Diabetic Meal Planning
Understanding diabetic exchanges
and carbohydrate counting
People with diabetes can choose from several meal-planning approaches. Regardless of the plan used, one principal remains a common factor—all meal plans are designed to encourage you to eat similar amounts of carbohydrate at similar times each day.
Exchange Lists and the Exchange System
The exchange system categorizes foods into three main groups: carbohydrates, proteins and fats. An exchange system meal plan doesn't dictate what foods you eat. Instead, you choose from "exchange lists" of foods with similar nutritional make-up. For example, foods from the carbohydrate/starch group—such as a slice of bread, a small baked potato or 3/4 cup of unsweetened dry cereal—all have about the same amount of carbohydrate, protein and fat. Therefore, they are all exchangeable with each other.
An advantage of the exchange system is that it's still the common language used for communication about food and diabetes. Cookbooks, magazine food articles and even some food labels use it.
Carbohydrate counting is keeping track of the number of carbohydrate grams you eat each day, not the individual foods. An individualized meal plan is designed so you eat a specific number of carbohydrate grams at each meal and snack. You then choose foods that total the specified number of carbohydrates.
Carbohydrate counting is based on the fact that within one to two hours of eating, 90% to 100% of digestible starches and sugars turn up in your blood as glucose. So the amount of carbohydrate you eat may also determine the amount of medication you need to cover the rise in blood glucose from meals and snacks.
How do you know how many grams of carbohydrate are in foods? The Nutrition Facts panel on the packaged foods lists the grams of carbohydrate in a serving.
An advantage of carbohydrate counting is you only keep track of carbs, instead of all components of your diet.