Carbohydrate Counting

You need carbohydrate counting to live fairly well as a diabetic. But you can choose which type to include in your diet and how much, since they're in almost everything you eat.

When sugar isn't processed well in the body, it will largely remain in the blood causing artery and nerve damage.

A diabetic needs to monitor themselves to counteract abnormal glucose levels.

Carbohydrates are starches and sugars. They're also fibers but these don't affect blood glucose.

Disclaimer!: This is a general guide. There are important differences between individual diabetics and diets. Insulin therapy should be carefully monitored together with a diabetic health care team. In case of doubts always refer to that specialist team for (ongoing) advice.

So if you choose to have a dessert you might want to consider the amount in your meal. Depending on where you are and your body, intake is generally limited to roughly 40 - 60 grams per meal.

Meals high in starches and flour have a high energy content. Moderation in anything is key. Carbohydrate counting or the amount allowed, however, is still a subject heavily discussed.

One of the reasons is the difficulty of matching an insulin peak with the glucose peak. Some MD's propose an amount as low 12 g of carbohydrates per meal. That's considered very low.

How much carbohydrates are allowed exactly depends on your activity level, medication, weight and blood glucose. For guidance refer to your diabetes care team.

Ways of Carbohydrate Counting

1. Food labels

Include all carbohydrate (the total) types mentioned on the label. Not just the sugar amount.

2. Reference guides

They can be handy when you have no scale or food labels to work with. These can be tables or visual guides such as illustrations or photographs showed in portions. Each visualized portion corresponds with an amount of carbs.

3. Diabetic food books and websites

Certain websites and books can take the tediousness out of carb counting. These bundled recipes range from ordinary (grandma's) to the more refined dishes. There's a lot on the market these days, free or payed.

4. Restaurant online guides

These days restaurants promote their business through a website. Many of them list nutritional information with each menu so as to accomodate health conscious customers. Do keep in mind the information is indicative as dishes may vary in size and ingredients.

Fast and Slow Carbs

Some diabetics feel plagued by the thought of carbohydrate counting every day. Which is understandable.

There are foods with a high GI but are allowed as long as the portion size is right. Or higher portions are ok as long as the GL is within the range.

Things can be complicated sometimes. That's where tables and applications come in to make life simpler. 

Over time however you will grow into the habit, memorize and estimate portion-to-carb ratios almost by automation.

A rule of thumb:

Sticking to slow carbohydrates and controlling portions goes a long way. Just like common sense.

The process can be tedious in the beginning.

It helps if you know:

  • What slow / fast carbs are.
  • Which foods have a low glycemic index.
  • The glycemic load.
  • That fats and proteins lower the glycemic index.

This of course comes with experience.

Slow carbs are good for everyone. Not just diabetics. They often have fibres which makes you feel full longer after a meal. You'd less likely have a snack inbetween meals.

To give you an idea between slow and fast carbohydrate foods here's a comparison: 

Slow Carbs:

Whole wheat bread
Brown rice

Fast Carbs:

Soda drinks
White flour
White rice
Fruit juice

The Problem with
the Glycemic Index

Controlling how fast blood sugar raises and drops is were the GI is your guide. Low GI foods let it raise slowly followed by a slow drop.

This has certain advantages like limiting the risk of cardiovascular diseases.

The only problem is, how do you determine the exact GI number when it's influenced by temperature, ripeness of a fruit, combination with other ingredients, the addition of water and so on?!

The answer is, you don't unless you're a scientist doing research!

Boiled potatoes and vegetables for example have a lower Glycemic Index than when you mash them.

It does help if you simply stick to foods that are known to have a low GI no matter the external influence on them.

Carbs are King

Carbohydrate counting takes a prime place in a diabetic's glucose management.

Because glucose levels depend greatly on the amount eaten then on the type. 

Since they are that critical they came up with the glycemic load of foods to indirectly proportionate carbs.

The GL is a measure for the load of carbs per meal. How much it will affect you as a diabetic.

In Short

The beginnings of carb counting can be a little tedious but once mastered it becomes second nature.

It helps a great deal in managing your blood glucose levels. It allows better control. More flexibility in the amounts of carbohydrates eaten over the day.

However, it doesn't mean you can eat in excesses as this would be unhealthy for anyone. But the occasional treat can be better planned with a matching insulin doses.

Once you know how to estimate the carbs that you're going to have, next is the amount of insulin needed. This is dependent on your activities, age, weight and how your body reacts to insulin.

To know this carbohydrate-to-insulin ratio you will need the help of a diabetic care team. They can estimate a starting ratio which can be fine-tuned in follow up controls. They can also tell how much carbs you're allowed to have per meal.