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1 Ready, Set, Start Counting! Carbohydrate Counting a Tool to Help Manage Your Blood Glucose When you have diabetes, keeping your blood glucose in a healthy range can help you feel your best today and in the future. Carbohydrate counting or carb counting is a flexible meal-planning tool (not a diet) that can help you understand how your food s affect your blood glucose level. Carbohydrate and blood glucose Any carbohydrate food you eat (e.g., milk, fruit, bread and pasta) is digested into glucose, which causes your blood glucose level to increase. However, eating some carbohydrates throughout the day is important because they provide energy and essential nutrients for your body. To better manage your blood glucose, energy levels and weight, pay attention to how much carbohydrate you eat. Maintaining the right balance between carbohydrate and insulin (whether your body produces it or you take it) helps to regulate your blood glucose level. Determining when and how much you eat and whether or not you have snacks should be based on your lifestyle, medications and meal-planning goals. A registered dietitian nutritionist (RDN) may consider the following ways for you to use carb counting to determine the healthiest plan for you: Setting a maximum amount of carbs for each meal within your healthy meal plan and/or taking diabetes medications can keep your blood glucose from getting too high. If you use diabetes medications or insulin, it may be important to eat the same amount of food and carbohydrate at the same time each day. Doing this can keep your blood glucose from getting too high or too low. If your insulin plan includes varying doses based on how much carbohydrate you are eating (carb/insulin ratio), accurate carb counting can help you determine how much insulin to take. Grains (e.g., breads, crackers, rice, hot and cold cereals, tortillas and noodles) Starchy vegetables (e.g., potatoes, peas, corn, winter squash, lentils and beans) Fruit and juices Milk and yogurt Sweets and desserts Non-starchy vegetables (e.g., carrots, broccoli and tomatoes) contain only a small amount of carbohydrates and do not affect blood glucose when eaten in small portions.

2 Learn how how to to read read food food labels labels Here are tips for to to keep keep reading mind mind food when labels. when reading reading food food labels. labels. Remember: Remember: Always Always compare compare the the serving serving size size listed listed to to your your actual portion. Carbohydrate s s and Carbohydrate s and portion sizes and portion sizes A A carbohydrate A carbohydrate is is is a a portion a Carbohydrate portion of of food, food, s like like such a a slice slice as a Learn actual how portion. to read food labels of of bread, and 1-ounce bread, portion that that slice has has sizes of bread, grams grams that of of has Here are tips to keep in mind when reading food labels. carbohydrate 15 A grams carbohydrate of (1 ( is (1 Remember: Always compare the serving size listed to your Nutrition Facts the = 15 grams of 3 Compare the a portion of food, like a slice actual portion. carbohydrate = 15 grams of = 15 Size 15 (30g) 1 Find the Serving Size 15 crackers (30g) size listed of bread, that has 15 grams of serving size listed about 14 carbohydrate). Servings Per Container about 14 grams of carbohydrate). carbohydrate ( serving size. to to your your actual Nutrition Calories Facts The total 3 Compare the The total = carbohydrate 15 grams of from any portion. The idea is that total 1 Find the Serving Size 15 crackers (30g) serving size listed food food has carbohydrate). the Servings Total Fat Per 3g Container about 14 has about the same effect 5% 5% serving size. to your actual carbohydrate from any food Calories Saturated Fat 0g 130 on on The blood total glucose. carbohydrate from any 2 Locate the portion. often has a similar effect on Cholesterol 0mg 0% 0% Small Small food portions has about of of the sweets same or or effect total carbohydrate Total Fat 3g 5% Sodium 160mg 7% blood glucose levels. Saturated Fat 0g 7% in the grams in one serving. 4 Count the grams on blood glucose. sugar sugar can can occasionally be be used 2 Locate the Cholesterol Total Carbohydrate 0mg 0% 22g 22g 7% 7% total carbohydrate of of carbohydrate in Small in place place of of portions other other of of sweets or or (Sugars are Sodium Dietary 160mg Fiber 2g 7% 2g 8% 8% in or the included one serving. 4 Count the grams or the number sugar can occasionally be used in this Total Carbohydrate Sugars Sugars 3g 22g 7% 3g containing containing place food. of food. other included in this Sugars 3g carbohydrate- sugar can occasionally be used of carbohydrate in place of other (Sugars are Dietary of Protein Fiber 2g number, so you do Protein 3g 8% 3g or the number of carbohydrate carbohydratecontaining or or weigh weigh food. Vitamin A 0% In this not not need to to count Vitamin 0% of carbohydrate s. In this Vitamin C 0% Measure Measure carbohydratecontaining Measure to number, so you do Protein 3g Vitamin 0% 10 them them separately.) s. example, In this 10 crackers not need to count Vitamin A 0% foods foods to learn learn or food. weigh Vitamin C 0% example, them separately.) have 10 would crackers about have 15 grams about what foods common to learn would have what common 15 grams about Measuring or of carb and of equal carb and portion what common 15 grams of carb and sizes look portion sizes look equal 1 carb. weighing foods equal 1 carb 1. carb. like. portion If you sizes do look like. can If like. you help If do you you do not have access not learn have not have what access access to a scale or measuring cups, The number of carbohydrate s you to a scale or The of s you refer common to a scale to these portion measuring hand-estimated sizes cups, look The The number of carbohydrate s s you you need need depends on your body size, activity refer to refer these to these hand-estimated depends need need depends depends on your on your body on body your size, size, body activity size, level activity and like. If you do not have access level and weight-management goals. weight-management level and weight-management to a scale or measuring cups, level and weight-management goals. An goals. RD or goals. RDN can help you determine the appropriate amount refer Determine to these carbohydrate hand-estimated s online of carbs for you. Visit Determine carbohydrate s online When When a a nutrition label is not available, often you you 3. to 3. Visit find Visit the home an the RD/RDN home page of page your near of preferred your you. preferred search search When can can find a nutrition find the the information label is not online. available, often you 3. engine engine Visit (like the Google (like home Google or page Bing) or of and Bing) your enter and preferred the enter key the search key can Determine find 1. Locate the information the online. engine (like Google Bing) and enter the key 1. Locate the carbohydrate name of the company name of the company s that that online produced words nutrition information for (the name produced words nutrition information for (the name or packaged the food, then visit its website. of the food you are looking for) the search 1. When Locate or a packaged nutrition the name the label of food, the is not company then available, visit its that website. often produced you 3. of words the Download food nutrition you a are nutrition information looking app for) for onto in the your search (the cell name window. can or 2. packaged Refer to a the reliable food, website then that visit provides its website. window. of the food you are looking for) in the search 2. find Refer the to information a reliable website online. that provides phone: nutrition information, such as: 4. Download a nutrition app onto your cell phone window Refer Locate nutrition to the a reliable information, name website of the such company that as: provides that produced 4. such Download as: a. For a a list nutrition of apps, app visit onto your cell phone a. Calorie King ( nutrition information, such as: 4. a. MyFitnessPal such Download as: or a nutrition app onto your cell phone a. packaged Calorie King the ( food and visit its website. public-resources/diabetes/ b. The USDA National Nutrient Database ( a. such MyFitnessPal as: 2. a. Refer b. Calorie The to ( a USDA reliable King National ( website Nutrient that provides Database 4. Check out your favorite chain restaurant s 5. Check a. ( out MyFitnessPal your favorite chain restaurant s nutrition b. nutrition The c. ( MyFoodAdvisor USDA information, National Nutrient such as: Database nutrition information on their website so you 5. information Check ( out on their your website favorite so chain you can restaurant s stick to nutrition a. c. Calorie ( can stick to your plan when you eat away MyFoodAdvisor your plan when you are eating away from home. King ( 5. information Check out your on their favorite website chain so restaurant s you can stick nutrition to c. MyFoodAdvisor from home. b. The USDA National Nutrient Database your information plan when on you their are website eating so away you from can stick home. to ( your plan when you are eating away from home. c. MyFoodAdvisor

3 Breads, Grains and Cereals ounce bread roduct slice bread, ¼ rge bagel, 6 ortilla) /3 cup cooked rice r pastaor pasta cup soup Breads, Grains and Cereals 1 ounce bread product (1 slice bread, ¼ large bagel, 6 tortilla) 1/3 cup cooked rice 1 cup soup ¾ ounce unsweetened cold cereal (serving sizes vary, check label) ounce nsweetened cold ereal (serving sizes ary, check ½ cup label) cooked cereal cup cooked cereal 3 cups air-popped cups air-popped popcorn opcorn Milk and Yogurt 1 cup milk Milk and Yogurt 1 cup low-fat or skim 1 cup milk, or low-fat 1 cup or low-fat fat-free or skim milk, or plain yogurt 6 ounces low-fat or fat-free plain or 6 ounces flavored Greek yogurt yogurt made with 6 ounces flavored low-cal yogurt sweetener made with (these low-cal vary, sweetener check (these vary, check label) label) Vegetables Fruits and Beans 1 small piece fresh ½ cup potato, Vegetables fruit Fruits sweet and Beans potato, peas, ½ medium fruit corn 1 small piece fresh ½ cup potato, sweet (apple, fruit banana) potato, peas, corn ½ cup cooked ½ cup medium canned fruit fruit ½ cup cooked beans, legumes (apple, banana) beans, legumes in own juice (garbanzo, kidney, kidney, ½ cup canned fruit black 1 in cup own melon juice black beans) beans) 1 cup honeydew or cantaloupe ½ cup fruit juice 2 TBSP dried fruit 1 1/4 cup 1 watermelon cup raspberries ½ cup fruit juice 1 ¼ cup strawberries 2 TBSP dried fruit 1 cup raspberries ¾ cup blackberries, 1 ¼ cup strawberries blueberries 1 cup blackberries 3/4 cup blueberries 1 cup winter squash 1 cup winter squash 1/3 cup cooked cassava, yam, taro 1/3 plantain (green or yellow) 1 ½ cups cooked vegetables (small portions of nonstarchy vegetables are free) 1 ½ cups cooked vegetables (small portions of nonstarchy vegetables are free) Sweets and Foods ¾ ounce snack food (pretzels, 4- crackers) Sweets and Foods ¾ ounce snack food (pretzels, 4-6 crackers) 8 baked chips, potato, pita 15 potato chips 1 ounce sweet snack (2 small sandwic cookies, 5 vanilla wafers) 13 regular chips, tortilla, potato 1 ounce sweet snack (2 small sandwich cookies, 5 vanilla wafers) 1 TBSP sugar or honey 1 TBSP sugar or honey ½ cup regular ice cream ½ cup regular ice cream The lists above provide a basic idea of the carb count in common foods. Each portion is one carbohydrate (15 grams of carbohydrate). Foods with fewer than 20 calories and fewer than 5 grams of carbohydrate Better carb s are considered free. These include sugar-free beverages, sugar substitutes, spices and seasonings. arb s for common serving sizes 1 regular sandwich = 2 carb s, or about Carbohydrate 30 grams of s carbohydrates for common serving sizes 1 6 sub sandwich = 3 carb s, or about 1 regular sandwich = 2 carbohydrate s 45 grams of carbohydrates or about 30 grams of carbohydrates 1 cup cooked rice or pasta = 3 carb or s, about 45 or grams about of carbohydrates 45 grams of carbohydrates 1 6 sub sandwich = 3 carbohydrate s 1 cup cooked rice or pasta = 3 carbohydrate s or about 45 grams of carbohydrates 1 medium (average) apple or banana = 2 carb 1 s medium or (average) about apple 30 grams or banana = of carbohydrates 2 carbohydrate s or about 30 grams of carbohydrates All carbs are not alike. Choose better carb s, Better such as carbohydrate whole grains s and less-processed foods. Carbohydrate counting is important, but the type of carbohydrate also is important for both blood glucose and overall health. All carbohydrates are not the same. Choose better carbohydrate s, such as whole grains and less-processed foods. Select whole grain bread, whole grain pasta an brown rice over white (refined) varieties. Experiment with many types of whole grains, including barley, oatmeal, quinoa and bulgur. Opt for beans and other legumes. Go for whole fruits instead of fruit juice or suga foods. Select whole grain bread, whole grain pasta and brown rice over white (refined) varieties. Opt for beans and other legumes. Experiment with many types of whole grains, including Select barley, a variety oatmeal, of vegetables quinoa and such bulgur. as cauliflow tomato, carrots and spinach (most vegetables a foods. great s). Go for whole fruits instead of fruit juice or sugary Select a variety of vegetables such as cauliflower, tomato, carrots and spinach (most vegetables are great s).

4 How much to eat? How much to eat? Women Men Many women need about Many men need about Women Men 3-4 carbohydrate s 4-5 carbohydrate s (45-60 Many women grams) at need each about meal 3-4 carbohydrate s (45-60 grams) at each meal (60-75 Many grams) men need at each about meal 4-5 carbohydrate s (60-75 grams) at each meal 1 slice (1 ounce) whole grain toast 1 small orange 1 slice (1 ounce) 1 small cup cooked orangeoatmeal whole 1 teaspoon grain light toastmargarine made with water 1 cup cooked oatmeal 1 teaspoon egg omelet light with margarine spinach made 1 cup fat-free with water milk and mushrooms egg omelet with spinach 1 small orange and mushrooms 12 cup tablespoons fat-free milk nuts 1 small orange 2 tablespoons raisins tablespoons nuts 6 ounces low-fat plain Greek yogurt 2 tablespoons raisins 2 carbohydrate s 1 cup brown rice 1 sandwich with 2 carbohydrate 11-2 cup cups brown chicken 1 rice whole small grain fruit bread s and veggie stir fry 1-2 cups chicken 1 small fruit 1-2 cups veggies and 1 small veggie fruitstir fry 1-2 cups veggies 0-1 small fruit 1 piece of chicken 1 cup pasta 1 piece cup winter of chicken squash 1 ½ cup pasta red sauce with meat 1 cup small winter fruit squash ½ 6 ounces cup red low-fat sauce with meat 1-2 cups broccoli plain Greek yogurt small fruit 6 ounces low-fat 1 large green salad -2 cups broccoli plain Greek yogurt 1 cup fat-free skim milk 0-1 large green salad 1 large green salad 1 cup fat-free skim milk 1 large green salad 3 carbohydrate s 0-3 carbohydrate s

5 My Individual Carbohydrate Goals TOTAL Time Carbohydrate s or grams Healthy eating is about more than just counting carbohydrates. It is important to eat balanced meals with an emphasis on vegetables and fruits. Eat a variety of foods. For most people these include: at least 5 servings of fruits and vegetables at least 3 servings of whole grains or legumes (beans) 2 3 servings of low-fat or fat-free dairy Adequate protein and healthy fats Protein foods (including meat, poultry and fish) and fats do not directly affect blood glucose and can help you feel satisfied, although they do add calories. To keep your heart healthy, choose healthy fats (like those found in nuts, seeds and fish) in appropriate portions. With all of the food you eat, remember that portion control is important Diabetes Care and Education Dietetic Practice Group. Permission to reproduce for non-profit educational purposes granted through For a referral to a registered dietitian and for additional food and nutrition information, visit the Diabetes Care and Education Practice Group at or the Academy of Nutrition and Dietetics at or

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