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Take Stock in Exchanges
Though all the numbers might seem confusing at first, understanding diabetic exchanges and carbohydrate counting can be key to achieving and staying in balance.
Depending on where and when you were diagnosed, your health-care professionals may have recommended either a diabetes exchange system or carbohydrate counting—two methods of keeping your diabetes under control. Here's a look at both of them.
Diabetes Exchange
One way to plan meals and keep diabetes under control is to use diabetes exchange lists. This system divides food into six categories: starch/bread, fruit, milk, vegetable, meat, and fat. With the goal of balancing insulin levels with carbohydrate intake, you swap, or "exchange," any food on the exchange list for another food on the list within the same category of food. One exchange approximately equals another in calories, carbohydrate, fat, and protein, with portion sizes adjusted accordingly. For example, two slices of bread may equal one bagel or 1 1/2 cups of Cheerios. To get started on the exchange system, you'll need to work with a dietitian, who can help you devise a meal plan that best meets your needs.
Carbohydrate Counting
Today, most people who are newly diagnosed with diabetes will learn about carbohydrate ("carb") counting, a newer approach to helping control the disease by balancing food intake and insulin levels. "Carb counting can help with glucose control because it focuses on carbohydrate, the nutrient with the greatest impact on blood glucose," says Jan Hangen, RD, a dietitian with Children's Hospital in Boston. Carb counting works like this: Learn the amount of carbohydrate in different foods—by reading nutrition labels and guidebooks. Then figure out how much insulin you'll need to cover a given amount of carbohydrate. Your dietitian or physician can help you determine the right amount.
One advantage of carb counting is that it helps pinpoint just how much carbohydrate can be eaten at each meal and snack. Also, insulin may be adjusted according to what you want to eat. For example, if you want to eat a larger meal, carb counting can help you figure out how much more insulin to take. People with diabetes or anyone who wants to be more mindful of what they eat can use this system to keep track of total carbs in the daily diet. Just remember that all carbs need to be counted when managing diabetes. And remember that nutrient-dense carbs—such as those from whole grains, legumes, fruits, and veggies—make good carb choices, Hangen says.
