Diabetic Living- Solving The Carb Puzzle

Better Homes & Gardens-Special Interest Publication: Spring 2010

This quick guide to carbohydrates will help you piece together a healthy eating plan.

Special Report By Hope S. Warshaw, R.D., CDE- (Original article reprinted in full, since so many people could not locate this article online and May issue is already on the stands)

Along with the diagnosis of diabetes comes a new vocabulary.  "Carbohydrate" is one of the most frequently used-and misunderstood-terms.  "Confusion about carbohydrates still reigns", says Johanna Burani R.D. CDE, author of Good Carbs, Bad Crabs- Lose Weight and Enjoy Optimum Health by Eating the Right Carbs. (De Capo Press, 2004).  "People I counsel are surprised to learn milk, yogurt, and fruits contain carbohydrate and are convinced that pasta, bread, and ice cream "turn to sugar" and shouldn't ever pass their lips again.

Yet experts say that food with carbohydrates are essentially for good diabetes nutrition.  Come along as we unscramble the crab puzzle.

 (Diabetic Living Magazine Image)


What's carb counting?

Carb counting is a method of diabetes meal planning.  It doesn't prescribe a certain amount of carbohydrates but is a way to include healthy foods, plan meals that contain sufficient carbohydrate to fuel the body, and fit a wide variety of foods, you enjoy while you control blood glucose levels. 

The carbohydrate in foods is the nutrition with the most impact on blood glucose, especially after you eat.  A key ingredient in achieving blood glucose control is having adequate insulin.  The balance between the carbohydrate and the achievable insulin-made by the body or that you take as medication-most impacts blood glucose levels and diabetes control.

Carb counting gained support in the United States when it was used successfully in the Diabetes Control and Complications trial in the 1980's says Karen Bolderman, R.D., CDE, PWD type 1, coauthor of Practical Carbohydrate Counting: A How-To Teach Guide for Health Professionals, second edition (American Diabetes Association, 2008)


Basic carb counting

Most people with type 2 diabetes who don't take insulin can use what dieticians call basic "carb counting".  Bolderman says, "You learn the foods that contain carbohydrate and how much carb to each each day." 


  How much carb to eat

The following starting points for daily carb grams or choices and
how to divide them among meals can work many people with
diabetes. Don’t limit carbohydrate to control blood glucose-
low-carb eating often leads to eating too much heart-harming
fat and may not necessarily improve blood glucose or weight
control over time.

Body/ size gender Carb grams/daily Carb grams*/meal Carb choices*/daily Carb choices*/meals

Smaller woman





Larger woman





Smaller Man





Smaller Woman










* Carb choice=15 grams of carbohydrates

  Advanced counting

"Advanced carb counting helps people who take insulin several times a day (with multiple daily injections or a pump) learn to adjust adjust their pre-meal rapid-acting insulin dose based on their blood glucose level and amount of carb they're going to eat," Bolderman says

What foods have carbohydrates?

Think of foods as packages of various nutrients.  "No one food has all the nutrients your body needs, which is why eating a variety of foods helps you meet your nutrition needs." Burani says.  The three main nutrients are: carbohydrates, fat and protein.  Most of the calories in the foods shown below are from carbohydrate. Some of these foods contain good or healthy carbs, and other less-healthful carbs.

What makes a healthful carb?


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