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Getting Started With Carb Counting

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Getting Started With Carb Counting

Whether you’re new to diabetes or consider yourself an old hand at it, something that you’ll quickly come to learn is that controlling your carbohydrate intake is a key part of managing your diabetes. Understanding what carbohydrates are, as well as how to successfully fit them into your eating plan, will make it a lot easier to keep your blood sugars within your target range.

Carbohydrate: First things first

You don’t need to have a degree in nutrition to figure out what to eat, but it helps to have some of the basics down. Eating for your diabetes is not solely about managing blood sugars. Sure, that’s a big part of it, but there are other goals of nutrition, as well. Here’s what the American Diabetes Association defines as “goals of nutrition therapy for adults with diabetes,” as per their Standards of Medical Care in Diabetes — 2021.

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1. To promote and support healthful eating patterns, emphasizing a variety of nutrient-dense foods in appropriate portion sizes, to improve overall health and:

2. To address individual nutrition needs based on personal and cultural preferences, health literacy and numeracy, access to healthful foods, willingness and ability to make behavioral changes, and existing barriers to change.

3. To maintain the pleasure of eating by providing nonjudgmental messages about food choices while limiting food choices only when indicated by scientific evidence.

4. To provide an individual with diabetes the practical tools for developing healthy eating patterns rather than focusing on individual macronutrients, micronutrients, or single foods.

That certainly seems like a handful, but the main point is that there are many reasons to focus on good nutrition. There is no one “diet” for diabetes, either. Different eating patterns can work for different people. Examples of eating patterns include the Mediterranean-style plan, the DASH (Dietary Approaches to Stop Hypertension) plan, a vegetarian or vegan plan, and even a low-carbohydrate plan. Your food preferences, lifestyle and health conditions all figure into what eating pattern will work best for you.

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Step 1: Learn what carb counting is

Carbohydrate, or “carb,” counting really isn’t all that new. Dr. Elliott Joslin, founder of the renowned Joslin Diabetes Center, taught carb counting to his patients back in the early part of the 20th century: “In teaching patients their diet,” he said, “I lay emphasis first on carbohydrate values, and teach to a few only the values for protein and fat.” Patients who came to Joslin Clinic in those days were taught by Dr. Joslin himself. Since those early days, many aspects of diabetes care have changed for the better, but carb counting has stuck around as simple yet effective approach to help people better manage their diabetes.

Carb counting involves counting the number of grams of carb in the foods that you eat. If you take mealtime insulin, you can go one step further and “match” or adjust your insulin to the grams of carb that you’ll be eating. Anyone with diabetes can do carb counting; it’s not a diet, but rather a tool to help you better plan meals and learn how your food choices affect your blood glucose levels.

Step 2: Know the foods that contain carb

Carbohydrate is a nutrient in food that turns to glucose (sugar) during digestion. Our bodies then use this glucose for energy. Here are the types of foods that contain carbohydrate:

  • Grains: e.g., bread, pasta, cereals, rice
  • Starchy vegetables: e.g., corn, peas, potatoes, lima beans
  • Fruit and fruit juices
  • Milk and yogurt
  • Sweets: e.g., ice cream, candy, cookies, sugary drinks

Nonstarchy vegetables, such as broccoli, green beans, and carrots, have a little carb, but not enough to affect blood glucose levels unless you eat excessive amounts. Keep in mind that carb can lurk in foods that you may not typically consider to be carb. Examples are salad dressings, spaghetti sauce, canned soups, and ketchup.

Step 3: Focus on slower-release carbs

Many people with diabetes mistakenly think that they have to stop eating carb altogether. Not only is this impractical, it’s hard to do, since many foods contain at least some amount of carb. In addition, if you choose wisely, you can reap a lot of benefit from carb foods — if you know the best choices, that is. What are the best choices? These are the carbs that are unprocessed and that contain fiber. Examples include:

  • Vegetables
  • Whole fruit (with the skin, when possible)
  • Legumes: e.g., kidney beans, black beans, chickpeas, lentils
  • Whole grains: e.g., quinoa, barley, brown rice, millet, oats, whole-wheat bread

Not only are these foods jam-packed with vital nutrients (vitamins, minerals, and antioxidants), they contain fiber, which slows the rate at which glucose from carbs enters the bloodstream. An added bonus: Foods that are high in fiber help fill you up, so that you may end up eating less. Finally, slower-release carbs offer protection against heart disease, stroke, and some types of cancer.

Refined carbs are the ones to eat less of. These include white bread, white rice, pastries, candy, and sugary drinks. Refined carbs tend to quickly spike your blood sugar (which is why juice, soda, and candy can be good choices if your blood sugar is too low); plus, they’re linked with causing health problems such as obesity, insulin resistance, and type 2 diabetes.

Step 4: Know your carb goals

The amount of carb that you need each day (and at each meal) depends on a number of factors, such as your age, gender, activity level, and weight goals. Ideally, it’s best to have a conversation with your healthcare provider, a dietitian, or a diabetes educator to determine the amount of carb that’s best for you and that can help you achieve your blood sugar goals.

To get you started, though, a suggestion for the amount of carb to aim for at meals and snacks is as follows:

  • Men: 45-60 grams of carb per meal; 15-30 grams of carb per snack
  • Women: 30-45 grams of carb per meal; 10-15 grams of carb per snack

Step 5: Start counting

One carb choice or carb serving is the amount of food that contains 15 grams of carbohydrate. Here are examples of what 15 grams of carb looks like:

  • 1 slice (ounce) of whole-grain bread
  • 1/3 cup cooked brown rice
  • 1 cup raspberries
  • ½ banana
  • ½ cup black beans
  • ½ cup corn
  • 1 cup milk
  • 3 cups popped popcorn

If your carb goal is, say, 30 grams for breakfast, you could have 1 slice of whole-grain toast (15 grams of carb) and ½ banana (15 grams of carb). You can still include protein and fat in your meal, too.

Carb counting isn’t difficult, but the challenge comes in with knowing how much carb is in the amount of food that you plan to eat. Here’s where to get help:

Aim to be consistent with the amount of carb you eat at your meals and snacks. This doesn’t mean that you have to eat the same foods all the time, but do your best to keep to your carb goal. Don’t forget to keep an eye on portions. Using measuring cups or a food scale help with portion control, which, in turn helps you stick to your carb goals.

Step 6: Keep track

The only way you’ll really know if your carb intake is working for you is by checking your blood sugars. Ideally, check before and about two hours after you eat. For most people, the blood sugar goal two hours after a meal is less than 180. Keeping a record of your food intake helps, too; that way, you can learn more about the foods that have less of an impact on your blood sugars

Carb counting is a flexible meal planning tool that can work with any type of eating pattern that you choose to follow. Once you get the basics down, you’ll probably find that meal planning gets a little easier. You’ll even be able to fit in a favorite treat now and then, if you so choose.

Want to learn more about carb counting? Read “Counting Carbohydrates Like a Pro.”

Amy Campbell, MS, RD, LDN, CDCES

Amy Campbell, MS, RD, LDN, CDCES

Amy Campbell, MS, RD, LDN, CDCES on social media

A Registered Dietitian and Certified Diabetes Educator at Good Measures, LLC, where she is a CDE manager for a virtual diabetes program. Campbell is the author of Staying Healthy with Diabetes: Nutrition & Meal Planning, a co-author of 16 Myths of a Diabetic Diet, and has written for  publications including Diabetes Self-Management, Diabetes Spectrum, Clinical Diabetes, the Diabetes Research & Wellness Foundation’s newsletter, DiabeticConnect.com, and CDiabetes.com

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