Carb Counting 101

In the early days of diagnosis you might hear the term "carb counting" mentioned and have little idea of how to apply this in your journey. I recall when Harrison was diagnosed we desperately wanted to understand the principle with little guidance from our then Dr and Dietitian. Months later - possibly even a year later - we had a much better understanding of carb counting and were consequently better able to keep our little toddler Harrison in range. Now years later we are almost able to evaluate just by looking at the plate. It's often still a guessing game but to have this understanding is definitely beneficial in your type one journey. Megan has prepared an awesome blog post diving a little deeper into Carb Counting which will hopefully give you great insight that you can add to your T1D Care Toolbelt.

What is Carbohydrate counting?
It is working out the amount of carbohydrates in the food and drink you are having and taking the right amount of quick/rapid acting insulin to match the carbohydrates so that your blood glucose levels remain constant.
 
Why Carbohydrate Count?
So that the glucose that appears in your blood after consuming carbohydrates can be controlled by the insulin you take. The amount of carbohydrate in a food influences how much your blood glucose goes up. Each 10g carbohydrate produces about 2-3mmol of glucose in the blood. Foods contain different amounts of carbohydrate, if you know exactly how much you are eating, you will be able to work out your insulin doses more accurately.
 
How does the insulin I take work?

• Long acting insulin- this keeps you going for a long period of time. This is not affected by the food and drink you take in but rather by how your body works
  
• Quick acting insulin- This is the insulin we use to Carbohydrate count. It works rapidly on the food and drink we take in and it is used to correct high blood sugars. This insulin is usually taken before meals.

 
New terms to learn:

• Insulin to Carbohydrate ratio: this is the amount of insulin you need to take to cover the amount of carbohydrates eaten
  
• Carbohydrate grams- this is the amount of carbohydrates you will calculate that you are eating
  
• Insulin sensitivity ratio or correction ratio: This is the amount of insulin that you will give to correct your blood sugars when they are high and the amount mmmol/l your blood sugar will decrease per amount of insulin taken

What is a carbohydrate?
Carbohydrate foods are often described as sugars and starches.

Sugars: all foods containing added sugar (sucrose) are carbohydrate foods.
They include sugar which may be added to food and

• sugar containing drinks,
• sweets & chocolates,
• honey, jams and marmalades
• sweet puddings and desserts

Natural sugars: the natural sugars fructose and lactose are found in fruit and milk and dairy foods and some vegetables

• Fructose is found in all fruit, fresh frozen, dried or tinned.
• Lactose is found in milk, yoghurt, cheese and ice cream.

Starches: potato, sweet potato,· bread, rice, pasta, noodles, roti, naan bread, wraps, couscous· breakfast cereals, oats,· starchy veg - sweetcorn, peas, pumpkin, buttnernut, carrots· lentils, beans and other pulses,· all flour products e.g. pizza, pastry, baked goods, biscuits, crackers, pancakes 

NOTE: All carbohydrate foods produce glucose in the blood
 
How to calculate how much carbohydrate in foods?
There are many different ways of working out how much carbohydrate you are eating, you may need use a few or all of the different ways. This will depend on the types of food you have to eat.
You will need to:

• Weigh some foods to find out your portion sizes then use food labels or carbohydrate portion lists to work out how much carbohydrate there is
• You may also find picture guides useful.
• Carbs and Cals- A visual guide to Carbohydrate Counting and Calorie counting for people with Diabetes.
• www.carbsandcals.com
• APPs like myfitnesspal.com, myfatsecret are also useful applications but please note there are some discrepancies so please always check the food label

Sometimes you will need to weigh a food to know how big your portion size is. This will help you to know exactly how much carbohydrate you are eating. We suggest checking your portion sizes for foods like rice, pasta, noodles, baked potato, breakfast cereals. 

You do not need to weigh these foods every time you eat them. Make a note of your portion size in handy measures using serving spoons or measuring cups. Try and re check your portion sizes every few weeks.
 
Tip :
Use a measuring cup for foods like rice, couscous, breakfast cereal make a note in your portion book about your portion sizes.
Other handy measures include:

• An egg sized potato or an ice cream scoop of mashed potato contains about 10g  carbohydrate
• An adults hand size slice of pizza is about 30g carbohydrate
• A measuring cup of pasta is about 30-40g carbohydrate, and a cup of rice  is 40-50g

 
Food labels

• A food label will tell you all about all the carbohydrate content of a food.
  
• You need to look up the total carbohydrate in the portion of food you eat.
  
• All carbohydrate foods produce glucose — both the sugars and starches so they both count.
  
• The ‘of which sugars’ tells you how much sugar has been added to the food
  
• Only use a food label if it tells you about a portion of your food as you eat it.

For example a packet of dried pasta—this food label tells you about 100g of uncooked pasta But  you need to know about your portion size of cooked pasta.
Sometimes you may need to weigh your food and work out the amount of carbohydrate. An example may be breakfast cereals.

Foods containing little or no carbohydrate
The foods below contain little or no carbohydrate, and therefore don’t really affect your blood glucose levels (when eaten in usual amounts).  You still need to eat some of these foods; you just don’t “count” them when working out how much carbohydrate is in your meals.
 

• Salad: lettuce, tomato, peppers, cucumber and most other salad items
  
• Vegetables: most (except potato, parsnip, sweet potato and sweet corn)
  
• Fats: margarine, butter, oil and cream
  
• Sugar free fizzy drinks and cordials
  
• Plain meats, eggs, most nuts and cheeses

 
Need more help? Please get in touch via our Warrior Dietitian contact form for a 1:1 consultation