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What Is the Exchange List for Diabetes?


Updated April 02, 2012

Question: What Is the Exchange List for Diabetes?

Meal planning with exchange lists has been around since the 1950s. The system was designed by the American Diabetes Association, the U.S. Public Health Service, and the American Dietetic Association. It is a commonly recommended diet for people with type 2 diabetes, but there is enough controversy over what the "best" diabetes diet is that it cannot be said that this is the official or standard diet for diabetes.

Generally, it seems that most agree the best diet for diabetes is one that is high in fiber, fruits, and vegetables but lower in calories, carbs, saturated fat, and trans fat.

This method of meal planning allows structure, ease, and variety. However, there is the potential for a person to follow the exchange list program yet make bad choices, making for a less nutritious diet.

Exchange List Basics

When using this diet plan, you are assigned a number of servings or exchanges you can have from various food groups. Your doctor, dietitian, or diabetes educator can help you figure out how many exchanges you could have from each food group or list.

In this plan, foods are divided into groups or lists called exchange lists:

  • Starches
  • Meat and Cheese
  • Vegetables
  • Fruits and Sugar
  • Milk
  • Fats
  • Free foods
  • Combination foods

Foods in a particular list are called "exchanges" and they are similar to each other in nutritional value. For example, all exchanges from the starch group would contain 80 calories, 15 grams of carbohydrate, 3 grams of protein, and trace amounts of fat. In other words, all the foods listed in the starch group would be interchangeable with each other.

Typically for a 2,000 calorie diet, there would be 11 starch exchanges, 8 meat exchanges, 4 vegetable exchanges, 3 fruit exchanges, 2 milk exchanges, and 4 fat exchanges.

Where to Find Exchange Lists

You can find lists online from various sources or buy books from the American Diabetes Assocation.


Another very common plan recommended to people with diabetes is carbohydrate counting. This is a very easy and flexible plan that allows for variety. However, this method has the same potential problem as exchange lists in that followers can make regular bad nutritional choices while still being within the guidelines of the plan.

The best diet for diabetes is any diet where the person following it can stick with it and make permanent healthy lifestyle changes while maintaining good blood sugar levels.

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