In the United States, 30.3 million people have diabetes, and a further 84.1 million have prediabetes, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

Diabetes is an incurable yet manageable medical condition in which the body struggles to regulate blood sugar. This happens when the body cannot produce enough insulin, or when insulin does not work correctly.

Insulin is a hormone that the pancreas makes to help the body process glucose, which is the simplest form of sugar. The cells use glucose to create energy. When the cells cannot take in glucose, it remains in the bloodstream, which can lead to severe health problems.

People who have diabetes must be careful about the foods they eat. Consuming an excess of certain foods might lead to persistent high blood sugar. This can lead to severe complications, such as nerve damage, vision and hearing loss, and cardiovascular disease.

In this article, we explore carb counting as a technique to help people with diabetes manage their blood sugar levels.

Carbohydrates are complex sugars. Many people with diabetes need to count the number of carbohydrates in each serving of food to control their blood sugar levels. People refer to this as carb counting.

Carb counting involves more than resisting a chocolate or ice cream craving, as some seemingly healthful fruits and vegetables might also contain a high carbohydrate content that contributes to blood sugar spikes.

How carb counting works

carb counting

The first step in carb counting is identifying which foods contain carbohydrates and how rapidly these carbohydrates will boost blood sugar levels.

People can use a system called the Glycemic Index (GI) to calculate this. Every food has a GI ranking, with higher scores demonstrating a food’s rapid effect on blood sugar.

Having diabetes often means that people struggle to regulate their blood sugar levels. So, it is also a good idea for people with diabetes to focus on their diet. Consuming low-GI foods can lead to a slower, more controllable increase in blood glucose levels.

Doctors and dietitians will help people with diabetes work out how many carbohydrates they should consume each day and suggest meal plans to help them maintain a healthful, nutritional balance.

Previously, doctors and dietitians suggested a typical range of carbohydrates that was a fit-all solution for everyone with diabetes.

Now, doctors and nutritionists work with individuals on a one-to-one basis to calculate the ideal daily caloric intake and carbohydrate percentages and servings each person needs.

These amounts will vary according to a range of factors, including the person’s weight, height, activity levels, and whether they are taking medications.

Aims of carb counting

Carb counting alone is not a substitute for managing diabetes using medical care and prescribed medications.

The goal of carb counting is to keep blood sugar levels steady for the following reasons:

  • maintaining overall health in those with diabetes
  • preventing the complications of excessively high or low blood sugar
  • improving energy levels

Getting started with carb counting

Carb counting may help many people with diabetes to maintain steady blood sugar levels. However, it is only one way to manage diabetes.

Before trying carb counting, people should always speak with a nutritionist, diabetes educator, or doctor to determine:

  • whether carb counting is appropriate
  • the recommended daily allowance for carbohydrates
  • which foods they recommend

Different people will require different amounts of carbohydrates depending on the type and severity of diabetes they have.

Speak to your doctor about the ideal calorie and carbohydrate intake.

Calculating carbs

When a person has to calculate how many carbs they can consume each day, it is vital to know which foods contain carbohydrates, how many they contain, and their caloric and GI value.

In general, 1 gram (g) of carbohydrate provides around 4 calories. This can help a person calculate how many calories a particular snack or meal is providing.

There is no single number of carbs that is safe for every person with diabetes. Doctors shape the target based on individual needs and disease progression.

It is essential for those with diabetes to understand the content of food nutrition labels. Some describe nutrient serving per half portion, so it is necessary to be sure of exactly how many carbs a meal provides.

When reading nutritional labels, take note of the total number of carbohydrates per serving and add these totals into the total daily carbohydrate allowance.

For example, there are approximately 15 g of carbohydrate in each serving of the following foods:

  • a slice of bread
  • one-third of a cup of pasta or rice
  • a small apple
  • one tablespoon of jelly
  • a half-cup of starchy vegetables, such as mashed potatoes.

However, non-starchy vegetables contain only 5 g of carbohydrate per serving. This means that a person with diabetes can safely eat three times more non-starchy vegetables than starchy vegetables.

Carb counting tips

serving cups

Carb counting may be challenging at first because it forces people to think about meals differently, and people might take a while to get used to it.

Some tips can help make carb counting a little easier, such as:

  • Counting mixed foods by the cup: On average, a fist is the size of a 1-cup serving. For a mixed dish, this is an effective way to judge the carb totals based on cup size.
  • Count tablespoons: It is helpful to know the number of carbohydrates in a tablespoon of food. People can count level tablespoons to create a healthful plate.
  • Count carbs in pizza using the crust: If possible, choose a thin-crust pizza. This will save 5–10 g of carbohydrate per serving size when compared to a slice of regular or pan pizza.
  • Smoothies may not always be the best bet: On average, a 12-ounce (oz.) smoothie might contain more carbohydrates than a regular soda if it contains juice. Drink smoothies in moderation.

Here is our recommended book: The Complete Guide to Carb Counting by the American Diabetes Association

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