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Diabetes: Counting Carbs if You Use Insulin


Table of Contents


Actionsets help people take an active role in managing a health condition.   Diabetes: Counting Carbs if You Use Insulin

Carbohydrate counting is an important skill to help you maintain tight control of your blood sugar (glucose) level when you have diabetes. It gives you the flexibility to eat what you want and increases your sense of control and confidence in managing your diabetes.

Actionsets help people take an active role in managing a health condition.  What is carbohydrate counting?
Actionsets help people take an active role in managing a health condition.  Why is carbohydrate counting important?
Actionsets help people take an active role in managing a health condition.  How do you count carbohydrate grams in your diet?
Actionsets help people take an active role in managing a health condition.  Where to go from here

What? - What is the medical information or key concepts related to the action?  What is carbohydrate counting?

Carbohydrate counting is a recommended method of meal planning for people who have diabetes. It involves matching your insulin dosage to the grams of carbohydrate in the foods you eat to keep your blood sugar level in your target range.

Carbohydrate—the body's main source of glucose—affects blood sugar more than any other nutrient. All forms of carbohydrate increase your blood sugar level. Foods that contain carbohydrate include:

Contrary to what you may have heard, you can eat sugar when you have diabetes. But if foods that contain sugar make up a large part of your diet, you are probably not eating enough of other more nutritious foods.

Test Your Knowledge

  1. Which of these foods contain carbohydrate?

    1. Wheat bread, rice, peas, and oatmeal

      Both answers are correct.

      Wheat bread, rice, peas, and oatmeal all contain carbohydrate. Carbohydrate is an essential nutrient found in foods such as bread, cereal, grains, and vegetables. It also is in fruit, milk, desserts, and candy.

    2. Cheesecake, skim milk, and pears

      Both answers are correct.

      Cheesecake, skim milk, and pears all contain carbohydrate. Carbohydrate is an essential nutrient found in foods such as bread, cereal, grains, and vegetables. It also is in fruit, milk, desserts, and candy.


Why? - Why the action is important?  Why is carbohydrate counting important?

Carbohydrate counting helps prevent low or high blood sugar levels, which can cause medical emergencies. Over time, high blood sugar levels can damage many body tissues and organs.

Counting carbohydrate grams allows you to match insulin to the food you eat every day to keep blood sugar at your target level. This method is effective because carbohydrate is the main nutrient that causes blood sugar to rise after meals, increasing the need for insulin. Carbohydrate turns into glucose within 2 hours after you eat.

If you use an insulin pump or take multiple insulin injections, you need to know how many grams of carbohydrate are in a meal to calculate how much rapid-acting insulin to take before you eat. A pump provides a continuous (also known as basal) rate of insulin throughout the day, but it must be programmed at meals to provide extra insulin to allow for the rise in blood sugar after meals. When you know how much carbohydrate you will eat, you can program extra units, or boluses, of insulin to cover your meals.

You figure out how much insulin to use based on your own insulin-to-carbohydrate ratio. This ratio may be different from one person to another, and even your own ratio may change over time. You and your doctor will calculate the ratio by recording the food you eat and testing your blood sugar after meals.

Test Your Knowledge

  1. Carbohydrate counting helps me know how much insulin I need to take at meals.

    1. True

      This answer is correct.

      Carbohydrate counting does help you know how much insulin to take at meals. You will use your own insulin-to-carbohydrate ratio to determine how many units of insulin you need to cover the carbohydrate in your meal.

    2. False

      This answer is incorrect.

      Carbohydrate counting does help you know how much insulin to take at meals. You will use your own insulin-to-carbohydrate ratio to determine how many units of insulin you need to cover the carbohydrate in your meal.


How? - Learn the steps involved in taking action.  How do you count carbohydrate grams in your 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. And you can get carbohydrate guides 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.

When 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 doctor may recommend that you take 1 unit of rapid-acting insulin for every 10 to 15 grams of carbohydrate you eat. So if your meal contains 50 grams of carbohydrate, and if your doctor has decided you need 1 unit of insulin for every 10 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:

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:

Other helpful suggestions

Test Your Knowledge

  1. I can eat only a certain amount of carbohydrate at one sitting, or my blood sugar will be too high.

    1. True

      This answer is incorrect.

      The amount of carbohydrate you eat at a meal can vary. You keep your blood sugar under control by matching the amount of insulin you take to the amount of carbohydrate you eat.

    2. False

      This answer is correct.

      The amount of carbohydrate you eat at a meal can vary. You keep your blood sugar under control by matching the amount of insulin you take to the amount of carbohydrate you eat.


Where? - Other resources and organizations that can help you take action.  Where to go from here

Now that you have read this information, you are ready to plan regular meals and snacks and calculate the amount of carbohydrate in your diet.

Talk with your diabetes specialist (doctor or other health professional, registered dietitian, or certified diabetes educator). If you have questions about this information, take it with you when you visit your diabetes specialist.

If you need help with carbohydrate counting or meal planning, see a registered dietitian.

If you would like more information on meal planning for people who have diabetes, the following resources are available:

Organizations

Academy of Nutrition and Dietetics
120 South Riverside Plaza
Suite 2000
Chicago, IL  60606-6995
Phone: 1-800-877-0877
Email: knowledge@eatright.org
Web Address: www.eatright.org
 

The Academy of Nutrition and Dietetics sets standards for all types of prescribed diets. The organization produces a variety of consumer information, including videos. This group will help you find a registered dietitian in your area who provides nutrition counseling.


American Diabetes Association (ADA)
1701 North Beauregard Street
Alexandria, VA  22311
Phone: 1-800-DIABETES (1-800-342-2383)
Email: AskADA@diabetes.org
Web Address: www.diabetes.org
 

The American Diabetes Association (ADA) is a national organization for health professionals and consumers. Almost every state has a local office. ADA sets the standards for the care of people with diabetes. Its focus is on research for the prevention and treatment of all types of diabetes. ADA provides patient and professional education mainly through its publications, which include the monthly magazine Diabetes Forecast, books, brochures, cookbooks and meal planning guides, and pamphlets. ADA also provides information for parents about caring for a child with diabetes.


References

Other Works Consulted

Credits for Diabetes: Counting Carbs if You Use Insulin

By Healthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer Rhonda O'Brien, MS, RD, CDE - Certified Diabetes Educator
Last Revised June 24, 2013

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