There are many methods for meal planning when you have type 2 diabetes. Carbohydrate counting, for example, offers a little more freedom than exchange lists or plans that list specific foods or meals. This method is flexible and suited for busy lifestyles where meals may be eaten on the run and away from home. Counting carbs is very helpful for blood sugar level management as well as for weight loss.
The reason why this way of eating is so popular is that it is simple. You just have to count carbs per meal or snack. However, if you want to make a little more effort and watch your fat intake, too, you may get even better results because high fat intake, especially saturated fat, can increase insulin resistance.
A Tailored Diabetes Carbohydrate Counting Plan
Your doctor or dietitian can help you figure out how many carbs you should have daily and per meal and snack. They will consider your medications, lifestyle, current diet, weight, height, gender, overall health and evaluate your carbohydrate sensitivity.
You may be asked to track your blood sugar levels before meals and 90 minutes after meals. You may also be asked to record how many carbs are consumed per meal. Of interest will be how much your blood sugar level rises after a meal and whether it appears you are more reactive to carbs at certain meal times. The goal is to have post-meal blood sugar levels with no more than a 30-40 mg/dL increase.
Alternatively or in addition, you may receive a carbohydrate count based on a daily calorie prescription. Generally, 50% of daily calories should come from carbs. Four calories equal 1 gram of carbs. So you divide the total daily calories by two and then divide that result by four for the total daily grams of carbohydrate.
Using this calculation, an 1,800 calorie diet would equal 225 grams of carbs per day.
1,800 calories divided by two = 900 (50% of daily calories)
900 divided by four = 225 grams of carbs per day
How Many Carbs for Me?
Common prescriptions are 45 to 60 grams of carbs per meal and 15 to 30 grams of carbs per snack. However, we are all different and it depends on your situation and how your body reacts at that mealtime. So, work with your healthcare team. For example, when I was pregnant with my son and aimed for tight control of my blood sugar levels, I had 30 grams of carbs per meal and 15 grams of carbs per snack. However, other pregnant women with diabetes may be able to eat much more.
What Foods Have Carbohydrates?
- Starchy foods (like breads, rice, pasta) and starchy vegetables (like potatoes and corn)
- Fruits and fruit juices
- Beans or legumes
- Milk and yogurt (cheese is counted as a protein)
- Candy, desserts, soda and most junk food
How to Count Carbohydrates
When you count carbs, you can either count total carbs per meal or you can count carbohydrate servings per meal. One carb serving = 15 grams of carbs. For example, a meal with 60 grams of carbs would equal four carb servings (60 divided by 15).
Carb counts can be obtained from:
- Food labels, food count books and websites
- Carbohydrate exchange lists
- Foods can be "eyeballed" to make close guesses of carbohydrate servings
- Your doctor or dietitian may have handouts with examples of carb servings
Examples of One Carb Serving
Getting the carb count from a food label or a food count resource is more specific. However, when these are not available, general ideas of one carb serving for common foods are:
- One small piece of fruit
- One slice of bread
- One six-inch tortilla
- Half a hamburger bun, English muffin or small bagel
- One cup plain or artificially-sweetened nonfat or low-fat yogurt
- One cup nonfat or low-fat milk
- Half cup pasta, bulgur, starchy vegetable, casserole, ice cream, fruit juice or oatmeal
- Third of a cup rice, beans, barley, couscous
- Three-quarters cup cold cereal
- Four to six crackers
- Three cups popcorn
- Six chicken nuggets
- Half small order of fries
- Two-inch square cake or brownie without frosting or two small cookies
- One tbsp. honey or sugar
- One cup of soup
Eyeballing Serving Sizes of Carbohydrate
- One cup = a fist, a tennis ball or baseball.
- Half cup = half a baseball, a light bulb or an ice cream scoop
- Quarter cup = a small handful
- Two tbsp. = one shot glass
- One tsp. = one dice or Scrabble tile
More Helpful Things to Know
- Carbs raise blood sugar levels most rapidly and effectively than any other food component.
- Almost 100% of the carbs in the foods you eat are converted into glucose within 90 minutes of a meal.
- Insulin resistance is increased with fat consumption (especially saturated fat).
- Keep intake of saturated and trans fats low. About 30% of calories should be from mostly healthy fats with no more than 7% from saturated fat. One serving of fat equals 5 grams of fat.
- Eating a serving of protein with each carbohydrate serving will help keep blood sugar levels stable. One serving of protein equals 7 grams of protein.
- Eating meals and snacks every two to three hours will also help stabilize blood sugar levels.
- Don't forget to look at serving sizes. Foods can be comprised of more than one serving.
Carbohydrate Counting. American Diabetes Association. Accessed: 08/15/2011 http://www.diabetes.org/food-and-fitness/food/planning-meals/carb-counting/
Johnson, Mary A. "Carbohydrate Counting for People with Type 2 Diabetes." Diabetes Spectrum 2000 13(3):149