Carbohydrate Counting – Should You Do It?

A Guide to Get You Thinking About Carbohydrates

Senior woman with her granddaughter chopping vegetables in kitchen
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Carbohydrates are found in a variety of foods - starches (bread, cereal, pasta), fruit, milk, yogurt, legumes (beans), starchy vegetables (peas, corn, potatoes) and sugary foods. Carbohydrates are the body's main source of energy. When ingested, carbohydrates get metabolized and turn into glucose (sugar) within about 90 minutes of ingestion.

Carbohydrates are a very important nutrient to monitor when you have diabetes because these are the types of foods that increase blood sugars the most. For those persons with diabetes, it is recommended that you eat a consistent, modified carbohydrate diet. The American Diabetes Association advises that monitoring carbohydrate intake whether by carbohydrate counting or experienced-based estimation remains a key strategy in achieving glycemic control. Some people benefit from eating a lower carbohydrate diet - discuss with your Registered Dietitian or Certified Diabetes Educator how many carbohydrates you should have per meal and what type of diet works best for you. If you decide you would like to begin to familiarize yourself with carbohydrate counting you can start here:

Familiarize Yourself With Carbohydrate Sources

Carbohydrates are found in starches (cereals, bread, grains) fruit, milk, yogurt, legumes (beans), starchy vegetables, and sugary foods. Some foods contain carbohydrate, protein, and fat - these types of food are called combination foods. For example, milk contains about 15 g of carbohydrates per 1 8oz cup, but it also contains protein and fat. Legumes or beans are a great source of protein, but they also contain carbohydrate. Foods that contain little to no carbohydrate are proteins - fish, chicken, eggs and cheese, fats - oil, olives and non-starchy vegetables - spinach, broccoli, peppers, eggplant, cauliflower (etc). If you are counting grams of carbohydrates you will want to look up specific foods - especially those without labels. Below are some great carbohydrate counting resources:

Watch Out for Hidden Sources of Carbohydrates

It's important to always read labels when carbohydrate counting. Sauces, condiments, and other ingredients can add carbohydrates that you may not be aware of. Protein sources contain no carbohydrate unless they are breaded, or topped with gravy. Fried foods and foods with heavy sauces are not the best choices anyway, because they are typically high in calories and fat. Other hidden carbohydrate sources are sugar-free foods, ketchup, barbecue sauce, fat-free salad dressing, flavored coffee drinks, and low-fat peanut butter.

What Does it Mean to Make Experienced-Based Estimation

People who've had diabetes for a long time know about experienced based estimation - they are able to determine an accurate serving of carbohydrates by "eye-balling" and they are aware of how certain foods affect their blood sugar. Another good way to practice portion control when monitoring your carbohydrates is to practice the plate method. The plate method can help you to reduce portions of carbohydrate, resulting in weight loss and improved blood sugar control. The idea behind the plate method is balanced, portion controlled eating. Using a nine-inch plate you want to aim to make 1/2 of your plate non-starchy vegetables, 1/4 of your plate lean protein and 1/4 of your plate a complex (about a fist full), high fiber carbohydrate. Limiting your carbohydrates to 1/4 of your plate can help to reduce portions or carbohydrates, lowering blood sugars and weight. The bulk of your meal is non-starchy vegetables which are low calorie and can help you to feel full and satisfied. An example would be:

4oz of grilled salmon with lightly sauteed spinach and mushrooms and 1 cup of quinoa or medium baked sweet potato


4oz of baked lemon chicken with roasted peppers and onions and 1 cup of cannellini beans


4oz grilled white meat turkey topped with lettuce, tomato on a whole grain bun served with roasted asparagus and salad.

All of these meals contain fiber, lean protein and are carbohydrate controlled. The aim is to never make carbohydrates the base of your meal - rather a side dish. 

Use Your Meter to Guide You

Your blood glucose meter can be a guide to carbohydrate regulation. Each person responds differently to certain foods and portions of carbohydrate. For example, if your meal plan allows you to eat 45 g of carbohydrate at dinner, but two hours after you eat your blood sugar is always above goal than perhaps you are either eating too many carbohydrates at dinner or maybe you are not carbohydrate counting correctly. Or, in the instance that you are not counting carbohydrates and your blood sugars are high, you can use your meter to help you determine what foods work best for your body, portions, and timing of your meals. The meal plan provided to you by your registered dietitian or certified diabetes educator is a guide but can be adjusted based on your goals, blood sugars, activity level, and weight status. 

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Article Sources

  • American Diabetes Association. Standards of Medical Care in Diabetes – 2014. Diabetes Care. 2014 Jan; 37 Suppl 1: S14-80.