Amy Reeder is a Certified Diabetes Educator with a master’s degree in nutrition from the University of Utah. She has worked in the diabetes field since 2005 and has been a Certified Diabetes Educator since 2007. 

There is a good chance your healthcare provider or diabetes educator has asked you about your carbohydrate intake. They want to know how many carbohydrates you eat each day and at each meal or snack.

The subject of carbohydrates comes up frequently in diabetes care because carbs in your diet increase blood sugar. Managing carbohydrate intake is a way to manage blood sugar, which helps manage diabetes and can prevent complications.

One way to manage carbohydrates is by using the Exchange System. Within this system are exchange lists, which are groups of foods that contain a similar mix of carbohydrates, protein, fat, and calories. The lists shows you how much you can eat of various foods for the same essential nutrition content. You can trade or "exchange" items on the list because they will affect your blood sugar similarly. Your healthcare provider may recommend a certain number of exchanges per day or meal based on your needs.

Examples of the exchange system

Foods in the exchange system are grouped as:

  • Starches and breads

  • Meats and meat substitutes

  • Vegetables

  • Fruits

  • Milk

  • Fats

In the starch group, some food examples that equal one starch exchange are:

  • ½ English muffin

  • 1 slice of bread

  • ¼ large bagel

Sample foods that equal one lean meat exchange are:

  • 1 oz. lean beef

  • ¼ cup low-fat or non-fat cottage cheese

  • 1 oz. white meat turkey or chicken, skinless

Benefits and drawbacks of the exchange system

You may or may not have heard of about the exchange system, but it is only one method of many. Others include measuring, eye-balling, the plate method, and carb counting.

The plate method is often the easiest of the bunch. This method involves managing the portions of different foods on your plate, making sure that ½ of your meal plate is filled with non-starchy vegetables, ¼ is filled with lean protein, and the other ¼ of the plate is filled with starch. The plate method allows a variety of foods and ensures that most of your choices do not come from the starchy carbohydrate group, thereby having less impact on your blood sugar.

The exchange system is somewhere in between the plate method and carb counting in terms of ease of use. However, the exchange system has fallen somewhat out of popularity recently. Not many healthcare providers or diabetes educators put this system high on their list when instructing on carbohydrate management.

While carb counting requires more math than the plate method or exchange system, it is a more precise method of managing carbohydrates, especially if you use rapid-acting insulin at meal or snack time as part of your diabetes treatment plan.

Remember, it is important to pick a method of managing carbohydrates that works for you. It is not necessary to move to a more advanced approach if you are doing well with your current treatment. Talk to a Certified Diabetes Educator or registered dietitian in your area to find the right plan for you.