How does carbohydrate counting work?

carbohydrate has the fastest effect on increasing blood sugars. The

number of grams of carbohydrate that a person can eat each day or at

each meal is determined by such things as their weight; whether or

not weight loss is a goal (which it frequently is in people with

adult-onset or type 2 diabetes); when and how much they exercise,

because exercise will lower their blood sugar; what diabetes

medication or insulin they are taking, and when; and other factors

such as age and medical issues such as the presence of high blood

fats.

For example, a 6' 2" tall man with diabetes who weighs 180 pounds and

wants to maintain his current weight might be told he could eat 350

grams of carbohydrate spread out over the day. His goal would be to

spread those grams out over the course of the day so that he doesn't

send his blood sugars too high at any one time. If he is taking

insulin or oral diabetes medication, he might also have to manage

when he eats his carbohydrate in such a way that there is enough

sugar from his meals in his bloodstream when his medication is

working its hardest.

"We now know that in general, a sugar-containing food like a piece of

angel food cake may have 30 grams of carbohydrate in it, but that

piece of cake will have the same effect on your blood sugar as 2/3

cup of rice or one cup of applesauce, both of which have 30 grams of

carbohydrate in them," says Chalmers. "So, if this man's meal plan

that he's developed with a dietitian states that he can eat 60 grams

of carbohydrate at a meal, it's his choice where he 'spends' those 60

grams. One time he may have 2/3 cup of rice and one cup of

applesauce, because that's what he feels like eating. Another time he

may decide to eat ý cup of applesauce, a cup of milk (12 grams of

carbohydrate) skip the rice, and have the small piece of angel food

cake for dessert."

People who develop diabetes when they are over 40 frequently develop

diabetes in part because they are overweight. Being overweight makes

it more difficult for their bodies to use insulin to convert food

into energy. For this reason, many patients with diabetes also have

weight loss as a goal. Because each gram of fat contains 9 calories

(while a gram of protein or carbohydrate contains only 4 calories),

fat gram counting as a means of losing weight becomes an additional

nutritional tool for many patients.

Frequently people with diabetes also have problems with high blood

fats and/or cholesterol levels, and will be prescribed a meal plan

that is low in fat as well. So even if they aren't overweight, some

patients may be counting grams of fat eaten at each meal or over the

course of the day, as well as how many grams of carbohydrate.

Joslin Diabetes Center, and many other organizations, sell food lists

that show how many grams of carbohydrate, and fat, are in most foods.

Also, most any food you purchase in a grocery story lists

carbohydrate and fat content as part of the food label requirements

mandated by the federal government.