Carbohydrate Counting For People Who Use Insulin: How Do I Count Carbohydrate Grams In My Diet

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How do I count carbohydrate grams in my diet?

To count carbohydrate grams at a meal, you need to know how much carbohydrate is in each type of food, whether it is a slice of bread, a bowl of lettuce, or a tablespoon of salad dressing. Fortunately, nearly all packaged foods have labels that tell you how much total carbohydrate is in a single serving. Carbohydrate guides also are available from diabetes educators and the American Diabetes Association.

To calculate the carbohydrate in food that is not packaged, you will need to know standard portions of carbohydrate foods. Each serving size or standard portion contains about 15 grams of carbohydrate.

Once you know the number of grams of carbohydrate in a meal, you can figure out how many units of insulin to take based on your personal insulin-to-carbohydrate ratio.

For example: Your health professional may recommend that you take 1 unit of rapid-acting insulin for every 10 grams of carbohydrate you eat. So if your meal contains 50 grams of carbohydrate, you would need 5 units of insulin to keep your post-meal blood sugar from rising above your target level.

Your insulin-to-carbohydrate ratio may change over time. In some people it will differ from one meal to another. You might take 1 unit of insulin for every 10 grams of carbohydrate for lunch but take 1 unit for every 15 grams at dinner. Keep the following in mind when counting carbohydrate grams:

• Portion control is important. If a package indicates it contains two servings and you eat the whole package, you need to double the number of grams of carbohydrate listed for one serving.
• Protein, fat, and fiber do not raise blood sugar as quickly or as high as carbohydrate. If you eat a lot of these nutrients in a meal, carbohydrate will convert to glucose more slowly than it would with a small amount of protein, fat, and fiber.
• Exercise affects blood sugar, allowing you to use less insulin than you would if you were not exercising. Keep in mind that timing makes a difference. If you exercise within 1 hour of a meal, your body may need less insulin for that meal than it would if you exercised 3 hours after the meal.

By keeping track of what you eat and testing your blood sugar after meals and exercise, you can learn to estimate the effect of protein, fat, fiber, and exercise on the amount of insulin you need.

Count carbohydrate grams and eat a balanced diet by:

• Talking with a registered dietitian. He or she can help you plan the amount of carbohydrate to include in each meal and snack.
• Weighing or measuring your food. You won't always have to weigh or measure your food; however, it may be helpful when you are first learning what makes up a standard portion.
• Counting either grams or servings of carbohydrate. A registered dietitian will help you plan how much carbohydrate, including sweets, to have in each of your meals and snacks.
• Eating standard portions of foods that contain protein. Foods that contain protein (meat and cheese) are an important part of a balanced diet.
• Limiting fats. A balanced diet includes a limited amount of healthy fats. Talk with a registered dietitian about how much fat you need in your diet.

Other helpful suggestions

• Read food labels for carbohydrate content. Be careful to consider the serving size on the package.
• Check your blood sugar level. If you do this before and 1 hour after a meal, you will be able to see how the food you eat affects your blood sugar level.
• Record what you eat and your blood sugar results in a food record. At each regular visit with your diabetes specialist, or whenever you think your diet plan needs adjusting, you can review your food record (What is a PDF document?).
• Get more help. The American Diabetes Association offers booklets to help people learn how to count carbohydrate grams in their diet, to measure and weigh food, and to read food labels. See the Where to Go From Here section below for the address and phone number of the American Diabetes Association. However, you will still need to talk with a registered dietitian to establish a plan that fits your needs.

Continue to Where to go from here

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Last updated:	August 14, 2007
Author:	Caroline Rea, RN, BS, MS
Reviewed By:	Caroline S. Rhoads, MD - Internal Medicine, Matthew I. Kim, MD - Endocrinology & Metabolism
Editors:	Susan Van Houten, RN, BSN, MBA, Pat Truman