Confusion reins! What's an "exchange"?

Hi Emma,

I know exchanges seem to be confusing. Believe me just trying to remember to take my meds can be confusing enough!!

The idea of food exchanges in non diabetic folks is to maintain a balance between proteins, carbs, fats, etc, keeping calorie intake to a certain level so as to lose weight. In a diabetic, food exchanges are used to help diabetics avoid the high and low glucose swings. Options like insulin doses, medicines, exercise (or lack of) all factor in to how those food exchanges are made. It can be confusing!

There is a great guideline here on healthcentral.com. David Mendosa also has a great glycemic index you can refer to when choosing foods. It's interesting to see that some foods you consider to be good for you aren't necessarily great and vice versa. That list is located here.

Good luck and stay in touch. Let us know how you are doing!

Vicki M

Hi Emma,

In the diabetic world, exchanges are a little outdated.  Perhaps this isn't so much the case with type 2 diabetes, but I don't know any type 1s who currently rely on the exchange system to manage their disease.

Before we all got on board with carb counting, food exchanges were used in diabetic meal planning.  As in, "one fruit exchange for a snack" or "2 bread exchanges for lunch."  Each meal needed to contain a certain amount of carbohydrate (from particular sources) so that one could plan their insulin injection properly.

Being diagnosed in 1993, I only did the meal exchange system for a few years before carbohydrate counting came along... thank goodness!

Good luck!

Hi, I have had Type I diabetes for 38 years.  It used to be that the Dr. would put you on a certain calorie diet, when you were diagnosed with diabetes.  The diet was divided into exchanges.  There were bread exchanges, which were starchy foods.  ie. bread, cereal, rice, corn, peas etc.  There were meat exchanges, which were meat and other protein, ie. eggs, peanuts, cheeses. There were vegetable , fruit and milk exchanges.  They would put you on a specific calorie diet and for each meal and snack you were required to eat a certain amount of exchanges per meal.  It used to be you were supposed to eat the same amount at the same time every day.  Talk about a hassle.  Now they typically have you count carbs, and you give insulin according to your carb to insulin ratio.  This way is much more flexible than the old way.  There are books that help to convert carbs to exchanges etc. Hope this helps

Susan