Max Carbs Per Meal

Chris Clement
By Chris Clement Latest Reply 2013-04-17 07:57:29 -0500
Started 2013-03-05 13:02:19 -0600

I am guessing the answer will vary a lot with a definite difference between Type 1 and Type 2 Diabetic answer:
What should the maximum carb intake per meal be for PWD? Those who are carb-conscious may be shooting for a minimal amount of carbohydrates for a single meal, while others may feel like it doesn't matter so long as they can count and dose properly. Personally, I don't always seek after lower carb; I'm a doser. But if I were to be more attentive I would consider more than just carbs. Something with higher carbs but very low fat, for example, would be pretty easy to dose. What are your thoughts?

52 replies

sammieruth 2013-04-16 02:53:03 -0500 Report

WOW! Reading all this stuff has me a bit stressed! Just diagnosed type 2 in December. Work third shift and those carb cravings come on strong about 3am. Trying to control. This is the first i have read about actually counting carbs per meal. It sounds difficult. I guess i need a carb counter book? Seldom eat potatoes, pasta, or white bread anymore. Do a fingerstick 2x's a day. Notice if i eat many carbs at all my readings go high. Sometimes I just want to bing pin any carb I can find. This it's going to be a long long journey :(

Graylin Bee
Graylin Bee 2013-04-16 03:13:19 -0500 Report

Howdy fellow night shifter. My work snacks vary from yogurt, to protein bars, to nuts. They seem to keep me away from extra carb foods. Lately I found I was having lows about 1am. Mewella, another diabetic connect member, suggested a piece of string cheese earlier in the shift might help. It really has.

I am on of the watch my carbs people. I limit the white starchy ones, the same ones you mentioned. Plus figured out most grains were not good for my bg. So I've really cut down on oats, corn, and rice as well. My bg numbers and A1c have improved.
At first carb counting is difficult. After awhile it gets easier. I'm bad with remembering numbers, yet I manage to remember quite a few of my usual foods' carb amounts. I double check the labels, in case I'm wrong. Or, in case they've changed the ingredients.
There are books and websites that give carb counts. I'll find a link to a good one when I get to my computor. Harlen, another member, really likes Calorie King.

sammieruth 2013-04-16 03:29:06 -0500 Report

Thanks for getting back to me so quickly :) i have been eating almonds with a few mini dark chocolate chips mixed in. Right now i just had a Jello snack. I noticed the grains give me high readings also. I get frustrated and wonder what can i eat. I used to eat oats in the morning until i had to do fingersticks. Well that went out the door real fast! We were also big soup bean eaters. That is now a no. I am getting tired of so much meat for protein but my readings stay down. No refried beans either. I know i sound like i am whining. I guess because i am. Sugar goes up alittle when i eat popcorn but i am not giving that up to! Am I??? By the way. I never have lowest. Had a reading one time of 97 and i was jumping for joy.

jayabee52 2013-04-16 22:49:46 -0500 Report

GB, I clicked on the lantus/counting carbs link and it was not clickable for some reason. I copied/pasted the link into my address bar and it worked fine.

Graylin Bee
Graylin Bee 2013-04-16 04:18:34 -0500 Report

Have you tried yogurt? Greek yogurts have a nice amount of protein. The different brands have different tastes, so you might have to do taste testing to find what you like. Local in my state is an australian style, not has high in protein as the Greek, but decadently good. I feel like I am indulging in a treat without being bad for me.
Love have almonds or cashews with a little chocolate handy as a snack.
Nature Valley has two bars I keep handy and are sold at Walmart and Grocery stores, sometimes I've found them at Target. One isAlmond Crunch with 13 grams carbs and 6 protien. It does have corn syrup and yellow corn flour. But one every so often hasn't spiked me. The other is Protein peanut, almond &dark chocolate. With 14 carbs and 10 protein. Has sugar, high maltose corn syrup, tapioca syrup, rice starch and rice maltodextrin, but again doesn't spike me.

Dr John
Dr John 2013-04-07 15:07:43 -0500 Report

The Food & Nutrition Board of the National Academies, Institute of Medicine has released new recommended dietary allowances (RDA) for energy yielding nutrients including carbohydrate.  The RDA for carbohydrate has been set at 130 grams per day for children and adults.

The standard recommendation for carbohydrate is 45-65% of total calories.  This means if 1800 calories are eaten each day, the recommended amount of carbohydrate is 202-292 grams based on 45-65% calories from carbohydrate.

Carbohydrate (glucose) is your body's favorite energy source.  Many organs in the body can use protein or fat for energy if carbohydrate is not available.  The brain, however, requires some carbohydrate (glucose) to function.

The brain uses an average minimum of 130 grams carbohydrate daily.  This minimal amount is where the RDA is derived.  Consider that other parts of the body would like to use carbohydrate for energy as well.

The importance of eating a diet with carbohydrate sources including whole grains, vegetables, fruits, and low fat dairy products is stressed in the American Diabetes Association journals.  The American Diabetes Association also indicates that consideration for the total amount of carbohydrate in each meal and/or snack should be held with high importance.

Institute of Medicine:  Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids.  Washington D.C., National Academy of Sciences.

Franz, Marion J.  Nutrition FYI.  So Many Nutrition Recommendations - Contradictory or Compatible?  Diabetes Spectrum 16:  56-63.
Minimum Carbohydrate Recommendations

Christine Carlson, MS, RD, BC-ADM, CDE
GlucoMenu® Nutrition Director

Type1Lou 2013-04-10 16:54:55 -0500 Report

But…have these recommended RDA's taken into consideration that those of us with diabetes may have more deleterious effects from the carbs eaten? I would not be following a low-carb diet if my pancreas' beta cells were producing the insulin I need to metabolize those carbs…alas, it doesn't, and like you, I am a Type 1. I function very well on 120 grams of carb per day and my last A1c was 6.8…still room to improve there. I am able to maintain my weight at 120 lbs…ok for my 5'3" height. I complete the NY Times Sunday Crossword every Sunday, and do the three crossword puzzles in the Tampa Bay Times daily… I am a voracious reader and a creative quilter…so I don't think my lower carb intake has affected my brain power at all. Lower carb definitely works for me.

Phillb80 2013-04-16 21:27:58 -0500 Report

Do you exercise regularly?

Type1Lou 2013-04-17 07:57:29 -0500 Report

Unfortunately, no! I was walking 3 miles at a brisk pace 3 to 4 times per week but got out of the routine. I DO need to resume that routine since I believe the regular exercise increases my insulin sensitivity and reduces my overall daily dosage of insulin with better BG control. I KNOW I need to do this but always seem to find something else to do…and with the hotter season arriving here in Florida, it's going to be even more difficult to get motiviated!

Dr John
Dr John 2013-04-10 16:57:42 -0500 Report

Your pancreas doesn't make insulin. That is why type 1's take exogenous insulin. 120 grams is marginal. It also depends greatly on your activity level.

Type1Lou 2013-04-11 11:16:13 -0500 Report

Gary Scheiner, MS, CDE writes the following in his book "Think Like a Pancreas"
"Type 1 diabetes, for lack of a better definition, refers to a lack of internal insulin production. Insulin comes from the pancreas,…There are groups of cells in the pancreas called "islet" cells, and within the islets are "beta" cells. Beta cells constantly measure blood sugar levels and produce insulin as needed, to keep the blood sugar level within a normal range.
In Type 1 diabetes, the beta cells are destroyed…rendering the pancreas unable to produce any insulin." But I'm sure you already know this.

Dr John
Dr John 2013-04-11 11:57:07 -0500 Report

Yes, I learned that in medical school. But, that is not the point. The point is just because your pancreas doesn't make insulin is no reason to not eat enough carbohydrates. That is what insulin injections are for - to replace what the pancreas doesn't produce.

jayabee52 2013-04-12 00:43:35 -0500 Report

IMHO that viewpoint is bass-ackwards.

I don't advocate eating NO carbs, but to minimize one's carb intake so one does not need to inject large amounts of exogenous insulin. To consume a lot of carbs just because one can due to the available of outside insulin, is doable but IMHO foolish.

Also, I recently (in research for another topic) read that glucose is not the ONLY fuel the brain can use. That article may be found here ~

According to that article the brain can run on ketones, And lactate and other substances. Near his conclusion the author states:
"So, a healthy, efficient brain is one that draws on several different fuels. A healthy, efficient brain is one that uses ketones (and perhaps lactate and other fuels) to spare some glucose. A complete reliance on glucose indicates an underachieving brain, a brain that could do so much better, a brain that could really use a coconut milk curry and some intense exercise every now and again. As far as we can tell, then, the absolute physiological minimum is 30 grams of glucose"

He also makes the claim elsewhere that on some of those other "fuels" for the brain, some of them work a bit better than glucose as a fuel. I myself have no anecdotal experience with that except when I was losing fat, I was likely burning ketones. And during that time I had a feeling of well being and clarity of thought. I didn't have any tests done so what I experienced could be subjective, but I remember a great sense of well being and clear thought. I think I may look further into this "Primal Eating Plan".


Type1Lou 2013-04-13 13:29:21 -0500 Report

Beautifully said James! Could this mean that those of us on lower carb diets may have over-achieving brains since we obviously aren't relying completely on glucose as brain fuel ????

Graylin Bee
Graylin Bee 2013-04-12 02:07:06 -0500 Report

Diabetes, too, can affect the brain. Children with type-1 diabetes lose some mental acuity when their glucose metabolism slows, says Jullie W. Pan of the Albert Einstein College of Medicine in New York. That can eventually affect their academic performance.

In type 1 diabetes, the body doesn't have enough insulin to do its normal job of transporting glucose into cells that would metabolize it. In fact, ketosis is a symptom of diabetic shock because it arises when glucose metabolism is suppressed. Insulin injections can boost glucose metabolism, but blood insulin can vary considerably between injections.

Pan is now studying the effect of ketone infusions in diabetic children to see whether the therapy might compensate for the effects of glucose-metabolism fluctuations on the brain.

Graylin Bee
Graylin Bee 2013-04-12 01:48:51 -0500 Report

James, check out this study. It briefly addresses brain fuels other than glucose.

Here is an axcerpt

The brain is a complex organ composed of a variety of cells, each having different metabolic needs. Neurons, astrocytes, oligodendrocytes, and capillary endothelial cells have a high rate of oxidative metabolism (Hertz 2008). Every brain cell can use glucose because all of them possess GLUTs and glycolytic and tricarboxylic acid (TCA) cycle enzymes (see Glucose and glucose transporters in brain section). Some glycolytic intermediaries are transported through astrocytic gap junctions (Giaume et al. 1997; Rouach et al. 2009). Moreover, astrocytes are able to synthesize glycogen from glucose. Glycogen can be used for energy production (glycogen degradation to glucose and glucose oxidation via glycolysis and TCA cycle) and for pyruvate carboxylation to oxalacetate catalyzed by pyruvate carboxylase (Ibrahim 1975; Hamprecht et al. 2005; Hertz 2008). Although the longstanding dogma of the brain as an organ relying solely on glucose for energy production is still largely valid to this day, a debate has begun regarding whether neuronal oxidative metabolism relies on astrocyte-derived lactate (the astrocyte–neuron lactate shuttle hypothesis; ANLSH) rather than on glucose during neurotransmission activity (Pellerin and Magistretti 1994). This hypothesis is controversial and has not yet been fully accepted. Our group has published some data suggesting that ascorbic acid can function as a neuronal metabolism modulator (Castro et al. 2007, 2008). Ascorbic acid, the reduced form of vitamin C, is very highly concentrated in CNS (Hornig 1975; Kratzing et al. 1982) and functions as an antioxidant, reducing reactive oxygen species to stable molecules (Padh 1990; Rose and Bode 1993; Sauberlich 1994). Glutamate is able to stimulate ascorbic acid release from astrocytes (Wilson et al. 2000; Castro et al. 2007) and neurons can take up ascorbic acid because they possess sodium–vitamin C transporters (SVCTs) (Castro et al. 2001). Intracellular ascorbic acid inhibits glucose use and stimulates lactate uptake by neurons (Castro et al. 2007, 2008). Therefore, ascorbic acid entry to neurons can change the metabolic substrates used in these cells.

In this review, we discuss the role of glucose- and lactate-like metabolic substrates and the modulation of neuronal metabolism by ascorbic acid. We review the expression and use of glucose and lactate for neurons and astrocytes. Further, we consider ascorbic acid transporters and ascorbic acid homeostasis in CNS. And finally, we discuss the idea of a metabolic switch driven by changes of ascorbic acid concentration in brain.

jayabee52 2013-04-12 03:36:53 -0500 Report

Thank you Graylin, so much for finding both of those articles! very interesting, informative and supportive!

Graylin Bee
Graylin Bee 2013-04-12 04:11:57 -0500 Report

You"re most welcome.
I enjoyed learning a tad more about what might be doing what.
Especially interesting reading that there are a few things that pass through the "brain barrier" Seemed the scientists were surprised when West Nile Virus could cross the barrier. Looks like there might be more getting into your head than they currently know.
I'm trying to remember if during my neuroinvasive WNV battle I accidentily ate more fats. Or perhaps it was the several weeks of being home alone and surviving on tortilla chips and Diet Dr. Pepper. During the first intense time, that might have helped make some beneficial ketones attack the virus. Heck I don't remember if I was still drinking the High fructose version or was drinking the diet stuff back then. till have some WNV damage needing rewired ito get to those memory tracks.
Wouldn't it be ironic if Dr. Pepper had worked in a medical capacity?

missymoose13 2013-03-25 02:34:35 -0500 Report

I tend to be a doser but since I have a problem with weight I try to keep the carbs down. I am at the age where I try not to beat myself up for too many carbs any more as long as my sugar levels are good

Anonymous 2013-03-20 09:20:56 -0500 Report

i am type 2…i count carbs i try hard to limit myself to 15 a meal…i snack on "free foods" at home…i limit bread intake and will make sandwiches as wraps using lettuce…i do carry cheese sticks with me and low carb fiber bars if i feel "low" i have a snack to much on…really its whatever makes you feel good thoughout the day. there are so many factors for each of us…everyones diabetes journey is different :)

Type1Lou 2013-03-12 18:09:15 -0500 Report

I'm a Type 1 and limit myself to 30 grams of carb for breakfast, and 45 grams each for lunch and dinner. That's a total of 120 grams per day. My last A1c was 6.9, so, if I reduced my carbs, I could probably get a better A1c. I've been able to maintain my weight at around 120 lbs and am a 5'3" tall 64 year old woman who is moderately active…all factors to consider. I just read an item in the last Diabetes Forecast that suggests a higher-fat meal will adversely impact BG control, even if the meal has the same number of carbs as it's lower-fat counterpart…food for thought!

JiMMy DCC 2013-03-12 16:47:37 -0500 Report

For me it's simple math. I don't want to gain weight. If I had 46 to 60g of carbs at each meal I would. So I know a couple of things. I know how much insulin per carb to cover. So I take 2u for every 15carbs. Also I know to really look at what I'm eating. Fiber counts against carbs. So if a piece of whole grain bread is 20 carbs but has 5 fiber… Then it's 15 for me. If there's fat in the meal like cheese or fatty meats then I Bolus after I eat not before. And veggies are so different than refined foods. So no matter what you eat - know what your eating. Then know how the carbs change your BG. Then wether you want to maintain weight - or like me lose weight - you'll have a better idea of how to approach each situation.

Gwen214 2013-03-09 15:45:37 -0600 Report

For me it's 15 to 45 carbs per meal, depending how I feel that day, because sometimes moodiness, emotions, sickness can alter blood sugar. Btw, I'm type 1

Just Joyce
Just Joyce 2013-03-07 12:35:02 -0600 Report

My doctor told me 60 carbs per meal as a T-2. I count carbs and based on the servings per meal I eat, my carbs per meal is less than that. I balance them out with protien. So If I want to eat a small potato and a roll I can because I have not exceeded my carb count for that meal.

RebC 2013-03-06 13:11:39 -0600 Report

I'm a doser. My carbs vary with each meal, and while I do try to keep it on the lower side, I am not against a roll or two (and mashed potatoes!) at Thanksgiving dinner. I try to eat protein whenever I eat carb, though. You, know. To balance it out :).

Chris Clement
Chris Clement 2013-03-07 10:42:10 -0600 Report

Agreed, I think it fine to break out of the regiment, so long as you can dose for it and keep in control. Do you have any sort of baseline you live by with carbs per meal? I see a lot of "Diabetic Recipes" with a variety of carbs per serving, and I am curious of what fellow PWD feel are too high of carb content to be considered diabetes friendly.

Mair 2013-03-06 12:07:29 -0600 Report

For me there were blood tests done before I was put on the pump. I am allowed 45gr of carb ber meal and 15 gr. for snacks. I found I have to keep it under 45 per meal for my A1C to be 6% though. I still keep trying.

old biker
old biker 2013-03-05 15:30:04 -0600 Report

I am a T2..At this point I know what foods I can eat and what foods I won't even look at. . My total carb intake for the day is between 80 and 100 carbs. My BG numbers stay below 140 and my A1c is 6,1. I am on insulin and metformin

Chris Clement
Chris Clement 2013-03-05 14:28:30 -0600 Report

I assume locarb is speaking as a Type 2 and davidhogan as a Type 1?

davidhogan 2013-03-05 14:49:54 -0600 Report

LOL well they never know what to call me, my endo says I was wrongly diagnosed as type 2 years ago based on my lack of insulin production and should consider myself a type 1, but I am fully insulin dependent, no matter what the "label" should be.

Chris Clement
Chris Clement 2013-03-05 14:57:57 -0600 Report

Interesting. But your endo has never tried to re-diagnose you to be sure? I'd think that would be an important thing for an endo to know to make sure you are receiving proper treatment. I'm curious.

davidhogan 2013-03-05 17:25:53 -0600 Report

I'm not sure what you mean by that (being re-diagnosed) as my BG levels and A1C's and bloodwork have been very good for going on 3 years since he and I started working on things together. So the RESULTS tell me I'm getting proper treatment, not a label. As I said in my first post I no longer produce insulin and we have looked at the bloodwork to back that up.

Chris Clement
Chris Clement 2013-03-05 17:41:00 -0600 Report

Oh, no I'm not doubting your treatment from a patient perspective. It's not all about the label, but I guess I'm the type of guy that likes to know exactly what I have going on. If your endo says you may have been, as you said, "wrongly diagnosed" it might make sense to re-categorize just for the sake of knowing. The difference between T1 and T2 is generally wide enough that it seems an endo would want to make the distinction as well. If your bloodwork shows you simply don't produce insullin, seems like endo might go, "Welp...looks like you are T1 now."

But, ULTIMATELY, if you are controlling it perfectly as you are, it's a less important technicality, and very cool. Glad to hear it, for sure. :) I was just curious as I don't know how a physician would treat a case such as yours.

davidhogan 2013-03-12 17:31:16 -0500 Report

I just got back from endo appointment and he said I was NOT a type 1 as that would indicate an auto immune disease and evidence of positive antibodies. He said I am an insulin deficient (not dependent) type 2 diabetic that follows a type 1 treatment. BTW A1C was a 5.7 from 5.9 3 months earlier so good visit.

Chris Clement
Chris Clement 2013-03-13 16:02:14 -0500 Report

wow, that is very very interesting, thank you for sharing that! Fascinated. So you in fact are still producing insulin, though very little. Right?

davidhogan 2013-03-05 19:04:46 -0600 Report

Shoot for all I know he did when he told me I was wrongly diagnosed and showed me I was not producing insulin and then put me on a bolus/basil regime. I treat myself as a T1 for my thought process, but I'm up to see him in 2 weeks and for the sake of curiosity I'll ask him to be more definitive to see what he says. ;-)

locarb 2013-03-05 14:00:41 -0600 Report

Interesting, I try to limit to no more than 20 (or so) carbs per meal also. There are instances when I have exercised a lot, or will be exercising shortly after eating, and allow more. I've managed to avoid diabetic medication and/or insulin since 2010 when I was diagnosed. My BG usually low 80's and 90's.
It did take time to get used to eating this way and to resist or lose cravings.
I want to reassure everyone that does happen. In time, you no longer have
interest in the things that had you avoided initially…you would probably have also avoided a dramatic change to your life. Yes, it's very ironic.

davidhogan 2013-03-05 13:31:03 -0600 Report

I think you have touched upon the great debate that we as diabetics face and everyone else as well. I have a carb formula so I can easily dose to fit, BUT I am a firm believer that excessive carbs especially those from processed foods, HFCS, sugars etc, are unhealthy. Emphasis on EXCESSIVE.

My pancreas may not be making insulin anymore but I KNOW years of chocolate chips cookies and sweet milk and sugar laden cereals while programming behind a computer into the wee hours of the morning did not do my health any good back in my 20's and 30's.

With that said and keeping it in mind for the amount you asked for my RED FLAG goes up at anything over 20 carbs in ANY meal. Meaning at that point I stop and tell myself I need to give more thought to my meal as in glycemic LOAD, protein and I'm not a firm believer in making fat a villain except for the noted bad fats.

SO my magic number is 20 to get my attention, and of course that's just me and I would never try to convince someone else it is what they should do.

IronOre 2013-03-05 15:15:03 -0600 Report

so basically your are allowed one slice or bread, and a little bit more than that, in carbs for each meal ?

davidhogan 2013-03-05 17:35:02 -0600 Report

No, I use Nature Valley butter bread at 12 carbs and another brand at 6 carbs when I do eat bread at all. I, unlike many other low carb watchers will eat certain rices but I make sure I eat high fiber beans at the same sitting. Brizeater asked for thoughts on maximum carbs and 20 is what get myself thinking further than basics.

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