How do I apply diabetic exchanges?

Ask Peggy

Peggy Woodward, RD

DEAR PEGGY: My son has type 2 diabetes, and I can't seem to find information about diabetic exchanges that I see on recipes. How do I use them? How can I find a daily list of how many exchanges are needed each day? I want to cook for him when he comes to visit, but I don't know how to apply the exchanges or how many he can have in a day. Thanks for your help —B.M., Bellflower, California

You've asked a really great question. I'll be the first to say that diabetic exchanges can be confusing. Newly diagnosed diabetics are usually referred to a registered dietitian who creates a meal plan that may incorporate the use of diabetic exchanges, carbohydrate counting or simple visual cues about portion sizes to help diabetics track what they are eating and stick to their plan. Each plan is personalized to the individual's specific calorie needs, which means there isn't a general list of exchanges for each day that I can give you.

The idea of exchanges means that foods in a particular group, like the starch group, are nutritionally comparable per serving. So they have about the same amount of carbohydrates, protein, fat and calories as other foods in that group. Any of those foods can be "exchanged" for another in the same group. For example, 1 slice of bread could be "exchanged" for 1/3 cup cooked rice.

If your son has visited a dietitian and uses diabetic exchanges, I would ask him how many exchanges he is allowed for the particular meal you are serving. You can use the recipes in Healthy Cooking with exchanges to find recipes that match the number he's allotted. Share your recipe ideas and the corresponding diabetic exchanges with him before he visits to make sure those foods will fit into his plan comfortably.