If you have diabetes, there is a good chance your healthcare provider or diabetes educator has asked you about 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 when eaten, carbs increase blood sugar. Managing carbohydrate intake is a way to manage blood sugar, and therefore manage diabetes to 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 for Diabetes

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. It is one method of many. Others include: measuring, eye-balling, the plate method, and carb counting.

The plate method is 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, but 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 when considering ease of use. However, the Exchange System has fallen somewhat out of popularity in recent time. Not many healthcare providers or diabetes educators use this system any more as their top choice when instructing on carbohydrate management. You can, however, still find information on the Exchange System and the following links are good references for the food exchange lists:

Mayo Clinic, "Exchange list: Meat and meat substitutes"

NIH, "Food Exchange Lists"

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.