For most people with diabetes, Carbohydrate Counting is a more flexible and simple alternative to the Exchange System. Since of all the nutrients we eat—protein, carbohydrate and fat—carbohydrate affects blood-glucose levels the most, this system focuses only on carbohydrates. You’ll keep a count of the carbohydrate you take in at each meal, aiming to stay within a predetermined daily range, based on your daily calorie needs. The goal is to make sure you’re eating a fairly consistent amount of carbohydrate each day, in a similar pattern. You can do this in either of the following ways:
Count Carbohydrate Grams. You aim for a specific amount of carbohydrate grams at each meal—say, 30 grams at breakfast, 45 grams at lunch and 60 grams at dinner. You track your carbohydrates throughout the day by keeping a running total.
Count Carbohydrate Servings. You track carbohydrate by thinking of it in terms of portions of foods. One Carbohydrate Serving (sometimes called a “Carbohydrate Choice”) is a portion of food that contains 15 grams of carbohydrate—about the amount in a small potato, a slice of bread or a medium apple. You aim for a predetermined amount of Carbohydrate Servings at each meal: typically 3 to 5 Carbohydrate Servings at main meals and 1 to 2 Carbohydrate Servings for snacks. For most people, the daily total number of Carbohydrate Servings will be about 12 (for a 1,500 calorie/day plan) or 16 (for a 2,000 calorie/day plan).
With either system, you’ll need to know the carbohydrate content of a food first. Your diabetes specialist can provide you with food lists to get started. Since carbohydrates are found in plant-based foods like grains, fruits and vegetables, and in sweets, as well as in dairy foods like milk and yogurt, those are the kinds of foods you’ll be monitoring most closely.
As you become more familiar with standard portions, you’ll be able to estimate the carbohydrate content of more complex foods, like pizza. Recipes with nutrition information are a good source of carbohydrate counts. On packaged foods, you’ll find the tally on the “Nutrition Facts” label: first, check the food’s “Serving Size,” then look for the “Total Carbohydrate” value in grams.
The “Dietary Fiber” listing is also important—the higher the better. With higher-fiber foods (more than 5 grams of fiber per serving), you can subtract the grams of fiber from the total carbohydrate count, since some of the carbohydrate in a high-fiber meal isn’t as available to be digested, when compared with a low-fiber meal of similar total carbohydrate content. That allows you to squeeze a few more carbohydrates into your meal while still staying on track with your daily carbohydrate goals.