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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
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
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
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
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
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 Works Consulted
American Diabetes Association (2013). Nutrition therapy recommendations for the management of adults with diabetes. Diabetes Care, 36(11): 3821–3842. DOI: 10.2337/dc13-2042. Accessed December 5, 2013.
American Diabetes Association (2013). Standards of medical care in diabetes—2013. Diabetes Care, 36(Suppl 1): S11–S66.
Campbell AP, Beaser RS (2010). Medical nutrition therapy. In RS Beaser, ed., Joslin's Diabetes Deskbook: A Guide for Primary Care Providers, 2nd ed., pp. 91–136. Boston: Joslin Diabetes Center.
Franz MJ (2012). Medical nutrition therapy for diabetes mellitus and hypoglycemia of nondiabetic origin. In LK Mahan et al., eds., Krause's Food and the Nutrition Care Process, 13th ed., pp. 675–710. St Louis: Saunders.
June 24, 2013
E. Gregory Thompson, MD - Internal Medicine
& Rhonda O'Brien, MS, RD, CDE - Certified Diabetes Educator
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