Carbohydrate Counting with Diabetes: Practical Pointers for Precision When Eating at Home

Posted by hope on Mon, 06/09/2014 - 15:13 in

It’s easy for your healthcare providers to say, “Count your carbs precisely for accurate bolus dosing.” It’s quite another to do it day in, day out across myriad foods and different combinations of foods you eat. Got that right!

One meal might be a straight-forward lunch: turkey sandwich with sliced tomatoes, side of sliced cucumbers, half of a large apple and glass of fat-free milk. No sweat! The next meal? A couple of new recipes for dinner: bean and corn enchilada casserole served with a side of red cabbage and carrot slaw. Well, not so easy!

Studies show carb counting accuracy is a challenge even among the most seasoned carb counters.1,2 Yet as you know, precise carb counts are critically important to determine accurate bolus insulin doses and glucose control, especially after eating.3

Check out these practical pointers to precisely count carbohydrates when you eat at home:

  • You've got a few advantages on your side. If you buy and prepare the foods you eat, you’ve got a front row seat - whether it’s a simple piece of fruit, glass of milk or a mixed up casserole you prepare. If you use a food with a Nutrition Facts label, the total carbohydrate count per serving is right in front of your eyes. Take advantage of these advantages.
  • Start thinking about the carbohydrate counts of foods at the point of purchase. Buy similar sizes of fresh produce, like fruits, vegetables and starches. Similar sizes can result in similar carb counts.
  • Be a creature of habit. OK, boring, if you will. But buying similar foods and preparing similar meals allows you to nail down the carb counts for the majority of the foods and meals you eat. Greater accuracy equals greater blood glucose control.
  • For unpackaged foods without a Nutrition Facts label, like breads at a farmer’s market or bagels at a deli, seek out the carb count from the Nutrition Facts from similar items. Make your best guess.
  • For mixed dishes that contain a source of starch (grains, pasta or beans/legumes), like the bean and corn enchilada mentioned above, you’ll likely be in the zone if you use 30 grams of carbohydrate per one cup serving.
  • Keep measuring equipment out and visible. Measure out portions of the common foods and calorie-containing beverages you eat and drink once in a while. This keeps your portions and your carb estimates more precise. Ah yes, our eyes (and thus portions) grow with time.
  • Challenge yourself on occasion to a measuring accuracy duel. Serve yourself a usual portion, say of oatmeal, rice, corn or squash. Then measure it with your measuring equipment. Too little, too much or just right? The better you train your eyes to estimate portions, the more accurate your carbohydrate counts will be when you eat at home or eat restaurant foods.
  • Calculate accurate carb counts for recipes and dishes you commonly prepare. Keep notes about serving sizes and carb counts on the recipe. Too much bother? Today there are plenty of recipes from diabetes and health-related cookbooks, websites and other online resources that typically provide the carb count.
  • Do you need to subtract fiber grams from your total carbohydrate count? Maybe. Expert consensus suggests that only people who count their carbohydrate intake to determine their doses of rapid-acting insulin need to factor in fiber. And that’s only when the fiber grams from a food or meal are individually or cumulatively five grams of fiber or more.4 If this is the case, subtract half the grams of fiber from the total carbohydrate count for the food or meal to account for the indigestible fiber.5

Stay tuned for my next Podder Talk post with tips to help increase your carb counting accuracy when you eat at restaurants.

The Omnipod insulin pump lets you create and name up to 36 carb or bolus presets in your PDM, so you can keep your carb count totals right at your fingertips. Click here to learn more about the Omnipod and try a free demo for yourself.

NOTE:  Information posted on Suite D is not intended to be taken as medical advice. Always consult with your healthcare provider for questions and guidance on managing any health-related issues.

  1. Brazeau AS, Mircescu H, Desjardins K, Leroux C, Strychar I, Ekoé JM, Rabasa-Lhoret R. Carbohydrate counting accuracy and blood glucose variability in adults with type 1 diabetes. Diabetes Res Clin Pract. 2013;99(1):19-23.
  2. Bishop FK, Maahs DM, Spiegel G, Owen D, Klingensmith GJ, Bortsov A, Thomas J, Mayer-Davis EJ. The carbohydrate counting in adolescents with type 1 diabetes (CCAT) study. Diabetes Spectrum.  2009;22(1):56–62.
  3. Evert A et al. Nutrition Therapy Recommendations for Management of Adults with Diabetes. Diabetes Care. 2013;36(11):3821-42.
  4. Wheeler M, et al. Choose Your Foods: Exchange Lists for Diabetes, Sixth Edition, 2008: Description and Guidelines for Use. J Acad Nutr Diet. 2008;(5):883-888.
  5. Warshaw HS, Bolderman KM. Practical carbohydrate counting: A how-to-teach guide for health professionals, 2nd ed. American Diabetes Association. 2008.