The concept of carbohydrate counting dates back to the 1920s. It received its well deserved recognition after being used as a flexible meal planning approach in the landmark Diabetes Control and Complications Trial. Traditionally, blood glucose management revolved around a fixed amount of carbohydrate that one would regimentally adhere too. Carbohydrate counting allows for a more personalized approach to managing blood glucose by allowing flexibility in the amount of meal time insulin one needs based on what they plan to eat.
Wouldn’t it be great to eat less (or more) carbohydrates based on hunger level and blood glucose trends? And, wouldn't you like the freedom to adjust meal time insulin based on this? Carbohydrate counting can be that Super Hero!
It’s important to note
- Accurate carb counting is key
- Amount of carbs trumps the type of carbs. To calculate the amount of meal time insulin, it's important to know the amount of carbohydrate one plans to eat. One should also be aware the type of carbohydrate determines how quickly the carbohydrate breaks down into glucose. Complex carbs like legumes break down slowly, while Simple carbs such as white rice break down quickly.
- Each macronutrient has a different effect on blood glucose. Carbohydrate has the maximum impact on blood glucose.
Step 1 - Detect the carbohydrate
- grains
- fruits and fruit juices
- dairy - cow’s milk, non-dairy milk, soy milk, oat milk, yogurt
- vegetables - starchy and non starchy vegetables (minimal effect on blood glucose, choose more on your plate)
- natural combination foods - legumes, lentils, nuts, frozen meals, soups
Step 2 - Choose a counting method... you have options!
There is always more than one way to solve a problem. Choose a method or combine methods to suit your needs. Accurate measurement of carbohydrates is key to accurate meal time insulin.
Exchange System
Pros - The exchange system classifies all carbohydrates as a serving of 15 grams. So as long as carbohydrates are measured correctly, it can be a quick and simple tool to use. Use this resource to learn about carbohydrate exchanges.
Cons - For those who are sensitive to small portions of carbohydrates, this method may not provide the needed accuracy. For instance a typical 6” tortilla = 15 grams. However, the same size tortilla can vary greatly in carbs based on different manufacturers, fiber content and thickness.
Portion Estimation
Pros - This is a visual tool. It is excellent for those times when you are away from home. Keep it handy, save it on your smartphone. Use it when you’re on the road, at a restaurant or a friend’s place! It recommends the use of known fixed measurements to estimate the carbohydrate portion. Great for children too, as visual cues can aid remembering portions. For instance a light bulb = 1 cup
Con - Accuracy can be off
Digital Food Scale
Pros - Accuracy with foods that do not fit in a measuring cup. Some digital scales come equipped with carb counting. This is a huge plus and time saver. Here's one that offers nutrition information.
Cons - Requires additional time
Nutrition Label Reading
Pros - Hands down, the most accurate method for carbohydrate counting. Whether it’s packaged food, an app or a restaurant’s nutrition facts, you can’t get more precise than this method. Nutrition labels also provide dietary fiber and sugar alcohol amounts for closer calculation of carb counts.
Dietary Fiber - Subtract the fiber grams from the Total Carbohydrate if there are > 5g per serving
Sugar Alcohols - Subtract half the sugar alcohol grams from the Total Carbohydrate. Subtract all if the type of sugar alcohol is Erythritol.
Read more about how to subtract fiber and sugar alcohols from carb counts.
Sample Nutrition Label
Cons - Measurement of carbohydrates using a food scale or measuring cups/spoons is a prerequisite for label reading.
Apps and other online resources
Carb counting can now be at your fingertips. Literally. There are so many apps and online resources to choose from. Here a few to explore:
- Myfitnesspal - choose the ones with a green check to confirm accuracy
- Cronometer
- Calorieking
- Fooducate - great to learn more about food while carb counting
- USDA food database
Step 3 - Publish your learnings. No need to ever count that food again!
Now that you have mastered the art of measuring carbs, it's time to simplify the work. Do you have your go to carbs that you prefer? Create your own cheat sheet, laminate it, save it on your phone or computer, frame it and hang it on the wall! Once the hard work is done, refer back to your list until it becomes second nature to know the carbs counts of your favorite foods.
Sample Cheat Sheet
Don't Forget
- Dietary Fat - foods rich in dietary fat can raise blood glucose later and over a longer duration of time, usually beyond the 4 hours seen with carbohydrates. Learn more about insulin adjustment strategies for fat here.
- Protein - approximately half the grams of protein break down into glucose. Many people need to cover higher protein meals with insulin. Read more here.
Do remember
Carb counting may appear to be an exact science, but it’s truly an art. Practice regularly and you will create a beautiful result!
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Reference
Diabetes Control and Complication Trial