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How To Count Carbs For Diabetes


Why Do You Need To Count Carbs

Carbohydrate Counting for a Diabetic Diet | Roswell Park Nutrition

Carb counting is regularly used by those who need to control their blood glucose quite tightly such as those with type 1 diabetes or type 2 diabetes, those who want/need to be in nutritional ketosis, to help reverse insulin resistance, and those who want to control their hunger and fat-burning ability.

But whether you are needing to limit carbs for medical reasons or weight loss, the only way to do so is by actively counting carbs in foods and the quantities of those foods you choose to consume.

How Many Carbs Should You Eat Per Day

The amount of carbohydrates you should include in your diet or nutritional plan depends on many factors, including the type of food or diet plan you follow as well as the physical activity you do during the day. The traditional plan suggests that about 60% of the total daily kilocalories should be included as carbohydrates. The amount of carbohydrates you require is related to the nutritional and glycemic goals you want to achieve while maintaining balance. This calculation is very personalized and considers different data, including your weight and height.

For some, this percentage is high, and they prefer low carb diets or meal plans. These types of low-carbohydrate diet plans are generating debate, but evidence shows that it is a useful method for some.


Tip #: Choose Quality Carbs

When it comes to the keto diet, both quality of food and quantity of food matter and both should be considered.

If you only count carb values but don’t care where those carbs are coming from, you are considered to follow a dirty keto diet.

If however, you count carb values AND you ensure your carbs are from whole food nutrient-dense sources, you are considered to follow a clean keto diet.

Instead of getting your carb intake for the day through refined foods such as white flour, white bread, white rice, pastries, sodas, snacks, pasta, sweets, and breakfast cereals, opt for whole foods that are nutrient-dense and will keep you satiated for longer.

These types of foods include leafy green vegetables, berries, and other nutritious foods that offer a high percentage of fiber.


The reason for choosing high-quality carbs is the wide range of nutrients that you will benefit from getting by consuming them. These include essential amino acids, essential fatty acids, vitamins, minerals, micronutrients, and health-promoting plant chemicals called phytonutrients which our bodies cannot make. These help to maintain a healthy immune system.

Quality carbs are also usually high in fiber which aids to slow the digestion of sugars and starches, preventing spikes in blood sugar and insulin closely associated with diabetes, heart disease, and weight gain!

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Why Should I Count Carbs

Carb counting is a flexible way to eat the foods you enjoy while maintaining a low-carb diet. It also helps you learn how certain foods affect your blood sugar so you can match the foods you eat to your insulin dose.

The three types of carbohydrates found in food are:


  • Sugars
  • Starches
  • Fiber

Sugar is a type of simple carbohydrate, meaning the body breaks it down quickly. This can cause blood glucose levels to rise and fall at very fast rates. Sugar is naturally found in fruits and milk. It’s also frequently added to packaged foods like candy and sodas.

Starches are found naturally in many foods that we eat. This includes bread, pasta, rice, and certain vegetables, like potatoes and corn.

Aim for consuming whole, minimally processed starches. Whole grains provide fiber and other vitamins and minerals essential for good health. Try to get at least half of your daily starch intake from whole grains such as brown rice, oats, and quinoa.

Fiber is a plant-based nutrient that the body can’t digest. It helps you feel full and slows digestion. Foods high in fiber can reduce your risk of heart disease and help to manage blood sugar. Good sources of fiber include whole grains, nuts, seeds, and beans.

How Many Carbs Should I Eat

How To Count Carbohydrates For Diabetes

As for the ideal number of carbs per meal, there’s no magic number. How much carbohydrate each person needs is in large part determined by your body size and activity level. Appetite and hunger also play a role.


In order to figure out how many carbs you should be eating, schedule an appointment with your RD/RDN or CDCES. Theyll work out an eating plan specifically for you. This service, when provided by a dietitian, is known as medical nutrition therapy.

Diabetes self-management education sessions also may include creating an eating plan. During the sessions, you’ll determine your carb needs and how to divide your carbs among your meals and snacks. Everybody’s insulin response is going to be different, and we don’t want to make the diet more restrictive than it needs to be to manage blood sugars.

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How Many Carbohydrates Should You Eat

Everyone may have variations in their daily carbohydrate goals as each individual has a unique metabolism, activity level, body composition and lifestyle.

Because everyone is different, its important to work with your doctor or diabetes educator to confirm the right amount of carbohydrates you should be eating.


In general, healthy adults should consume about 135g of carbs daily and diabetics should almost never exceed 200g of carbohydrates daily .

Get an idea of how many carbs you need with our free carb calculator.

Tip #: Set Your Daily Carb Limit

Setting your daily carb limit depends on what you want to achieve as well as the type of diet you are following.

If you are unsure of how many carbs you should be eating per day, consider the following categories of carb levels. Generally, a low-carb diet is considered to be:

  • < 100g/day = moderate low-carb
  • < 50g/day = low-carb
  • < 20g/day = keto

Many readers like to begin by simply reducing their carbs to a level that is sustainable and weight loss still occurs. Choose simple low-carb meals for beginners and begin to make easy low-carb side dishes.

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What Is An Insulin

Your insulin-to-carb ratio indicates how many grams of carbs one unit of rapid-acting insulin covers to ensure that your blood sugars stay in your desired range.

Your carb ratio is often initially set by your doctor when you are diagnosed but should be updated regularly . A carb ratio of 1:10 means that that 1 unit of rapid-acting insulin will cover 10 grams of carbs. A higher ratio indicates that you need less insulin to cover your carbs.

Let me give you an example:

If my carb ratio is 1:10 and Im eating 30 grams of carbs, Ill need 3 units of rapid-acting insulin to cover the meal , however, if my carb ratio is 1:15 Ill only need 2 units of rapid-acting insulin

That a higher carb ratio means less insulin can take a little time to wrap your head around but its an important fact when you start adjusting your carb ratio.


If you time the peak of your insulin with your meal, an accurate carb count combined with an accurate carb ratio will mean that your blood sugar should stay within your desired range and below 180 mg/dl .

If the timing of your insulin for the meal is off, but your carb count and carb ratio is right, you might see your blood sugar go slightly out of range but it should be back in range within 90 minutes

How Many Carbs Should A Person With Diabetes Have In A Day

Why understanding carbs (and how to count them) matters | Carb counting with Jess | Diabetes UK

Studies have shown that many different levels of carb intake may help manage blood sugar, and the optimal amount of carbs varies by individual.

The American Diabetes Association used to recommend that people with diabetes get around 45% of their calories from carbs.

However, the ADA now promotes an individualized approach in which your ideal carb intake should take into account your dietary preferences and metabolic goals .


Its important to eat the number of carbs at which you feel best and that you can realistically maintain in the long term.

The typical American diet provides around 2,200 calories per day, with 50% of them coming from carbs. This is equivalent to 275 grams of carbs per day .

A severely restricted intake of less than 50 grams of carbs per day appears to produce the most dramatic results and may reduce or even eliminate the need for insulin or diabetes medication. This represents 910% of daily calories on a 2,0002,200-calorie diet .

When tracking carb intake, experts sometimes recommend focusing on your net carbs instead of the total amount of carbs you eat. Net carbs is total grams of carbs minus grams of fiber .

People with diabetes can also benefit from diets that allow up to 26% of their daily calories to come from carbs. For people who eat 2,0002,200 calories a day, this is equivalent to 130143 grams of carbs .


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Carb Counting And Diabetes

Carbohydrates, or carbs, are naturally found in certain foods. For example, grains, sweets, starches, legumes and dairy all contain different amounts of carbs. Get up to speed on the three types of carbs, and what foods have them.

When foods and drinks with carbs are digested, the carbs break down into glucose to fuel our cells, and the body’s blood glucose, or blood sugar, level rises. In people without diabetes, blood sugar levels rise after eating but the body’s insulin response keeps levels from rising too high.

If you have diabetes, the process doesn’t work as designed. How carb counting can help your blood glucose control depends on your treatment regimen and whether or not your body makes insulin.

  • Type 1: If you have type 1 diabetes, your pancreas no longer makes insulin, so you need to take background insulin as well as offset the carbs in your food with mealtime insulin doses. To do this, you have to know exactly how many carbohydrate grams are in your mealcue carb counting!
  • Type 2: Because people with type 2 diabetes are resistant to insulin and may not produce enough of it, its important that you be mindful of your carb intake. To avoid blood sugar spikes, it helps to eat a consistent amount of carbs at meals throughout the day, rather than all at once. People taking oral medications may use a more basic form of carb counting than those on insulin.

Say Hello To The Carb Counting Bible

Carbs & Cals is nationally recognised as the leading carb counting resource for people with type 1 diabetes. It has been the number 1 bestselling carb counting book on Amazon for 6 years running, and our products have received more than 2,000 five-star reviews.


The Carbs & Cals method is both revolutionary and incredibly simple. We show thousands of food photos with the carb values clearly shown for each image. This visual approach makes it highly effective for learning how to count carbs and manage your type 1 diabetes. Lets get your carb counting skills sorted!

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Tip #: Recognise Where Carbs Hide

Carbohydrates are easily hidden in sauces, dressings, and other condiments, especially those that have been sweetened. Its one of the reasons that I strongly advocate for making your own homemade low-carb sauces.

Sweetened yogurts and milk are also high in carbohydrates so reading the nutritional label on these items is a must!


And if you think the only sugar you need to look for is … sugar, think again There are over 50 names of sugar and the sneaky food manufacturers will use a variety of sugars so they fall lower in the list of ingredients to confuse you.

So honey, agave, fruit crystals, fruit syrup, apple concentrate, organic coconut nectar, HFCS, corn syrup solids, beet sugar … they’re all sugar.

It’s called “confusion marketing”.

Sugar is sugar no matter what you call it.

Libby Jenkinson, MPS

Very Low Carb Ketogenic Diets

Diabetes Handout Tearpad How to Carbohydrate Count

Very low carb diets typically induce mild to moderate ketosis, a state in which your body uses ketones and fat, rather than sugar, as its main energy sources.

Ketosis usually occurs at a daily intake of fewer than 50 grams of total carbs .


Very low carb ketogenic diets were prescribed for people with diabetes even before insulin was discovered in 1921 .

Several studies indicate that restricting carb intake to 2050 grams per day can significantly reduce blood sugar levels, promote weight loss, and improve cardiovascular health for people with diabetes .

In addition, these improvements often occur very quickly.

For instance, in a small 3-month study, people consumed either a low carb diet containing up to 50 grams of carbs per day or a calorie-restricted low fat diet.

The low carb group averaged a 0.6% decrease in hemoglobin A1c and lost more than twice as much weight as the low fat group. Whats more, 44% of them discontinued at least one diabetes medication compared with 11% of the low fat group .

In fact, in several studies, participants have reduced or discontinued use of insulin and other diabetes medications due to improvements in blood sugar control .

Diets containing 2050 grams of carbs per day have also been shown to lower blood sugar levels and reduce the risk of disease in people with prediabetes .

Another study found that the diet might actually improve kidney function in people with type 2 diabetes and normal renal function or mild kidney disease .

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Total Vs Net Carbs For Diabetes

Most people with diabetes must rely on counting carbohydrates when they eat food to help manage their blood sugar levels.

But that can become trickier when food labels sometimes differentiate between total carbohydrates and net carbohydrates.

What is the difference between these two types of carbohydrates and which one should you use for your diabetes management?

This article will explain what total carbohydrates are, what net carbohydrates are, and how to determine when to use each number.

All Carbs Are Not The Same

Keep in mind that the type of carbs you eat can have different effects on your blood sugar. You should also know that your body uses two types of carbs for energy: simple and complex. They affect your body a little differently.

Simple carbs are sugars. Your body digests these very quickly, so they raise your blood sugar quickly too. These include sugars that are added to processed foods such as:

  • Table sugar
  • Fruit juice concentrate

Fruit and milk contain simple carbohydrates naturally.

Complex carbs are starches. They take longer for your body to digest than simple carbs. So they take a little longer than simple carbs to affect your blood sugar. Youâll find them in:

  • Bread
  • Corn
  • Whole fruit

Fiber is also a carbohydrate, but your body doesnât digest it, so it doesnât affect your blood glucose.

When you read a nutrition label, it will tell you the amount of total carbohydrates in a serving. Ask your doctor, diabetes educator, or dietitian whether itâs OK to subtract any of the fiber grams from the amount of total carbs. Some methods of carb-counting say itâs OK, while others say to go by total carbs.

Show Sources

University of Illinois at Urbana-Champaign McKinley Health Center: âMacronutrients: the Importance of Carbohydrate, Protein, and Fat.â

CDC: âCarbohydrates.â

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How Do You Calculate Net Carbohydrates

To calculate net carbohydrates, one would take the total number of carbohydrates and subtract both the total number of grams of fiber and the number of grams of sugar alcohol.

However, since sugar alcohols can affect blood sugar minimally, and everyone digests sugar alcohol differently, some people may prefer to subtract only half the number of sugar alcohols for net carbohydrates.

Net Carb = Total Carbs Fiber Sugar Alcohols

The resulting number is the net number of carbohydrates in a serving of food, and for optimal blood sugar management, one would count that as the number to base insulin and/or oral diabetes medication on.

Mindy Nichols, RD, CDE says, Net carbs are only estimations, as everyones digestive systems and bodily processes are different. Working with your doctor, experiment and see what works best for you!

Its important to note that if you live in some countries outside of the United States, the total carbohydrate number already has the total grams of fiber subtracted out, so there is no need to do the equation.

Carbs Are Simple Yet Complicated

How to Count Carbs for Diabetes

Historically, meat was viewed as having so few carbs that it wasnt even included in carb counts, but thats changing, especially for PWDs who are dedicated to eating low-carb.

Gary Scheiner, renowned Certified Diabetes Educator and author in Pennsylvania, explains that for people with diabetes on ketogenic diets, or eating very low-carb meals, he now teaches them to count half the protein grams as carbs.

In addition to counting protein, the latest dietary advice from the ADA, their Consensus Report on Nutrition Therapy for Adults with Diabetes and Pre-diabetes, also recommends considering the impact of fat, although no specific guidance is provided in to how to go about doing that.

Does this elevate carb counting to an unmanageable level of complexity? Certified Diabetes Educator and nutrition author Hope Warshaw acknowledges that counting carbs and now assessing protein and fat can be arduous and time consuming. So much so that she advises people with diabetes who take mealtime insulin to simply log their glucose levels after eating, and take notes of the reaction when and for how long following different combinations of food. Then with notes and experience, PWDs can act on those observations. So if for example you note that your favorite burrito dish typically makes your blood glucose level rise 60 points after an hour and a half, you can take that into account for either insulin dosing or post-meal exercise.

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