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Why
Count Grams of Carbohydrate?
By knowing
how much carbohydrate is eaten, blood sugar levels can be partially
controlled. This technique is helpful even if insulin is not currently
being taken. Just keeping the CHO intake consistent from meal
to meal can help stabilize blood-sugar levels. Even though the
amount of CHO eaten (portion size) is important for blood sugar
control, eating too much CHO can lead to weight gain, especially
if insulin is being taken. Eating a variety of low-calorie foods is important for good health and weight control.
Helpful Hints
The magic
number is "15" for counting CHO because, 15
grams of CHO = one carbohydrate choice or serving.
- If the
food label indicates 5g of fiber or more per serving,
deduct this from the total CHO amount since fiber does not directly
affect blood sugar values.
- If a snack
includes 15g or more of CHO, more insulin may be needed (possibly
1/2 the amount normally taken). This depends on individual blood
sugar values.
- Sweet alcoholic
beverages may require additional insulin. Dry wine, light
beer, etc. may be better choices than sweet wine. It is preferable
to drink alcohol with food to avoid low blood sugars. Avoid
alcohol during pregnancy!
- Glycemic
Index for a food indicates how quickly/how much blood sugar
increases after eating the food. Keep a record of food intake
and blood sugar levels. This will help identify which foods
are more likely to cause blood sugar levels to climb quickly.
Other foods consumed, the fiber content, & method of cooking
can also affect the glycemic index of a particular food.
Easy
Steps to Carbohydrate Counting
- Identify
which foods have carbohydrate:
|
Starches |
Fruit
Juices |
Vegetables |
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Milk/Yogurt
|
Sweets |
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|
- Determine
the portions of foods you plan to eat:
For example, measure by volume (1 cup), weight (3 oz) or count
(2 each).
- Determine
the number of grams of CHO food you plan to eat: (food labels,
carbohydrate counting books, exchange lists)
- Total
the grams of CHO you plan to eat for each meal.
- Start
with the CHO factor 15 or use a factor according to your weight.
Divide the total CHO grams at each meal by your factor. This
is how much Regular/Humalog [fast-acting] insulin you will take
before you eat. The factor is the number of grams of CHO one
unit of Regular/Humalog insulin will cover.
- ALWAYS
check your blood sugar before you eat.
If your pre-meal BS is over 150 mg/dl, consider 1 additional
unit of Regular/Humalog for every 50 points over 150.
If you are pregnant and your pre-meal BS is over 100 mg/dl,
use the supplemental insulin sliding scale your physician or
nurse gives you. You will probably need more insulin for elevated
blood sugars.
- Give
the appropriate amount of insulin for the grams of CHO you
plan to eat at the meal plus/minus extra insulin needed based
on your blood sugar.
- Record
your blood sugar value in your log prior to eating the next
meal.
- Make
any needed adjustments in the factor based upon this blood sugar.
If your blood sugar is still too high, you may need to reduce
your factor by several points (more insulin). If your blood
sugar is too low, you may need to increase your factor by several
points (less insulin).
Examples
of Carbohydrate Counting (examples coincide with 1-9
above)
4. Total
grams of CHO for each meal.
|
Food
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CHO
g
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2
slice bread (starch)
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30
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ham,
cheese (meat)
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0
|
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1
cup peach (fruit)
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30
|
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1
cup pasta (starch)
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30
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1
cup low-fat milk (milk)
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12
|
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TOTAL
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102
|
5.102g
CHO ÷ 15 [factor], you should take 6.8 units Regular/Humalog
insulin.
Even if you
do not take insulin, being aware of how much CHO you eat at a
meal can help control your blood sugars.
6. For
example, if your blood sugar is 200 mg/dl you may need 1 additional
unit of fast-acting insulin to take care of the pre-meal elevated
blood sugar.
If you
are already pregnant, consult with your physician or nurse. You
will probably need to add more insulin according to a sliding
scale designed for you!
7.
Give 6.8 units Regular/Humalog insulin for the CHO you plan
to eat + 1 unit for the high pre-meal BS. A total of 7.8 units.
8.
Your BS before your next meal should range between 80-140 mg/dl.
If you
are already pregnant, your pre-meal BS should be <95 and/or
<120 mg/dl 1 hr after meals.
9. Your
CHO factor may vary from meal to meal. You may need more insulin
with breakfast.
One half
cup of the food in the above label has 13g of CHO.
ESTIMATED
INSULIN TO
CARBOHYDRATE RATIO (FACTOR)
Based on Body Weight
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Weight
in Pounds
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Units:
Grams CHO
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100-109
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1:16
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110-129
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1:15
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130-139
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1:14
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140-149
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1:13
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150-169
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1:12
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170-179
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1:11
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180-189
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1:10
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190-199
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1:9
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200-219
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1:8
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220-239
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1:7
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240+
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1.6
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For example,
if you weigh 140 lbs.; 1 unit of Regular/Humalog insulin will
cover about 13 grams carbohydrate. Your CHO factor is 13.
Recommended
References:
American Diabetes/American Dietetic Associations, 1995, Exchange
Lists for Meal Planning
Holzmeister, Lea Ann, 1997, The Diabetes Carbohydrate and Fat
Gram Guide.
Kraus, Barbara, 1995, Calories and Carbohydrates, 12th Ed.
Borushek, Allan, 1999. Gram Guide, The Doctor's Pocket Calorie,
Fat & Carbohydrates Counter
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