How Many Carbs per Day Are Right for Me?: Managing Diabetes

According to the Centers for Disease Control and Prevention (CDC), people with diabetes should get approximately 45 percent of their calories from carbohydrates. And while this is an average, the total amount of carbohydrates you should eat in a day is different for everyone.

In fact, studies have shown that there is no ideal amount of calories consumed from carbohydrates, fat, and protein. Instead, macronutrient amounts should be individualized. However, because carbohydrates affect blood sugar the most, monitoring carbohydrates whether by carbohydrate counting or estimated guessing can improve blood sugar control. 

Registered dietitians, nutritionists, and certified diabetes educators (CDEs) can create individualized meal plans based on eating patterns, goals, food preferences, lifestyle, and culture, etc. 

Generally, if you have diabetes and are prescribed a diet that contains 45 percent of calories from carbs, on a 1600-calorie diet, you would consume about 45 to 60 grams of carbs per meal and 15 to 30 grams of carbs for a snack. That looks like 135 grams to 180 grams of carbs per day, broken down into three meals (not including any additional snacks). This may change depending on your specific calorie needs.

Additionally, some people benefit from eating a consistent carbohydrate diet, for example, eating the same amount of carbohydrates per meal daily (especially when taking fixed doses of insulin). Others practice estimated guess carbohydrate counting or eat low-carb diets. 

The daily recommended intake of carbohydrates for adults ranges from 45 percent to 60 percent of calories. On a 1600-calorie diet, that looks like 180 to 240 grams per day or 60 to 80 grams of carbs per meal. On a 2000-calorie diet, that looks like 225 to 325 grams of carbs per day or 75 to 108 grams of carbs per meal.

Figuring out the right amount of carbohydrates you should eat daily needs to be a collaborative effort between your healthcare provider, a dietitian or certified diabetes educator, and you. Specific factors that influence your carbohydrate intake include:

• Age
• Sex
• Weight
• Activity level
• Blood sugar numbers

And then how you divide your total carb intake throughout the day will also depend on a variety of conditions, including:

• Diabetes medicines (some medicines need to be taken with food and if you are taking insulin, the timing of your carbohydrates will matter)
• Eating patterns
• Blood glucose response
• Exercise

A good way to determine your ideal carb intake is to test your blood sugar before and after you eat. If your blood sugar is in target range two hours after a meal, then you know your meal plan is working for you. 

Carbohydrates are a primary source of energy for the body and provide plenty of vitamins and minerals, but not all carbs are created equal. Carbs can be any type of sugar, starch, or fiber—they're all structures made up of glucose molecules. During digestion, the body breaks down carbs into their glucose building blocks. Eating a high amount of carbs can quickly raise blood sugar levels, thanks to an impending flood of glucose in the bloodstream.

People with diabetes should skip or limit refined carbohydrates (consisting mostly of processed and packaged foods) in favor of complex carbohydrates, which are slower-burning starches like whole grains such as brown rice or oats, or veggies like squash or potatoes, in portion-controlled amounts. 

The carbohydrate count, fiber and added sugars of all packaged foods can be found by reading the Nutrition Facts label. For foods without a label, it can be helpful to use a food journal app where you can input the portion size and food type and thereby determine the approximate number of carbs you're consuming. Counting carbs can be helpful to keep an eye on your overall intake, especially if you have been diagnosed with diabetes.

Another way to keep track of your carbohydrate intake is by creating a meal plan with your dietitian. Mapping out your daily meals can provide a helpful framework for making sure that you're balancing your carb intake to just 45 to 60 grams per meal (or less). When planning your meals, pair any carbs with a protein and fat to slow the glucose uptake into your bloodstream.

Here are a few things to consider when creating a meal plan:

• Studies have shown that eating a lower-carbohydrate breakfast may help to improve weight and blood sugars. In addition, other studies suggest that a high-fat, high-protein breakfast can help reduce blood sugars throughout the day.
• Focusing on a high-fiber lunch with plenty of veggies and whole grains will help sustain you through any afternoon slumps.
• A dinner packed with lean protein, green veggies, and a complex carb side is filling and nutrient-dense, meaning you'll be less likely to reach for a carb-heavy dessert later.
• Juice, milk, soft drinks, and alcoholic drinks are usually high in carbs. If you're limiting your carb intake, these beverages can count for a lot. Stick to water, sparkling water, coffee, and tea for a healthy, no-carb option.

The following sample meal plan provides roughly 45 to 60 grams of carbohydrates per meal and 15-30 grams of carbohydrates per snack.

Breakfast: 

• 3 eggs with two slices of whole grain toast (30g carbohydrate), lettuce, tomato
• 1 small piece of fruit (15g carbohydrate)
• Total carbohydrate: 45g carbohydrate 

Lunch: 

• Salad with lettuce, cucumber, carrot, 1/4 avocado (~5g carbohydrate) 
• 1 cup low-sodium lentil soup (30g carbohydrate)
• 3 cups air-popped popcorn (15g carbohydrate)
• Total carbohydrate: ~50g carbohydrate

Snack:  

• 1 small apple (15g carbohydrate)
• 1 tablespoon peanut butter 
• Total carbohydrate: ~15g carbohydrate 

Dinner: 

• 4 oz grilled salmon
• 1 cup roasted asparagus with 1/2 cup cannellini beans (20g carbohydrate )
• 1 large sweet potato (35g carbohydrate)
• Total carbohydrate: ~55g carbohydrate

Snack: 

• 1 nonfat plain Greek yogurt (7g carbohydrate)
• 3/4 cup blueberries (15g carbohydrate)
• Total carbohydrate: ~22g carbohydrate 

While sugar can have a place in a lower-carbohydrate diet, it's important to be aware of the fact that sugar has zero nutrient density, meaning no vitamins or minerals are present. Keep an eye on added sugars in packaged foods, which can be the biggest culprit of empty carbs. Current dietary guidelines recommend that no more than 10 percent of calories come from added sugar. That specifically looks like:

• No more than 6 teaspoons or 25 grams of added sugar for adult women without diabetes
• No more than 9 teaspoons or 37.5 grams of added sugar for adult men without diabetes

There are no current recommendations for added sugars for adults with diabetes. If you have diabetes, work with your care provider and dietitian, nutritionist, or CDE to determine the daily amount of added sugar that's right for you.

High-quality sources of fat and protein play a big role in diabetes management, as they can slow the entry of glucose into the bloodstream and be used for energy when you're limiting carbs.

Proteins to include as part of your healthy diet:

• Meat, such as poultry, fish, and lean red meats
• Eggs
• Beans and legumes
• Soybeans, tempeh, and tofu
• Nuts and seeds

Fats to include as part of your healthy diet:

• Avocado and avocado oil
• Olive oil and olives
• Nuts and nut butters
• Seeds, such as sesame seeds, pumpkin seeds, sunflower seeds, etc.
• High-quality full-fat, grass-fed dairy

When planning your meals, keep a mental checklist of a plate complete with complex carbs, protein, and healthy fats, which will help you keep your glucose levels in better balance than by eating simple or refined carbs alone.

Everyone with diabetes, especially those who are recently diagnosed, should receive diabetes self-management education (DSME) on an ongoing basis. DSME has been proven to help diabetes outcomes through individualized education. If you have not received this type of education, ask your primary doctor about where you can find a certified diabetes educator.

Until then, you can start by implementing a modified, consistent carbohydrate diet. The American Diabetes Association recommends starting with about 45 to 60 grams of carbohydrate per meal. You may ultimately end up on a lower carbohydrate diet, but testing your blood sugar before and after meals can help you to see if your current meal plan is working. Ideally, two hours after eating, your blood sugar should be less than 180mg/dL. If it is higher, you may need to adjust your meal plan by reducing your carbohydrate intake.