Questions About Carbohydrate Counting

From this document you will learn the answers to the following questions:

Can my insulin be adjusted based on how much carbohydrate I eat?

How can you learn how much insulin you need?

What type of food is Cuisine Chicken Fettucini?

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Questions About Carbohydrate Counting What is carbohydrate counting? Carbohydrate counting simply means keeping track of the amount of carbohydrate you eat at each meal and snack. The amount of carbohydrate you eat at a meal has the most influence on how high your blood glucose will rise after the meal. Protein and fat have very little effect. Being consistent in the amount of carbohydrate you eat at meals from day to day will help keep your blood glucose levels more consistent. You can benefit from carbohydrate counting if you take insulin, pills, or if you just manage your diabetes by healthy eating and regular physical activity. How Do I Count Carbohydrate? Counting Grams of Carbohydrate 1) Food Labels - Look at the Total Carbohydrate information on the Nutrition Facts label for the amount of carbohydrate per serving. 2) Books - Look up carbohydrate gram values of foods in a variety of resource books. You can count carbohydrate in two ways: 1) You can count the number of grams of carbohydrate from food labels or books on gram values of carbohydrate or 2) You can count carbohydrate choices or servings where each serving is equal to 15 grams of carbohydrate. A carbohydrate choice is also equal to one fruit, starch or milk exchange. Nutrition Facts Serving Size 8 fl oz Servings Per Container 12 Amount Per Serving Calories 110 Calories from fat 0 Total Fat 0 g Sodium 0 mg Total Carbohydrate 28 g Dietary Fiber 1 g Sugar 24 g Counting Carbohydrate Choices 1) Use Exchange Lists for Meal Planning and count each serving of fruit, starch or milk as 1 carbohydrate choice (equal to 15 grams of carbohydrate.) 2) Use reference books to look up carbohydrate gram values of foods. Then divide the number of carbohydrate grams by 15.

Examples of Carbohydrate Counting Amount Food Exchanges Starch Fruit Milk Carbohydrate Choices Carbohydrate Grams 1 15 INFORMATION FROM EXCHANGE LISTS ½ Grapefruit 1 1-6 inch Corn tortilla 1 1 15 1 cup Raisin Bran 2 2 30 INFORMATION FROM FOOD LABELS AND RESOURCE BOOKS 1 Stouffer s Lean Cuisine Chicken Fettucini 3 34 1 Whopper 3 47 1 bar Häagen-Dazs Ice-cream bar 1½ 24 How much carbohydrate should I have at each meal? This is best answered by a registered dietitian familiar with diabetes management. It will depend on many factors such as your height and weight, your current diabetes treatment, and your eating schedule. If you already have a meal plan, such as a 1200 calorie meal plan, you can easily find out how much carbohydrate you re currently getting at each meal and snack. If you don t have a dietitian, call your local hospital or ask your physician to recommend one. You can also call the American Dietetic Association at 800-3661655. Can my insulin be adjusted based on how much carbohydrate I eat? Yes, if you take 3 or more injections of insulin each day. You can learn how much insulin you need for the amount of food you plan to eat at each meal. If you are less hungry, you can take less insulin. This gives you more flexibility in deciding what and how much you eat than if you only take one or two injections each day. Talk to your health care team about insulin adjustment and carbohydrate counting. The University of Georgia and Ft. Valley State University, the U.S. Department of Agriculture and counties of the state cooperating. The Cooperative Publication # FDNS-E-86-1 Reviewed by Connie Crawley June 2011 Extension Service and the University of Georgia College of Agricultural and Environmental Sciences offer educational programs, assistance and The University of Georgia and Ft. Valley State University, the U.S. Department of Agriculture and counties of the state cooperating. materials to all people without regard to race, color, national origin, age, sex or disability. Cooperative Extension, the University of Georgia Colleges of AgriculturalAction and Environmental Sciences and Family and Consumer An Equal Opportunity Employer/Affirmative Organization to a Diverse Force Sciences, offers educational programs, assistancecommitted and materials to allwork people without regard to race, color, national origin, age, gender or disability. Bulletin # FDNSE-86-1 Reviewed June 2011 An Equal Opportunity Employer/Affirmative Action Organization Issued in furtherance of Cooperative Extension work, Acts of May 8 and June 30, 1914, The University of Georgia College of Agricultural and Committed to a Diverse Work Force Environmental Sciences and the U.S. Department of Agriculture cooperating. Gale A. Buchanan, Dean and Director

Group 1 Menu for Carbohydrate Counting List an example of foods that total 60 grams of carbohydrate (+/-5) at both lunch and dinner using food labels for breakfast and McDonald s for lunch. BREAKFAST Type of Food Serving Size Carbohydrate (grams) LUNCH Total: Type of Food Serving Size Carbohydrate (grams) Total:

Group 2 Menu for Carbohydrate Counting List an example of foods using the Exchange Booklet and McDonalds Nutrition Information to get 4 carbohydrate choices from each meal at both lunch and dinner. BREAKFAST Type of Food Serving Size Carbohydrate (choices) LUNCH Total: Type of Food Serving Size Carbohydrate (choices) Total:

McDonald s Food Item Breakfast Items Egg McMuffin 300 29 18 12 830 2 starch Sausage McMuffin 370 28 14 23 790 2 starch 1 high fat meat Sausage McMuffin with Egg 450 29 20 28 930 2 starch 2 high fat meat English Muffin 150 27 5 2 260 2 starch Sausage Biscuit 410 30 10 28 930 2 starch 1 high fat meat 3 1/ Sausage Biscuit with Egg Bacon, Egg, & Cheese Biscuit 490 31 16 33 1010 2 starch 1 high fat meat 5 fat 480 31 20 31 1410 2 starch 2 high fat meat 2 1/ Biscuit 240 30 4 11 640 2 starch

Ham and Egg Cheese Bagel Spanish Omelet Bagel Steak and Egg Cheese Bagel Sausage (1 serving) 550 58 26 23 1490 4 starch 690 60 27 38 1570 4 starch 5 fat 700 57 38 35 1290 4 starch 4 medium fat meat 170 0 6 16 290 1 high fat meat 11/ Scrambled Eggs (1 order 2 eggs) 160 1 13 11 170 Hash browns 130 14 1 8 330 1 starch Hotcakes (plain) 340 58 9 8 630 4 starch 1/ Hotcakes (margarine- 2 pats & syrup) 600 104 9 17 770 7 carbohydrates 3 fat Breakfast Burrito 290 24 13 16 680 1 1/2 starch

Muffins/Danish Low-fat Apple Bran Muffin 300 61 6 3 380 4 starch Apple Danish 340 47 5 15 340 3 1/2 starch Cheese Danish 400 45 7 21 400 3 starch 3 1/ Cinnamon Roll 390 50 6 18 310 3 starch 3 fat Sandwiches Hamburger 280 35 12 10 590 2 starch Cheeseburger 330 36 15 14 830 2 starch 1 1/ Quarter Pounder 430 37 23 21 840 2 1/2 starch Quarter Pounder with Cheese 530 38 28 30 1310 2 1/2 starch 3 medium fat meat 2 1/ Big Mac 570 47 24 34 1090 3 starch 4 fat

Big N Tasty 540 39 24 32 970 2 1/2 starch 2 high fat meat 3 fat Big N Tasty with cheese 590 40 27 37 1210 2 1/2 starch 3 high fat meat Crispy Chicken 500 46 22 26 1100 3 1/2 starch 3 fat Fillet-O-Fish 470 45 15 26 890 3 starch 4 fat Chicken McGrill 400 37 25 17 890 2 1/2 starch 2 high fat meat Chicken McGrill (without mayo) 300 37 24 6 800 2 1/2 starch 2 lean meat Grilled Chicken Flatbread Sandwich (with cheese and sauce) Grilled Chicken Flatbread Sandwich no cheese Grilled Chicken Flatbread Sandwich no sauce 540 56 28 24 1620 4 starch 410 54 21 13 960 3 1/2 starch 460 53 28 16 1450 3 1/2 starch 1/

Grilled Chicken Flatbread Sandwich no cheese or sauce 340 52 21 7 800 3 1/2 starch 1 lean meat French Fries French Fries (small) 210 26 3 10 135 2 starch French Fries (medium) 450 57 6 22 290 4 starch 3 fat French Fries (large) 540 68 8 26 350 4 1/2 starch 4 fat French Fries (Supersize) 610 77 9 29 390 5 starch 5 fat Chicken McNuggets/Sauces Chicken McNuggets ( 4 piece) Chicken McNuggets ( 6 piece) Chicken McNuggets ( 9 piece) 210 12 10 13 460 1 starch 310 18 15 20 680 1 1/2 starch 2 1/ 460 27 22 29 1020 2 starch 3 fat

Hot Mustard Sauce 60 7 1 3.5 240 1/2 carbohydrate BBQ Sauce 45 10 0 0 250 1/2 carbohydrate Honey Mustard 50 3 0 4.5 85 Salads and Salad Dressings Chef Salad 150 5 17 8 740 1 vegetable 2 lean meat Garden Salad 100 4 7 6 120 1 vegetable Grilled Chicken Caesar Salad 100 3 17 2.5 240 1 vegetable 2 very lean meat Caesar Dressing 150 5 2 13 390 3 fat Fat-Free Herb Vinaigrette Dressing Honey Mustard 35 8 0 0 260 1/2 carbohydrate 160 13 1 11 260 1 carbohydrate

Ranch Dressing Red French Reduced-Calorie Dressing 1000 Island 170 3 0 18 460 4 fat 130 18 0 6 360 1 carbohydrate 130 11 1 9 350 1 carbohydrate Without dressing Desserts/Shakes Fruit & Yogurt Parfait 380 76 10 5 240 5 carbohydrate Fruit & Yogurt Parfait no granola Vanilla Reduced-Fat Ice Cream Cone McDonaldland Cookies 280 53 8 4 115 3 1/2 carbohydrate 150 23 4 4.5 75 1 1/2 carbohydrate 230 38 3 8 250 2 1/2 carbohydrate 1 1/ Nutrient values obtained from McDonald s Corporation, 2002

Food Labels Orange Juice Nutrition Facts Serving Size 8 fl oz Servings Per Container 12 Amount Per Serving Calories110 Calories from fat 0 Total Fat 0 g Sodium 0 mg Total Carbohydrate 28 g Dietary Fiber 1g Sugars 24 g Protein 2 g Vit C 130% Niacin 4% Calcium 2% Folate 15% Thiamin 10% Vit B6 6%

Food Label Vanilla Wafers Nutrition Facts Serving Size 8 wafers Servings Per Container 11 Amount Per Serving Calories120 Calories from fat 20 Total Fat 2g Saturated Fat 0g Polyunsaturated Fat 0g Monounsaturated Fat.5g Cholesterol 0mg Sodium 105 mg Total Carbohydrate 24 g Dietary Fiber 0g Sugars 12 g Protein 1g Vit A 0% Vit C 130% Calcium 2% Iron 4%

Carbohydrate Counting Resources General Information on Carbohydrate Counting: The American Diabetes Association Complete Guide to Carb Counting (3 rd Edition) Karmeen Kulkarni, MS,RD,CDE and Hope Warshaw, MMSc, RD,CDE http;//store.diabetes.org Carbohydrate Counting 4 th edition International Diabetes Center Publishing 888-637-2675 or www.idcpublishing.com Count Your Carbs: Getting Started (Spanish too) The American Dietetic Association www.eatright.org Carbohydrate Values of Foods Without Nutrition Labels: The Diabetes Carbohydrate and Fat Gram Guide 4th edition Lea Ann Holzmeister, RD American Diabetes Association 800-232-6733 or http;//store.diabetes.org The Complete Book of Food Counts 9 th edition Corinne Netzer, Dell Publishing Pre-order to be published Dec. 2011 Barbara Kraus Calories and Carbohydrates, 16 th Edition Marie Reilly-Pardo, www.amazon.com and major bookstores Web site for carbohydrate counts: www.calorieking.com (click on database) Carbohydrate Values for Restaurant Foods: Fast Food web sites such as www.mcdonalds.com or www.pizzahut.com ADA Guide to Healthy Restaurant Eating, 4 rd Edition Hope Warshaw, American Diabetes Association - http;//store.diabetes.org New Text Revised 9/11