Carbohydrate Counting for Diabetes Meal Planning

Assorted Bread, bread sticks, crackers
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There are many methods for meal planning when you have Type 2 diabetes. One nutrient that always must be considered is carbohydrate. Carbohydrates are the macronutrient that impact blood sugars the most. When they are eaten, they turn into sugar and act as the body's primary source of energy. When it comes to meal planning, the American Diabetes Association recommends that meal plans be individualized based on a variety of factors including lifestyle, medication regimen, weight,etc. Carbohydrate counting is one type of meal plan that is flexible—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.

A Tailored Diabetes Carbohydrate Counting Plan

Your doctor or dietitian can help you figure out how many carbs you should have, including meals and snacks. In efforts to create these meal plans, they will consider your type of medication, lifestyle factors such as exercise, current diet, weight, height, gender, overall health. An evaluation of how you respond to certain types and amounts of carbohydrates also helps them create an individualized meal plan.

You may be asked to track your blood sugar levels before meals and two hours after a meal to see how your body responds to certain foods and certain food combinations. You also may be asked to log the types of foods you are eating and how much so that they can calculate how many carbs are consumed at each of your meals. 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 American Academy of Diabetes recommends that people with diabetes should have blood sugars less than 180mg/dL two hours after the start of a meal. Keep in mind, though, all blood sugar targets should be individualized.

You may receive carbohydrate count based on a daily calorie prescription. The percentage of carbohydrates should be individualized based on your blood sugar goals, weight, etc.

How Many Carbs?

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, which means we all need different types of meal plans. Your specific meal plan should depend on your type of lifestyle, food likes and dislikes, weight, and how your body reacts at that mealtime. Work with your healthcare team to design the best meal plan that suits your needs. 

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

Your dietitian or certified diabetes educator can teach you how to count carbohydrates. They will review labels with you to help you identify carbohydrates. In addition, they can provide you with resources and tips on how to count foods that do not contain labels. Typically, people count total grams of carbohydrates. Some people still use an older method of carbohydrate counting and count carbohydrate servings per meal. For example, one carb serving = 15 grams of carbs. If you were prescribed 60 grams of carbs for one meal, that would equate to four carb servings (60 divided by 15).

Carb counts can be obtained from:

  • Food labels, books, websites, apps
  • 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 (size of tennis ball)
  • One slice of bread
  • One six-inch tortilla
  • Half a hamburger bun, English muffin 
  • One cup plain or artificially-sweetened nonfat or low-fat yogurt
  • One cup of milk
  • One third cup of cooked pasta, rice, barley, couscous
  • Small (3oz) potato
  • Half cup of corn, beans, peas
  • Half cup oatmeal
  • 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

  • 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
  • One tbsp = one thumb
  • Two tbsp = one shot glass
  • One tsp = one dice or Scrabble tile

More Helpful Things to Know

  • Carbs raise blood sugar levels more 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.
  • 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. Some studies even suggest eating protein first to lower blood sugars. 
  • 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.
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Article Sources

  • American Diabetes Association. Standards of Medical Care in Diabetes – 2015. Diabetes Care. 2015 Jan; 38 (Suppl 1): S1-90.
  • Carbohydrate Counting. American Diabetes Association.
  • Johnson, Mary A. "Carbohydrate Counting for People with Type 2 Diabetes." Diabetes Spectrum 2000 13(3):149
  • Shukla A, Iliescu R, Thomas C, Aronne L. "Food Order Has a Significant Impact on Postprandial Glucose and Insulin Levels." Diabetes Care. 2015; 38(7):e98-e99.