Carb Counting

Carb Counting for Diabetes

What Are Carbohydrates?

Carbohydrates are the nutrients that have the greatest effect on blood sugar levels. Almost all carbohydrates eaten turn into sugar within 1-2 hours. The more carbohydrates eaten, the higher blood sugar levels rise. While carbohydrates are needed for energy, it is important to not overload the body's insulin supply. The key is to eat carbohydrates as a part of a balanced meal plan.

What Is Carb Counting?

Carb counting is a meal-planning method commonly used by people with diabetes. In this method, food labels and food composition tables are used to identify and add the number of carbohydrates eaten during each meal or snack. The goal is for the total carbohydrate intake to stay nearly the same at each meal and to match a suggested amount, as determined by a person?s activity level, height and weight. A physician, dietitian or diabetes educator can help determine how many carbohydrates an individual should eat during each meal or snack.

What Are the Benefits of Carb Counting?

Carb counting is precise method that helps improve blood sugar control. It also allows for flexibility of food choices. People who practice carb counting can enjoy a variety of different foods. Even occasional sweets are allowed as long as they are accounted for in the carbohydrate count. The table below demonstrates how two very different meals can add up to the same number of carbohydrates.

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Remember: Even if a food is low in carbohydrates, it can still be high in fat and calories. Pay attention to portion sizes of all foods eaten.

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How to Count Carbs

Two Ways to Count Carbs There are two ways to count carbohydrates, by grams or by carb choice. With either counting method used, the goal is to eat a specific amount of carbohydrates at each meal or snack, as determined by individual needs and recommendations from a healthcare provider. To count by grams, add the total grams of carbohydrates for foods eaten. For example, if 1 cup of milk and a small apple are consumed and both have 15 grams of carbohydrates, the carb count is 30 grams. To count by carb choice, add the total amount of carbohydrates grams consumed and divide that number by 15. One carb choice equals 15 grams. The table below outlines how to count carb choices depending the number of carbohydrate grams.

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Steps to Count Carbs:

  1. Identify foods and drinks that have carbohydrates.
  2. Determine the number of carbohydrate grams or the carb count of a serving.
  3. Know how many servings you should eat each day.
  4. Spread carbohydrate servings over the entire day.
  5. Check your blood sugar two hours after the start of a meal. If your blood sugar is greater than 180 mg/dL, you may need to adjust your carbohydrate intake.
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Insulin and Carb Counting

Matching Insulin to Carbs Matching insulin doses to the amount of carbohydrates consumed helps control blood sugar levels. This advanced carb counting method also can allow those with diabetes to be able to make more food choices. Used with 3-4 daily shots of insulin or an insulin pump, matching insulin doses to carb count mimics the action of a pancreas. To do this, each individual has to figure out his or her insulin-to-carb ratio. For example, 1 unit of insulin may be needed for every 15 carbs eaten. Ratios vary between individuals and can change over time. A healthcare provider can help determine your insulin-to-carb ratio. Be sure to test blood sugar before and 2 hours after a meal

How to Use Your Insulin-to-Carb Ratio:

  1. Add up the total number of carbohydrate grams in a meal.
  2. Divide the total number of carbohydrate grams by your insulin-to-carb ratio.
  3. Inject the insulin needed to match your carbohydrate intake.

Example: Your meal has a total of 45 carbohydrate grams. Your insulin-to-carb ratio is 1 unit per 15 carbohydrate grams. So, 45 grams divided by 15 equals 3 units of insulin needed for this meal.

Insulin Correction Factor An insulin correction factor (ICF) is how many points blood sugar drops with 1 unit of insulin. ICF varies among individuals and corrects high or low pre-meal blood sugar levels. An ICF dose is either added or subtracted to the dose given before the meal. How to Use Your ICF:

  1. Subtract your target blood sugar level from current blood sugar level.
  2. Divide by your ICF.
  3. Adjust pre-meal insulin dosage accordingly.

(Current Blood Sugar - Target Blood Sugar) Insuling Correction Factor = Correction Insulin Dose Example: Your current blood sugar level is 200 and your target blood sugar level is 120. This is a difference of 80, which is divided by your ICF. If your ICF is 40, you would need 2 units of insulin to correct your current blood sugar level. Add this insulin dose to your insulin-to-carb ratio dose.

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