch- or starch-and-vegetable-base casserole or hearty soup.
Want to know exactly how many grams of carbohydrates are in your serving of brown rice? Measure it out and weigh it on a food scale. Look for a model that provides the gram weight of foods and/or the carb counts based on an internal database. Most cost $40-$100. Browse scales online at the Diabetes Mall (diabetesnet.com/dmall).
Food—sugar, carbohydrate, fiber, protein—is not your enemy. With the help of a wide variety of tasty, low-carb recipes and quick tips to help you eat more healthfully, you can take control of your diabetes with every bite.