Ready, Set, Start Counting
How to use carbohydrate counting to keep control of your blood glucose levels.
Adapted from Diabetes Care and Education Dietetic Practice Group (www.dce.org)
Carbohydrate counting is one of the many ways to help manage your blood glucose control. Carbohydrate counting is not a diet. It is a meal planning tool that helps you understand how your food choices affect your blood glucose level.
Carbohydrate and blood glucose
The carbohydrate you eat is digested and broken down to glucose, which is then absorbed into your bloodstream to provide energy to your body cells. The right balance between carbohydrate and insulin (made by the pancreas or from injections (helps keep your blood glucose levels normal). When you eat, how much you eat, and whether or not you have snacks between meals should be based on your lifestyle, medications, and meal planning goals. An accredited practising dietitian (APD) can help you choose, from the goals below, an eating plan that is best for you.
Consistency
For many people who use insulin or other medications to help control their blood glucose levels, it is important to eat regularly. Planning the amount of carbohydrate you eat at each meal can help keep your blood glucose levels from going too high or too low.
Matching
Some insulin plans allow you to vary meal times or carbohydrate amounts. If you follow this type of insulin plan you need to know how to match your insulin to the amount of carbohydrates you eat.
To count carbohydrates you need to know:
Foods that contain carbohydrate
- Grains, breads, pasta, rice, cereals and dried beans
- Starch vegetables (e.g. potato, sweet potato)
- Fruits
- Milk and yoghurt
- Sweets and desserts
Portion sizes/exchanges
- A 'carbohydrate choice/exchange' is a portion of food that has 15 grams of carbohydrate.
- (1 carbohydrate choice = 15 grams of carbohydrate)
- Measure or weigh foods to learn what common portion sizes look like.
How to read a food label
- Find the serving size
- Find the total carbohydrate in one serving (Sugars are included in this number, do not count them separately).
- Compare the serving size on-pack to the serve size you would normally eat.
- Calculate the amount of carbohydrates in your portion. For example, if 'one serve' on-pack is one slice of bread (15g carbohydrate) and you would normally eat two slices, simply double the amount of carbohydrate in one serve (i.e. 30g).
- You can count grams of carbohydrate or carbohydrate portions/exchanges.
Glycaemic Index
It is important to take into consideration the glycaemic index effect of the carbohydrate foods that you eat.
When carbohydrates are digested to glucose, the glucose is taken into the bloodstream causing blood sugar levels to rise. The level to which they rise and how quickly they rise will vary for different carbohydrate foods. High GI (gylcaemic index) foods cause a rapid rise in blood glucose as they are digested quickly, whereas carbohydrates with a lower GI release glucose into the bloodstream more slowly, producing a smaller rise in blood glucose levels, which helps to sustain energy and reduces the desire to snack.
The gylcaemic index (GI) is a ranking of individual carbohydrate foods, based on their effect on blood glucose levels. The GI ranks foods from 0 to 100. High GI foods (GI>70) raise blood glucose levels moderately, whereas low GI foods (GI<55) raise blood glucose levels just a little.
It is important to note that a food is not 'good' or 'bad' based on it's GI value. Therefore, your food choices should not be solely based on their GI value. Eating a wide variety of foods from the core food groups and including some lower GI foods is the key to a balanced and enjoyable way of eating.
A balanced diet is more than just carbohydrate counting.
The proportions of carbohydrates, protein and fat in your eating plan depend on your body weight, activity levels and lifestyle factors. What you eat also depends on what foods you enjoy. An accredited practicing dietitian (APD) can you help you plan what's right for you - including portion sizes, carbohydrate counting, types of food and overall timing.
For a referral to a dietitian or more information on meal planning contact the Dietitians Association of Australia at www.daa.asn.au or (02) 6282 9555.
Carbohydrate choices
How many carbohydrate choices you need will depend on your size and activity level. Speak to an accredited practising dietitian (APD) who can help you determine the appropriate amount of carbohydrate portions you need to suit your diet and lifestyle needs.
Each portion is one carbohydrate exchange (15 grams of carbohydrate)
Foods with less than 20 calories (84kJ) and 5 grams of carbohydrate are considered 'free'. These include: sugar-free soft drinks and cordials, alternative sweeteners (e.g. Equal, spices and seasonings).
Grains, Breads, Cereals
- 30g bread (1 slice bread, 1/2 medium bread roll)
- 1/2 cup cooked beans or legumes (e.g. lentils)
- 1/3 cup cooked pasta or rice
- 3/4 cup breakfast cereal
- 1/2 cup cooked cereal (e.g. porridge)
Milk & Yoghurt
- 1 cup milk
- 2/3 cup unsweetened yoghurt or sweetened with alternative sweetener (e.g. Equal)
Fruits
- 1 small fresh fruit (e.g. apple)
- 1/2 cup canned fruit
- 1 cup melon or berries
- 1/2 cup unsweetened fruit juice
- 1/4 cup dried fruit (e.g. sultanas, apricot halves)
Vegetables
- 1/2 cup potato, sweet potato, or corn
- 3 cups raw vegetables
- 1½ cups cooked vegetables (Small portions of non-starchy vegetables are free, e.g. carrots, broccoli, cabbage)