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Diabetes Forecast

The Healthy Living Magazine

45 Top Carb-Counting Tips

Tried-and-true tactics for fine-tuning your techniques and attitudes

By Tracey Neithercott , , , ,
45 Top Carb-Counting Tips

Sandra Kemppainen/Thinkstock

Carb counting sounds simple. After all, anyone who’s passed third grade knows the basics of adding numbers. Unfortunately, counting carbohydrate grams isn’t as easy as one, two, three. That’s why Diabetes Forecast went to the experts for help. Who better to give tips on carb counting than the people who do it day in and day out? Read on for 45 tried-and-true carb-counting how-tos.

1. Don’t go at it alone.

“It’s really important to work with your doctor,” says Tammy Walker, 36, who was diagnosed with type 1 diabetes four years ago. “If you’re newly diagnosed and your doctor doesn’t have the experience, have your doctor refer you to a dietitian to teach you how to eat.”

2. Starting is the hardest part.

“It’s getting past that initial ‘I can’t do it,’ ” says Daniele Hargenrader, 31, who’s had type 1 diabetes since she was 8. “The first days and weeks are the hardest. Anyone can change.”

3. Know what you’re counting.

Count total carbohydrate grams, not just the sugar grams listed on the food label, says David Frank, 41, who was diagnosed with type 2 diabetes a year ago. A cereal may only have 1 gram of sugar, for instance, but 21 grams of carbohydrate. “You have to look at the carbohydrates because carbohydrates break down into sugar.”

4. Your meter is your best friend.

“The only way you can really know what your blood sugar is doing is if you have a readout. You can’t guess what your blood sugar is,” says Hargenrader. “And you can’t guess how many carbs you need if you don’t check your blood sugar.” Checking before a meal and about two hours after the first bite shows you how what you eat affects your blood glucose. Intensive insulin users may do this frequently; for others, it can be helpful to do so when starting new medication or making other treatment changes.

5. Kids are capable of carb counting.

“They start to remember things,” says Gabrielle Brits, whose 11-year-old son, Austin Cottarel, was diagnosed with type 1 in 2005. “He’s a big fan of Goldfish, and he memorized [that] he could have 55 Goldfish for one snack.”

6. Try an app.

“If I were trying to count carbs on something that wasn’t an electronic application, it would drive me insane,” says Hargenrader, who relies on her Calorie Counter & Diet Tracker app by MyFitnessPal for carb counting and reviewing data in chart form. “It is probably the most valuable free thing that any person with diabetes can possess.” Another favorite carb-counting app: CalorieKing Food Search.

7. Mind your portions.

“The main thing is portion control,” says Christi McWhiney, 49, who’s had type 1 diabetes since she was 7. Inflated portions mean more carbs for which to account.

8. Buy snack packs.

Before diabetes, “I would have just sat down with the bag [of potato chips] and eaten them,” says Jim LaRose, 44, who was diagnosed with type 1 diabetes two years ago. “Now I buy in single servings. It makes it so I don’t have to think so hard about portion control.”

9. Eat off a smaller plate.

“If you eat on a big plate, you put more food on it,” says Walker. To make sure she doesn’t load up on carb-heavy foods, she downsized her dinnerware. “If you get a small plate, you’re going to eat smaller portion sizes.”

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10. Invest in a food scale programmed with nutrition facts.

“The average apple we buy is two or three carb servings,” says LaRose. But that apple may be larger or smaller than average. Weighing food on occasion removes the need to guesstimate.

11. Make use of measuring cups.

“We try to measure things out, especially things like rice,” says Brits. “I’ll just grab my [measuring cups] and put the rice in there, then put it on the plate.”

12. Refresh your memory.

“Every once in a while, check yourself. Pull out the scale. Pull out the measuring cups. Once in a while I’ll estimate a cup of soup; then I’ll pull out the measuring cups and see how I did,” says LaRose. “If I go too long eyeballing stuff, those amounts start to creep up. What I estimate to be a cup or 1/2 cup isn’t anymore.”

13. Read the nutrition information.

“Look at labels to check out the carbs, the calories, and the fiber content,” says Walker. Other nutrition facts you might want to consider: total and saturated fat grams and sodium.

14. (Advanced Carb Counting) Focus on fiber.

Hargenrader considers her food’s fiber content when counting carbs. That’s because some kinds of fiber aren’t broken down in the body and therefore don’t affect blood glucose levels. The general rule: If “insoluble fiber” is listed in the Nutrition Facts panel, subtract all grams of insoluble fiber from the total carbohydrate amount. That said, most people don’t need to subtract fiber from total carbohydrate, so discuss your options with your health care provider.

15. Pay attention to serving size.

“I find it especially important to look at serving size. Sometimes you’ll look at something and, in our supersized world, you think this [package contains] one serving,” says LaRose. “But you look at the serving size and it’s 2 1/2.”

16. Accuracy matters.

“If you’re eating five things and each one is 5 or 10 [grams of] carbs off, now that is going to make a difference in your blood glucose,” LaRose says.

17. Count on variation.

“There’s a great ramen place around the corner from my work, and I can tell you, depending on the cook, how many grams of carbs [the meal] will be,” says Ray Rokicki, 35, who was diagnosed with type 1 diabetes in 1991. He discovered, after some time, that one chef’s heaping portion was behind his mysteriously high blood glucose.

18. Avoid buying tempting foods.

“I try to keep out [of my home] foods that are triggers for me, that I know I’ll just eat and eat and eat—like potato chips,” says LaRose

19. Choose nutritious snacks.

“You could eat almost a whole bag of sugar snap peas and have almost no carbs [1 cup of raw sugar snap peas has only 5 grams of carbohydrate]. They give you that crunch when you’re craving potato chips,” says Frank. “If you catch me with a real desire to have chocolate, you’ll catch me with cocoa-dusted almonds. They can have as low as 8 grams of carbs for 25 almonds.”

20. Know how much liquid fits in your cup.

“I always drink milk out of the same glass on a daily basis,” LaRose says. “I don’t have to pull out the measuring cup because I know what a cup looks like in that glass.”

21. List carb counts for school nurses.

“When [our son] was really little, we’d pack his lunch, and for everything we’d write the [grams of] carbs down on an index card for the nurses,” says Brits.

22. Keep a food journal.

“The food diary really makes you be honest with yourself because you can’t deny what you’ve written down,” says Rokicki. Not sure why your blood glucose spiked in the afternoon? Your food journal may reveal your lunch packed more carbs than you remember.

23. Some things are out of your control.

“You can eat the same meal at two different times, and your blood sugar might be different each time,” says Rokicki.

24. (Advanced Carb Counting) Deliver an extended bolus.

Insulin pump users can dose mealtime insulin to “match” higher-carb, higher-fat meals such as pizza. “When dosing with the pump, you can do a square wave [bolus], where you can tell the pump to give you insulin over a period of time. It helps me keep my blood glucose really level,” LaRose says.

25. Enjoy nonstarchy vegetables.

“I try to keep salads in the fridge,” says Walker. “I buy the bagged salads. I don’t have time to cut up salads.” Nonstarchy veggies are low in carbohydrate and packed with vitamins.

26. Talk with school administrators.

“The school has hot lunches and they have nutrition information they get from the food company, and it has most of the carbs,” Brits says. “We had to go to the person at the school district level [who] works with the company and request the information.”

27. Plan ahead.

“When we go out to eat, we kind of have an idea of what [my son is] going to order,” says Brits. “Then we’re getting on the CalorieKing app [to determine carb amounts].”

28. Rethink restaurant portions.

Hargenrader tends to halve the portions of starchy foods and grains when she dines out. “Eat all of your [nonstarchy] vegetables. Then if you have a portion of rice, put half on a side plate or ask them to take it away,” she says.

29. Ask for nutrition facts.

“If you’re at a restaurant, you can ask them for the nutrition facts,” Brits says. “Most places will have the nutrition information available.” Many chain restaurants post nutrition information on the company website, too.

30. Make friends with your waiter.

“My biggest tip, and I’ve worked in all parts of the food-service industry—cook, server, bartender—is: Do not be afraid to ask for modifications,” says Hargenrader. “If you don’t ask for it, it’s not going to happen.”

31. Skip the sauce.

Added sugar and starch can lurk in sauces. “Sauces can be so difficult as far as how many carbs they have,” LaRose says. “A red sauce? Maybe they add sugar to it at this restaurant and not another.”

32. Test your soda.

“The question is, ‘Is this really diet?’ ” Rokicki puts a drop of soda on a urine glucose test strip to determine if his drink has sugar. “It’s saved me maybe two or three times. When you start to look at the [beverage] serving size in a restaurant, I can’t imagine what my blood sugar would have been from that.”

33. Trust your gut.

“My favorite tool is common sense,” Hargenrader says of dining out. “If you see something on the menu and you think, ‘Hmmm, I wonder if it’s healthy,’ it’s probably not.”

34. (Advanced Carb Counting) To fine-tune mealtime insulin, check after you eat.

“Finishing a meal isn’t when dealing with a meal ends,” says Rokicki about people using intensive insulin therapy. Checking before you eat and two hours after the first bite of food can tell you how well you “matched” your insulin dose to the meal, so you can adjust in the future as needed.

35. Eat homemade.

“We try not to give Austin a lot of [school-made] hot lunches,” says Brits. “There’s a lot of additives and sugar. We can more successfully manage what he’s eating by packing his lunch.”

36. Plan for road trips.

“My doctor says to take a cooler with you. Pack it with fruits, healthy snacks, maybe a turkey [sandwich],” says Walker, who, as a caseworker, spends her workday on the road. Counting the carbs ahead of time (and even writing the number on your bag) can make insulin dosing quicker.

37. Give your child a smartphone.

“[My son] has a smartphone, so he has the CalorieKing app on it and can look up carb counts,” Brits says. “If he goes to the movies, they may not have the nutrition information right there. He can look it up.”

38. Don’t let “low calorie” fool you.

“A lot of the chain restaurants have a ‘lighter fare’ or lower-calorie menu,” says LaRose. “One of the things to remember: Lower calorie doesn’t always mean lower carb.”

39. Go easy on yourself.

“Don’t punish yourself if your sugars aren’t perfect,” says Rokicki. “There are so many variables. Is the scale calibrated correctly? Did you use a level ¼ cup or a heaping 1/4 cup?”

40. Your carb needs may change.

Additional exercise or the desire to lose weight may require a change in your eating plan. “Your diabetes changes over time, so you have to continually change your diet,” says Walker.

41. Prepare to make some sacrifices.

“I can order a hamburger, but I don’t order the fries,” Frank says. “A huge portion of my carbs will be from the bun.” Or, eat some fries and no bun. Or a little bit of both carb-rich foods.

42. But don’t deprive yourself.

“Deprivation is one of the worst things you can do,” says Hargenrader. Being overly restrictive can make sticking to an eating plan harder—and high-carb foods appear all the more temping. “You can eat anything you want but halve [the portion size].”

43. Ask for help.

“You will not be a pro overnight. It is a work in progress,” says Walker. “It takes a lot of training and support from other people. You can’t do it yourself.”

44. Learn from your mistakes.

“Don’t waste time beating yourself up over mistakes,” Hargenrader says. “The more time you spend tearing yourself down, the less time you spend learning from it.”

45. You’ll get the hang of it.

“If you do it long enough, it becomes habit,” says Walker. “It’s like breathing. It becomes second nature.”

 
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