Choosing the method that works best for you depends in part on how you control your diabetes, but it also depends on your willingness and ability to use the method. Some people like a detailed meal plan that covers all the food groups; others would rather work around a carbohydrate goal for each meal and decide for themselves which foods (from which food groups) to eat. In many cases, people use a combination of methods to arrive at a meal-planning system that works for them. (See “Tools for Meal Planning” for a list of helpful resources.)
Sources of carbohydrate
Whatever meal-planning method you use, it’s important to gauge how much carbohydrate you eat. Foods containing carbohydrate directly affect your blood glucose level soon after you eat them. If you eat too little carbohydrate, you risk developing low blood glucose. If you eat too much carbohydrate at one sitting, your blood glucose level can skyrocket. For many people, eating about the same amount of carbohydrate at snacks and meals from one day to the next can aid in blood glucose control. People who use rapid- or short-acting insulin before meals may have more flexibility in the carbohydrate content of their meals since they can adjust their insulin dose according to the amount of carbohydrate they plan to eat. (This technique is best learned with the help of a diabetes professional.)
Determining how much carbohydrate to consume at each meal and snack is a matter of some trial and error. Dietitians typically recommend starting with about 4 carbohydrate choices (or 60 grams of carbohydrate) per meal at breakfast, lunch, and dinner. People who need more food might also have one or two snacks in their meal plan containing 1–2 carbohydrate choices (15–30 grams of carbohydrate) per snack. The amounts of carbohydrate in each meal can be fine-tuned based on blood glucose monitoring and personal preference.
Many foods contain carbohydrate, so learning which foods contain carbohydrate can be the first step toward adding more variety to your meal plan. The table “Carbohydrate Choices” lists some of the many options.
Starches and breads. Breads, cereals, dried beans, pasta, rice, potatoes, sweet potatoes, and winter squash are all sources of carbohydrate. One serving of each of these foods (as specified here) provides about 80 calories, 15 grams of carbohydrate, 3 grams of protein, and 0–1 grams of fat. Because they contain about the same amount of nutrients, a serving of one can be swapped for a serving of another without jeopardizing your blood glucose control. Therefore, if your meal plan calls for 1/3 cup of rice but you’re in the mood for something crunchy, you could have 3 cups of popped popcorn or 4–5 crackers instead. Similarly, if you’re eating on the run, you might choose a piece of toast over a half-cup serving of hot cereal. As long as the amount of carbohydrate in a serving is the same, one food can be substituted for another.
Some starchy foods are good sources of fiber, a form of carbohydrate that isn’t absorbed by your body but performs some important functions nonetheless, one of which is preventing constipation. Most Americans are advised to consume 25–35 grams of fiber per day, but check with your doctor or dietitian for the amount of fiber that’s right for you. Since fiber doesn’t raise blood glucose level, the number of grams of fiber in a serving can be subtracted from the total grams of carbohydrate if there are more than 5 grams of fiber per serving.