Carb Counting for Type 2 Diabetes

By GabbyPA Latest Reply 2015-07-11 18:16:35 -0500
Started 2012-05-06 16:25:17 -0500

By Everyday Health

By Chris Iliades, MD
Medically reviewed by Lindsey Marcellin, MD, MPH

Counting carbs and understanding the glycemic index are important for anyone managing type 2 diabetes. Along with exercise, eating the right diet is key for controlling the condition, and these methods can help you plan your diet and manage your blood sugar.

Counting carbs with diabetes

A healthy diet consists of a balance of carbohydrates, proteins, and fats. However, people with type 2 diabetes need to watch carbohydrates most carefully.

"Any food that contains carbohydrates is digested into sugar, which increases your blood glucose level,” says Lanah J. Brennan, RD, a nutrition expert and certified diabetes educator practicing in Lafayette, La.

In people with type 2 diabetes, the body’s insulin doesn’t properly move sugar out of the blood and into cells to be used as energy. For this reason, eating too many carbs can raise the amount of sugar in your bloodstream and lead to complications.

“It’s important to eat carbohydrates throughout the day for energy and nutrients that your body needs," add Brennan. But the key for type 2 diabetes is to eat carbs in limited amounts at each meal and snack. Counting carbs is the best way to monitor your carb intake and keep sugar from building up in the blood.

Carb Counting

Counting carbs is a way to help you pay attention to how many carbohydrates you eat. “Carbohydrate counting can help you manage your blood glucose by helping you maintain a consistent blood sugar level as you’re eating meals and snacks during the day," Brennan explains.

Carb counting is important for anyone with diabetes, but can also be used by anyone trying to control their weight. If you have type 2 diabetes, you’ll need to work with your dietitian or diabetes educator to determine the right amount of carbohydrates for your individual diet.

Your carb-counting number will depend on your age, your weight, how much you exercise, and what medications you may be taking. Use these basic tips to manage carbohydrates and diabetes:

Most people with type 2 diabetes should stick to eating around 45 to 60 grams of carbohydrates per meal.
Foods that contain carbohydrates include starches, fruits, vegetables, dairy products, beans, and sweets.
For foods that have nutrition labels, add up the grams of carbohydrates per serving and stick to the serving size. If you eat more than one serving, you’ll have to take this into account.
For foods without nutrition labels, estimate the amount of carbohydrates by using a food chart. For example, one small piece of fresh fruit has about 15 grams of carbohydrates.
Remember carb counting for beverages. Fruit juices and alcoholic beverages in particular add lots of carbs.

It's also important to include protein and fats in your meals, but these aren’t included in carb counting. "Total carbs should make up about 45 to 60 percent of your daily diet if you have type 2 diabetes," says Dinamarie C. Garcia-Banigan, MD, an endocrinologist and diabetes specialist at the Lahey Clinic in Burlington, Mass.

Using the Glycemic Index

The glycemic index is another method that can help you plan your diabetes diet. It is a measurement of how much a particular carbohydrate-containing food raises your blood sugar. By choosing lower glycemic-index foods, you may be able to avoid spikes in your blood sugar.

Research shows that the type of carbohydrates is important for people with type 2 diabetes, but the total amount of carbs has a bigger impact on blood sugar. That means you should use the glycemic index for "fine-tuning" your diet, but not as a substitute for carb counting.

Ask your dietitian or diabetes educator for a chart of high and low glycemic foods to go along with your carb counting chart. You can also find these charts online. Here are some basics on glycemic index:

Foods with a high glycemic index have numbers between 70 and 100, and they tend to raise blood sugar more than lower glycemic-index foods.
Foods with a glycemic index under 50 are considered low glycemic-index foods and will raise blood sugar less.
Low glycemic foods include dried beans, legumes, non-starchy vegetables, fruits, and whole grains.
High glycemic indexes can be found in foods that are highly processed like baked goods, white bread, white pasta, and white rice.

The Bottom Line on Carbohydrates and Diabetes

"Your diet is your number-one weapon against type 2 diabetes,” Dr. Garcia-Banigan says. “Understanding how to balance your diet and control your carbohydrates needs to become part of your healthy lifestyle."

Carb counting and the glycemic index are important for controlling blood sugar, but you also need to manage your portion sizes. "And don't forget to include lean protein and avoid saturated fats," Brennan adds.

Balancing nutrition, carbohydrates, and diabetes can seem like a lot to handle, but these basic guidelines can make it easier to manage. Remember there’s no one diet that works for everyone with type 2 diabetes. Talk to your dietitian or diabetes educator to come up with the right carb-counting number for you so you’ll be able to keep a steady flow of energy throughout the day, maintain a healthy weight, and manage your blood sugar.

26 replies

Kalisiin 2015-07-10 21:03:28 -0500 Report

Are you KIDDING!?!?
45 to 60 grams of carb PER MEAL? Srsly?!?

45-60 percent of your caloric intake?? Srsly??

I don't think much of this article.

GabbyPA 2015-07-11 14:45:31 -0500 Report

That is what is recommended, but I cannot consume that much personally. I have to try to keep it below 20 per anything. If I can keep it under 10 I am really happy.

But there are many people who eat that much per day. We all metabolize it differently and my mom can do those percentages. She was bugging me because I was eating much less. I listened to her because I wanted more, not because my body could handle more. Now I am back on track eating much less.

jimmuel 2012-05-10 14:30:38 -0500 Report

thats a good artical,thanks for sharing Gabby,I need to no more about glycemic index

jayabee52 2012-05-10 20:10:28 -0500 Report

see my response below. There are links to find the Glycemic Index and Glycemic Load there.

jimmuel 2012-05-11 01:07:37 -0500 Report

thanks I put the links on my tool bar so I can just click on them an it go's to it,thanks james this is an artical all diabetics need to learn

jayabee52 2012-05-08 20:33:53 -0500 Report

Thank you for sharing that Gabby!

Two of the nutrition websites to which I look are here ~ , and here ~

A good Glycemic Index (GI) which has the Glycemic load (GL) connected to it may be found here ~

For an explanation of GL see this here ~ (also includes a GI and GL chart)

GabbyPA 2012-05-09 07:39:43 -0500 Report

It is pretty basic, but I find that sometimes getting back to the basics of it all helps me more than my experiments.

Sean-Michael 2012-05-09 19:47:47 -0500 Report

well the basics seem like a good thing for the section of discussions for those new to diabetes, and it went into more detail than I'd heard before. At first I thought it would be same ol same ol, but it was a bit more.

GabbyPA 2012-05-10 20:18:18 -0500 Report

That's why I don't mind posting things that seem "old" because a new person is going to read it and even us old folks can learn things from hearing things over in a new light.

robinsonb 2012-05-17 08:33:39 -0500 Report

I weigh 110 how many carbs should i eat at a meal? never know for sure. like for breakfast today cottage cheese with tomatoes a few small dill pickels then one small flatbread cracker with almond butter on it? not alot of carbs .. should i eat more? i dont know what or if i am eating enough of them I try to keep everything low… but i have two drs and one thinks i should be concerned and another thinks i should not

my fasting BS was 106 with a A1c of 5.8 told me to watch diet and cut things out which i did
6 weeks later i went to my gp he did blood work i had changed diet
blood sugar fasting was 103 only came down 3 numbers in 4 weeks work but the A1c changed to 5.5 I think so he said dont worry about the other Numbers ur fine the other dr was a alarmist
so I am still eating healthy but i had cut out even beans can i have them and can i have oatmeal? i did add a little blueberries in my protein drink which i make with water
and now that i have added these few things when i test again in a couple of months things could go up again? not sure… and i feel like i am such a bit***ch thanks

Nick1962 2012-05-17 09:37:20 -0500 Report

Even though your fasting number only came down 3 points, a .3 point change in your A1.c means your daily averages are better. It’s just a coincidence that you test in the morning and those numbers are pretty consistent. It seems like you are getting a little “dawn effect” or “liver dump” in the morning. A small snack before bed may change that morning number.
I certainly wouldn’t cut out beans, since they are a good source of needed protein, however, if they are like canned baked beans with lots of sugary sauce, then yes. Yes, you can have oatmeal (steel cut is better), but again, watch what you put on it.
What you don’t mention is how much exercise you get. How many carbs you can work in depends a lot on that. Carbs are fuel for the body, and the trick is to take in just what you need to get (and keep) you going without having extras that get stored as fat/sugar. The amount of carbs you need per meal will change from day to day. I limit mine to 30 or less per meal, but I also need to lose weight and I’m not terribly active most days. Obviously at 110 pounds, you’re not overweight (unless you’re only 4’5” tall), so you could get away with more.
Your numbers are good, just elevated. At this point I wouldn’t get too terribly worried about carb count, just cut back on potatoes, breads, pastas, and sugary things. If things start getting worse, then we can talk about serious carb counting.

Kalisiin 2015-07-10 21:05:48 -0500 Report

Forgive me for sounding stupid, but what is the actual difference between steel-cut or rolled oats…and why are they better?

Nick1962 2015-07-11 18:16:35 -0500 Report

Good question and not a stupid one either. I’d bet most people don’t know the difference.
Both start with the single whole grain oat, so no real difference there.
Rolled oats are first steamed to make them soft then “rolled” through a press to make them flat, then toasted, so they are actually partially cooked, and their fiber is broken down a little making them a little easier to digest (plus they lose a little fat and sugar in the process).
Steel-cut or “Irish” oats are whole, round, and firm, but cut up into pieces making them the consistency of a course cornmeal, so there’s a big texture difference, and they taste a little nuttier.

Here’s the main difference though. If you measure each by WEIGHT, they have virtually the same nutritional value. But since we tend to measure by VOLUME, you actually get more steel cut oats per quarter cup because of the shape.

A quarter-cup of dry rolled oats will make almost a cup of cooked oats and has about:
80 calories
2.5 g protein
1.5 g fat
14 g carbohydrates
2 g fiber
no sugar

A quarter-cup of steel-cut oats will make about 1 cup when cooked and has about:
150 calories,
7 g protein
2.5 g fat,
27 g carbohydrates,
4 g fiber
1 g sugar.

So really, if we nit-pick, steel cut oats have a slightly better protein and fiber to carb ratio, BUT if you only eat half the amount.

I’m not a big oatmeal fan, but I did learn steel-cut oats don’t make good oatmeal cookies.

robinsonb 2012-05-17 10:12:28 -0500 Report

Thank you…
was feeling so down today and very confused about what i eat, and how much… Love your reply thank you. Haha and loved ur sense of humor.. I am five ft 1/2 in tall. I clean houses for a living so i think i am pretty active however with this economy I am not at this point cleaning every day so i do need to fit some sort of exercise in, like maybe walking or wearing leg weights when i do walk I am not looking to lose more weight at this time. well, I have cut out what you suggested.. no breads or pasta etc… as far as beans i can cook them in a slow cooker or for sure rinse them well. will look up some receipes on them.

i haven't heard of liver dumping? I do sometimes have a snack before bed I always have a chamomile tea but some times with greek yogurt maybe a few blueberries and cinnamon sometimes a pc of celery with peanut butter, not regular store bought peanut butter fresh ground, and sometimes nothing at all… last night i happened to have a few chix livers left over from dinner… but didn't check morning numbers. I am letting Dr's do that and going by the A1c.
I think my husband is tired of hearing about it what i can have and can't have. i think he thinks i am a little neurotic about it. I guess I am… He thinks i can just relax and eat … I am trying to do that. and with your encouragement and advice I will try to relax as I am sure being upset isn't helping either…

thanks so much for your time
have a good day

DeanaG 2012-05-17 18:59:18 -0500 Report

Stay on the track you are on, don't let it develop into full blown diabetes.
I wish that 10 years ago they would have explained to me the road I was headed down, instead of just telling me my "sugar is a little high"

Nick1962 2012-05-17 13:36:00 -0500 Report

No need for thanks, that’s what we’re here for – to learn from one another.
Well, you’re certainly more active than I am sitting in front of a computer all day, so maybe getting some activity in on your days off like you said will help. The minor tweaks to the diet will too. Trying to eat consistently helped me a lot – eating about the same carb/sugar level each day, trying not to have big gaps where you don’t eat, then try to make it up, etc.

Dawn Effect (or liver dump) happens when you go for an extended period of time (like sleep) without food. Your liver literally manufactures and dumps glucose into your system thinking you’re not going to feed it. This happens to everyone. By eating something at night, your body has fuel to work on while you sleep, so the chicken livers, the peanut butter, were a good choice because they were a good source of protein which stays with you longer. Making it a habit might be a good idea. The tea may not be so good at night because it does have a good amount of caffeine (even if it’s decaffeinated), and it tends to lower blood sugar levels in some.

You’re doing OK, and it’s good to be aware of things like you are. It’ll keep it from getting worse. If your doctor was really concerned, he would have sent you home with a meter and test strips, but for now the changes you made are good.

Oh, and beans – I use them a lot. Cold side salads, soups, dips. Lots of good uses for beans.

Have a good day too!

robinsonb 2012-05-17 14:18:16 -0500 Report

yikes… i think i might be going too long between meals sometimes its just hard to eat if i am not hungry… better quit doing that…

thanks for the heads up on the liver dumping I will def do that at night…
I thought the goal is to have a low sugar level in the AM hence, the Tea????

and I have done nothing today but sit in front of the computer… rainy here in Fla…I should be doing something like shopping but this is what i chose…
Have a good one

Nick1962 2012-05-17 14:42:14 -0500 Report

Yup, might be a good idea to maybe have smaller meals (leaving you a little hungry) and snack in between. Keeping a good steady supply of fuel keeps you from getting highs and lows.

It is good to have a low morning number, but you still will burn about 500 calories in your 8 hour sleep just by being alive. So if you go to bed low, come morning your body thinks you're on a hunger strike, and BAM! the liver kicks. A decent night time snack tells your body "don't worry, I've got you covered until breakfast". Same thing would happen if you went 8 hours without food during the day.

robinsonb 2012-05-17 15:40:49 -0500 Report

I'm responding to something you commented on about alcohol…
You mean i can have a glass of wine??????????????????????????????? OMG that would be great!!!!! especially with friends occasionally… and i would only have one but really????

Nick1962 2012-05-17 16:01:19 -0500 Report

Well, I won't just simply say yes, I don't know if you're on medications, have trouble with alcohol, allergies etc., so I'm not the one to give blessings.
I will say that many people think wine is just simply grape juice with alcohol, but it's not (if you've read that whole thread).
I've been in a wine club for 3 years now, and I wake up with BG numbers between 75-88, and my last A1c was 4.9. You can draw your own conclusions from that, but if you do select to enjoy, do so responsibly, and never on an empty stomach.

robinsonb 2012-05-17 16:11:16 -0500 Report

Thank you Nick1962
No I am not on any meds and dont have a problem with alcohol I think my last glass of wine was christmas. but have been afraid to drink it. also haven't had Grape juice either.. afraid of all juice except the green juice that i juice myself.

Well i think i will hold off till i can get a number under 100 in the morning I think the goal is under 100 but they prefer under 90
I have not reached that yet…
I am trying thou and hope that i can reach it…
but you have GREAT numbers.
Do you take meds or do you control yours by your diet?
if you control by diet I want a list of the foods you eat!!! Great job… and thanks again you have been a delight today!!!!!

jayabee52 2012-05-17 16:44:42 -0500 Report

I also control my Blood Glucose (BG) readings simply by my meal plan. I eat a high protein / very low carbohydrate meal plan and avoid almost all products made with grains. I've written up a discussion where I tell what I do. You can take a look and see if it would work for you. Please find it here ~ Would love to hear your thoughts about it either here or on the discussion I just posted.

Blessings to you and yours!


robinsonb 2012-05-17 17:34:24 -0500 Report

Sorry to hear the news about your kidneys. that is tough. I am sorry but so proud of what you have accomplished with diet alone. It is very helpful I too eat as simple as i can with all this being so new to me. I too feel a little deprived but yet to have ice cream. still trying to get my number under 100 i think that is the goal. thanks for all your input today and sharing what foods you eat…
Best of health to you

Nick1962 2012-05-17 16:22:05 -0500 Report

Sure! Grape juice is definately a no-no (beer too - too many carbs).
I control through diet alone. I was on meds for a little while when first diagnosed, but got off those and a few others as well.
You're doing things exactly right - asking questions here, doing your research, and paying attention to what you eat.
Tell you what, I'll follow you and if you follow me back I can answer any questions via the DC e-mail (this way we won't be filling Gabby's e-mail with a bunch of notifications-sorry Gabby).
Yup, it's been fun!

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