At first, carbohydrate counting can seem overwhelming, but once you become familiar with reading labels, portion sizes and understanding the reason for carb counting, it will become second-nature. First of all, it is important to know who should be carb counting. Carb counting is not for everybody with diabetes. That’s right, I said it. Just because you have diabetes does not mean you need to carb count. How many times have you read a nutrition facts label and have been totally confused? Total carbohydrates, fiber, sugars, sugar alcohol? What does it all mean? When someone is carb counting the only items to worry about on a nutrition facts label is serving size and total carbohydrates.

understanding carbohydrate counting for people with diabetesWho should carb count?

  • People on meal time insulin i.e. Humalog, Novolog, or Apidra. The point of carb counting is to know how much meal time insulin to take with meals. Once you can show you are counting correctly you eventually will receive an insulin-to-carb ratio.  What is an insulin to carb ratio? Using a special formula your endocrinologist or diabetes educator will determine your insulin to carb ratio. People have different ratios depending on their glucose response to food, and how much insulin they take on a daily basis. For example, someone can have a 1:10 insulin carb ratio. What this means is that for every 10 grams of carbohydrates you eat, you need 1 unit of insulin. So if a person eats 60 grams of carbohydrates with breakfast he or she will need to take 6 units of meal time insulin. But again everyone has different ratios. Ratios can be different for each meal; the way to figure out what your insulin carb ratio is to contact your local Certified Diabetes Educator. 
  • People interested in utilizing an insulin pump. One of the determining factors for people to receive an insulin pump is to ensure they are carbohydrate counting correctly.
  • People on an insulin pump. The user enters in carbohydrate amounts so the pump can calculate how much insulin is needed to cover food.

Food items with labels make it very easy to carb count. But what about foods without labels; such as fruit, potatoes, pasta, rice, rolls from a bakery? This is when measuring cups and food scales become very beneficial. Remember; fruit, vegetables, starch, and milk all have carbohydrates.

Examples of 15 gram carbohydrate serving of fruit 

4 oz. apple, 4 oz. banana, 6 oz. orange, ½ cup juice, 3 oz. grapes, 1 cup raspberries

Visit our Carbs in Fruits Calculator

Examples of 5 gram carbohydrate serving of nonstarchy vegetables =½ cup cooked  or 1 cup raw

Broccoli, spinach, tomatoes, cauliflower, lettuce etc.

Examples of 12 gram carbohydrate serving of milk

1 cup milk

Examples of 15 gram carbohydrate serving of starch

1/3 cup pasta, 1/3 cup rice, 1 oz. bread, 1 slice of bread, ½ cup oatmeal, ½ cup corn, 3 oz. potato

If you are interested in carbohydrate counting, start paying attention to labels, keep a food journal and record everything you are eating with the total grams of carbohydrates. If measuring and weighing seems unappealing, pour your cereal, rice or pasta out in a bowl and guess how much you think is in it. Before you start eating go back and measure it and see how accurate you are. If you do not guess correctly, this will reinforce the need to measure food properly. To ensure correct carbohydrate counting you will need to measure and weigh your food for at least a couple of days. If after carb counting a while - you find your glucose numbers are showing less control, I would encourage you to dig out your food scale and measuring cups to review portion sizes again.

Remember carbohydrate counting does not necessarily mean “healthy eating;” you still want to focus on healthy eating by choosing more whole grains. In order to tell if a starch is a whole grain, the first ingredient should have the word “whole.” For example, the package may say, “whole wheat flour,” “100% whole wheat flour”, or “stone ground whole wheat”. Other foods are whole grain but may not say it. These food items include: quinoa, oatmeal, oats, popcorn, and corn.  Not only do we want most of our carbohydrates coming from whole grains but we also want to include fruits, vegetables, and dairy into the mix. We also want to work on eating less processed carbohydrates like French fries, potato chips, fried foods, cookies, cakes, etc. 

Like most things, counting carbs takes work and practice. Keep in mind, changing eating patterns to reflect healthier behaviors can control blood glucose levels and even help with weight loss! Please continue to follow future posts as we discuss the plate method, combing meals, and food groups.

Read the second part of the Carbohydrate Counting Series - Reading Food Labels for Carb Counting