Carb Counting - What is Carb Counting and How to Count Carbs

Carbohydrate counting is a method of understanding the affect of carbs on your blood sugar
Carbohydrate counting is a method of understanding the affect of carbs on your blood sugar

Carb counting is a way of better understanding carbohydrates and how they affect your blood sugar, medication requirement and insulin requirement.

Carbohydrate counting has a different role for people with diabetes who use insulin and those that don’t.

For people with type 1 diabetes and those with type 2 diabetes who require insulin, carbohydrate counting is a way of matching insulin requirements with the amount of carbohydrate that you eat or drink.

For people with type 2 diabetes who don’t require insulin, carbohydrate counting is a way of regulating the amount of carbohydrate you consume and monitoring how this affects your blood glucose control, weight management and medication intake.

What is carbohydrate counting?

For people with diabetes who require insulin, carbohydrate counting is a way of matching insulin requirement with the volume of carbohydrates that you eat or drink.

For people with diabetes who don’t require insulin, carbohydrate counting is a way of managing diabetes that can lead to better control of blood glucose, greater freedom of lifestyle and a healthier body.

However, carbohydrate counting requires patience and diligence.

Learning it successfully means understanding carbohydrates, learning how to adjust your insulin or medication accordingly, and measure your blood glucose levels regularly for clarity.

How do I understand more about carbohydrate counting?

To learn more about carbohydrate counting, most people with diabetes require a healthcare professional to help.

This may either be your diabetes healthcare team or via a carbohydrate-counting course (offered for free to people with type 1 diabetes by many UK PCTs).

There may be many courses available in your area, and your diabetes healthcare professionals should also be able to arrange one-to-one guidance.

Transcript

It's come a long way and it's coming back into fashion. All the people I know who have had diabetes for a long time and are in pretty good nick carb count. It's a good way of eating healthy and you don't have to be diabetic to do it. It does help if you have diabetes to get the hang of it. It's not an exact science but it's always a little hit and miss.

If you can stick to some basic rules and see how foods effect you then you will understand the foods which work best for you. You may have heard of the traffic light guide - red, orange, green - for foods. With green, they were trying to imply you can eat as much as you like of green foods, etc. Foods in the middle were eat some, but not a lot and reds were stay away.

It's easier with diabetics in a way, as you will know that you can eat things like cheese but it won't have a massive effect on your blood sugar level. It's still fat, no doubt, fat and protein - so you need to bear that in mind and keep it in context.

A lot of carbohydrates will fit into the middle ground - they will give you energy quite quickly so your basic brown bread gives you a slower release pattern. It marries the effect of insulin as it goes in. Then you have your reds that deliver the energy too quickly for your insulin to be able to match. The traffic light system is helpful.

Another thing that is helpful is labels. Read the label. Don't just look at the sugar content but the carbohydrate content which is probably even more important. There are a lot of badly labelled foods out there. They may say they're sugar-free, but will be full of carbohydrates; so if you think you can have them because there is no sugar in them, you'll be sadly mistaken.

Another thing to be aware of is the Glycemic Index. For example, if you have a cheese sandwich with pickle then you're not just eating carbohydrates. The bread is carbohydrate, cheese is protein and fat and the pickle is carbohydrate and some sugars which will release energy quite quickly. The point being you're not eating one food in one food group - you're eating a mix. That can affect how they're absorbed. The release rate may be different from eating bananas all day long.

Most of us eat various different foods that can give spikes of sugar. As a diabetic, to know how much carbohydrate is in a serving and how it's going to release it's energy is how you can marry the insulin to the carbohydrate and hopefully end up with good blood sugar control.

Why are carbohydrates important to understand?

Every carbohydrate we eat is converted into glucose and has an impact on blood sugar levels.

However, a zero carbohydrate diet is not recommended, as some carbohydrates play important roles in whole body health.

How much carbohydrate does the body need?

The amount of carbohydrate required by the body will vary depending on age, weight and activity levels.

Levels of carbohydrate intake advice vary depending on the individual.

Some people with diabetes prefer a low-carbohydrate diet whilst others prefer to follow the NHS/DUK diet advice.  

What are carbohydrates?

Carbohydrates are commonly found within the following foods:

  • Grains (breads, pasta, cereals),
  • Fruits
  • Vegetables
  • Root crops (potatoes, sweet potatoes, and yams)
  • Beer
  • Wine and some hard liquors
  • Desserts and sweets
  • Most dairy products, except cheese,
  • -ose foods like sucrose, fructose, maltose.

How should I count carbohydrates?

Most foods are only partially carbohydrate (although some foods are entirely carbohydrate). To ascertain the carbohydrate content of these foods it is necessary to use food labels, along with reference books or computer programs, and a scale and list of carbohydrates.

Counting carbohydrates can take a while to become competent, and for some time it will be necessary to weight and measure foods.

Over time, people with diabetes accumulate a knowledge base and train understanding of serving sizes and weights. Common food lists should be kept.

Effect of proteins on blood sugar levels

It is not just carbohydrates that affect blood glucose levels, proteins also play a part.

The effect of protein is less pronounced and they are broken down much slower than carbohydrates.

This is useful to bear in mind and could explain why carb counting alone may not always correspond to the right insulin dose.

What carbohydrate counting equipment do I need?

Many people with diabetes have scales, as well as weighing and measuring equipment to measure volume.

Mostly, food labels give both weight and volume measurements, but some do not.

Match your measurement with the reference material to give you the most accurate results possible.

The following techniques can help in understanding carbohydrate counting:

  • Using food labels. Use of food labels, a measuring cup and a calculator make it possible to identify carbohydrate content in food. Measure and understand your preferred serving size, based on the label amount.
  • Using books and the Internet. Nutrition books and online resources can provide useful information and a quick and easy way to look up brand-name food information. Many recipe books include detailed carbohydrate information.
  • Using a scale. This is useful to learn for measuring carbs in odd-sized foods such as fruit or soup. For this type of carbohydrate counting it is necessary to have a gram scale, a calculator and a list of carb percentages (available online).  You may then weigh food and check carb percentage from your scale.

Remember, there is a vast amount of carbohydrate counting and general carbohydrate information in the Diabetes Food Forum.

What the community have to say about carbohydrate counting

  • Carbsrok: You need to be counting the carbohydrate in your food. Please go back to your Diabetes team and say: 'look, I am completely confused. I need help sorting this.' Take pen and paper with you so you can write things down. Ask for guidance on Carbohydrates. And how to match your insulin to food intake. A low GI/ Glycaemic load need to be considered. Take one day at a time otherwise you will feel completely overwhelmed by it all.
  • Copepod: Most food packets have carbohydrate content in the nutritional information - you need to count total carbohydrate, not just the sugar, and also bear in mind some foods have different values for raw & cooked food. Having said that, once I've weighed a food once, I just estimate by sight after that, which is useful when eating away from home. For fruit and vegetables, you'll need a guide, either book or online.
  • Gazhay:I would highly encourage every diabetic to go on DAFNE course, even the 'carb counting haters'. As it can be a very individual thing, and surely getting all the education about it is a good thing, whether you choose to continue it or not.
  • Wallycorker: Over the last 5 months after attending sessions on carbohydrate management she had attained a magnificent HbA1c of 5.6 - down from readings near to - or in - double figures. What's more by following the techniques explained to her she had lost a massive five stones in weight in the same period of time. Yes five stones in five months - I am certain that is what she said - just through carbohydrate management or carb counting as it is sometimes known.
  • Hellsbells: I was diagnosed with T2 almost 2 years ago. I waited 5 months to see dietician who advised me to eat carbohydrate based meals. In fact, when I told her I was carb counting as a way of controlling my bg levels she told me my medication (metformin) would not work if I didn't eat plenty of carbs! I also asked about portion control. She replied that she would discuss this with me at our next meeting which would be in 3 months time. Needless to say, I didn't go back.
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