Counting Carbohydrates Equals Better Glucose Control

Controlling the level of glucose (a type of sugar) in your blood—your blood glucose level–can be a challenge if you have diabetes. Learning how to track the amount of carbohydrate you eat will help you balance your blood glucose level and keep you as healthy as possible.

What Are Carbohydrates?

Also known as “carbs” or starches, carbohydrates are the main source of energy for your body. Carbohydrates are made up of complex sugar molecules. Your digestive system breaks down almost all these complex sugars into glucose, a simple sugar that carries energy into the cells of your body. Because carbohydrates are digested and converted into glucose fairly quickly, they can have a big and immediate effect on your blood glucose level. Protein and fat, the other main sources of food energy, areconverted into glucose more slowly.

Glucose and Insulin

Think of a glucose molecule as a little energy packet. The insulin hormone latches onto the packet and delivers it inside the cells of your body. Once inside, it is burned like a fuel. Just as gasoline provides the energy to run your car, glucose provides energy to the cells of your organs, muscles, brain and nerves.

Sources of Carbohydrate

There are two main types of carbohydrates: simple and complex. Simple carbs are found in sweets, such as sugar, honey, candy, desserts and sweetened beverages. They also are found in more nutritious foods, such as fruit and milk.

Complex carbs are also found in starches. Starches include grain products, such as bread, crackers, pasta and rice, as well as dried beans (legumes), corn and potatoes. Your body breaks down complex carbs into glucose more slowly than simple carbs. That means that they do not raise your blood glucose level as quickly.

Non-starchy vegetables, such as salad greens, string beans, broccoli, tomatoes and peppers, also contain small amounts of carbohydrates. It is important to include these veggies in your diet because they are also rich in fiber.

Controlling the level of glucose (a type of sugar) in your blood—your blood glucose level–can be a challenge if you have diabetes. Learning how to track the amount of carbohydrate you eat will help you balance your blood glucose level and keep you as healthy as possible.

Diabetes and Carbohydrates

If you have diabetes, you body has a harder time converting glucose into energy. This happens either because your body does not make enough insulin (type 1 diabetes) or because either the body does not produce enough insulin or the cells ignore the insulin (type 2 diabetes). In both cases, glucose cannot get into the cells to be burned for energy. Instead it builds up in the blood. Over time, high blood glucose levels can lead to heart disease, stroke, kidney disease, blood vessel damage and serious vision problems.

Controlling your blood glucose level is important if you have diabetes. You can feel unwell if your blood glucose level swings too far in either direction. If it is too low (hypoglycemia) you may be shaky, jittery or irritable, have a headache or feel extremely hungry. High blood glucose (hyperglycemia) can make you very thirsty, urinate a lot, blur your vision, and make you tired.

Carb Counting as a Control Tool

Carbohydrate counting, or carb-counting is a useful way to control your blood glucose level. It also helps to keep you from eating too many carbs at one time, which will make your blood glucose level spike. Instead, carb-counting helps you plan your day and helps you to eat smaller amounts of carbohydrates or carbs,

throughout the day. It can also help you balance your blood glucose level and carb intake with the amount of diabetes medications, such as insulin, that you take.

Setting Your Daily Calorie Goal

Your first task is to find out how many calories you need to eat each day to help you maintain your weight or, if you wish, to lose weight. How many calories you need depends on yourage, body weight, when and how often you eat, your activity level and the type of diabetes medicine you are taking. Your healthcare provider or dietitian can help you figure out how many calories you need.

Like many people with type 2 diabetes, you may be overweight. Losing just 10 percent ofyour body weight can make a big difference inyour ability to control your blood glucose level. Shedding excess pounds lets insulin work more effectively in your cells. If you want to lose weight, you must reduce by at least 250 to 500 the number of calories you would eat each day.

How Many Calories Should Come from Carbs?

When you know how many calories you need each day, you can figure out how many of those calories should come from carbohydrates at each meal. Typically, about half of your calories should come from carbs because your body can convert them into energy more easily than protein or fat.

For example, if you need 1,800 calories a day, then 50% of those calories, or 900, should come from carbohydrates. To make food choices, you will need to convert those carbohydrate calories into grams of carbohydrate. One gram

of carbohydrate has 4 calories. So, in the example above, you would divide 900 by 4, which translates into 225 as the grams of carbohydrate you need each day.

Balancing Your Carb Intake

To control your blood glucose level, spread your carb intake over the course of the day. Suppose you have three meals and two snacks each day. In this example, where your recommended carb intake is 225 grams, you could have 60 grams at both breakfast and dinner, 45 grams at lunch, and 30 grams for each of your two snacks. Another approach would be to divide the 225 grams into 5 small meals each day. That way, you would eat 45 grams of carb at each meal.

How to Count Carbs

Once you know how many grams of carbohydrate you need to eat at each meal or snack, you need to choose foods that will provide those carbs for you. There are many tools that can help you count carbohydrates.

• Use carb counter booklets that list the amount of carbohydrates in foods. Most of these booklets list portion sizes for different foods in 15 gram servings. The American Diabetes Association has a few reference books that you may find useful. (For example, “FlashCarbs” has a color photo of the food on one side and its carbohydrate value on the other, along with helpful meal planning tips. Or you may prefer “Carb Counting Made Easy”, which has easy-to-use carb counting and meal planning information.) With these lists you can easily include any combination of foods to meet your carbohydrate goal. Carbohydrate counter booklets are available at many drug stores, food markets and bookstores. This information is also available in “Exchange Lists for Meal Planning,” a booklet from the American Diabetes Association and American Dietetic Association. You can order the booklet from the American Diabetes Association by phone (1-800-232-6733) or online (www.diabetes.org).

• Read the nutrition labels on packaged food products (shown above). The label lists the number of servings in the container and the total carbohydrates in the package. To find the carbs in the example, you would multiply the total carbs (13 grams) by the number of servings (2) to find out that one package has 26 grams of carbs.

• Use cookbooks that list the nutrient content for each recipe to help you determine the amount of carbs in dishes you cook at home, such as soups and casseroles. Divide by the number of servings to calculate the carbs per serving.

These tools are simple to use—you do not have to be a math whiz! With a little experimenting, you will find a carb counting system that works for you.

Tips for Success

Here are some suggestions for making carb counting part of your life.

• Keep a food diary for two weeks. Write down what and how much you eat and

drink at each meal. Use the diary to practice counting the carbohydrates in each meal and snack. Before long, you will be able to do the carb counting in your head.

• Pay attention to portion size. When you begin counting carbohydrates, use a set of measuring cups and spoons to see what a proper portion looks like on your plate. Soon you will be able to “eyeball” a proper serving. If you are trying to lose weight, the American Diabetes Association suggests that you “Rate Your Plate.” When you prepare a meal, draw an imaginary line through the center of your plate, and then divide one of the sections in two. Fill one-fourth of your dinner plate with grains or starchy foods such as rice, pasta, potatoes, corn or peas. Fill one-fourth with protein, such as meat, fish, poultry or tofu. Fill the last half of your plate with non-starchy vegetables like broccoli, carrots, cucumbers, salad, tomatoes and cauliflower. Add a glass of non-fat milk and a small roll or piece of fruit, and you are set. Remember, portion size is the key here.

• Include fresh fruits and vegetables. These foods are usually rich in vitamins, minerals and fiber—all important for your health.

A Word About Low-Carb Diets

Very low-carbohydrate diets, such as the Atkins diet, are popular, but they may not be a good choice for people with diabetes. They are often low in vitamins, minerals and fiber. The high protein content in these diets may stress your kidneys, and high fat levels may also increase your risk for heart disease. Check with your doctor or dietitian before you try any “low-carb” diet.

Remember that the key to good blood glucose control is carb control. All carbohydrates can work in your diet—even occasional sweets—if you know how to count them and fit them into your overall diet.

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