Carbohydrate counting, or carb counting, is a meal planning system in which you eat a specific number of carbohydrate grams at each meal or snack. While it is an effective plan for anyone with an eye on their diet, it is especially helpful for people with diabetes.

Carb counting is easy to learn. Most people feel it gives them flexibility in food choices, making social situations and eating out easier. The most compelling reason to use carb counting is simply because it can improve blood glucose control. Before you start, consult your dietitian or health care provider. There is no meal planning approach that’s right for everyone — each person needs an individualized plan.

Carbs, Carbs Everywhere
Carbohydrates are the basis of all the food groups, so you’ll find them in nearly every food. With carb counting, the source of the carb isn’t as important as how much of it you eat. That’s good news for people with diabetes because carbs are in starches, fruits, dairy products, vegetables and, dare we say it, sugary sweets. This plan lets you eat a wide variety of foods, as long as you stay within your per-meal allowances of carbs.

How Carb Counting Works
1. Make a Plan
Work with a registered dietitian (RD), preferably one who is also a certified diabetes educator, to determine the number of carbohydrate grams you should have at each meal or snack, and whether to count “grams” or “choices.” Grams are counted simply by adding the total carb content in each food serving. Choices, like the familiar exchanges, are selections from food groups. One choice equals 15 grams of carbs. Choices are less precise than grams, but easier to use and accurate enough for people who don’t take insulin.

Each person’s plan differs. This is just one example:

2. Learn the Carb Counts of Foods.
You’ll need your blood glucose meter, a food scale, measuring cups and spoons, carbohydrate content guidebooks, and the Nutrition Facts on food labels. You’ll use these essential tools at every meal while learning the system, and then only at a few meals each week once you’re comfortable with measuring.

If you are counting “choices” and are familiar with the exchange system, you can easily memorize these converted measurements.

3. Start Counting
You can choose your favorite foods within your plan. You can learn to eat more or less of certain foods based on how they affect your blood glucose. Test about two hours after eating. Record your meal selections and glucose levels, and look for patterns of highs and lows that could be associated with specific foods. Review the records with your health care professional. You can improve your blood glucose control using carbohydrate counting. Talk to your health care professional to get started.

What About Everything Else?
In a typically healthy diet, 50-60 percent of your day’s total calories come from carbs. The rest come from protein and fat, which don’t contain any carbs and, therefore, aren’t added to the total carb gram count. Even so, you still have to watch fat, calorie, and cholesterol intake, and eat a balanced diet of foods from the groups in the Food Guide Pyramid. Even within the carb groups, make sensible choices: ice cream is a carb choice, but a sundae at every meal certainly is not healthy eating.

You also have to be careful about how much you eat. Most people need about three to four carb choices at each meal. If you are very large, very small or very active, this amount may not be right for you. Most people also do best with no more than one to two carb choices for any planned snacks they eat. Portion control is probably the most difficult aspect of a carb counting plan and a key factor in any healthy diet. Too much of even the healthiest food can be bad for you, and can lead to hyperglycemia (high blood sugar).

It Always Comes Back to Monitoring
Blood glucose monitoring helps you know whether the carbs you ate are in balance with your body’s insulin. You can make very healthy food choices and still have poor blood glucose control if your carbohydrate choices, diabetes pills, or insulin do not balance. Monitoring can help tell you how a certain food affects your body.