The Carbohydrate Counting System. Some people plan their carbohydrate intake using a system called carbohydrate counting. It is based on two premises:
-
All carbohydrates (either from sugar or starch) will raise blood sugar to a similar degree. In general, 1 gram of carbohydrates raises blood sugar by 3 points in people who weigh 200 pounds, 4 points for weights of 150 pounds, and 5 points for 100 pounds.
-
Carbohydrates have the greatest impact on blood sugar; fats and protein play only minor roles.
In other words, the amount of carbohydrates eaten (rather than fats or proteins) will determine how high blood sugar levels will rise. There are two options for counting carbohydrates: advanced and simple. Both rely on collaboration with a doctor, dietitian, or both. Once the patient learns how to count carbohydrates and adjust insulin doses to their meals, many find it more flexible, more accurate in predicting blood sugar increases, and easier to plan meals than other systems.
The basic goal is to balance insulin with the amount of carbohydrates eaten in order to control blood glucose levels after a meal. The steps to the plan are as follows:
The patient must first carefully record a number of factors that are used to determine the specific requirements for a meal plan based on carbohydrate grams:
-
Multiple blood glucose readings (taken several times a day)
-
The time of meals
-
Amount in grams of all the carbohydrates eaten
-
Time, type, and duration of exercise
-
The time, type, and dose of insulin or oral medications
-
Other relevant factors, such as menstruation, illness, and stress
The patient works with the dietitian for two or three 45 to 90 minute sessions to plan how many grams of carbohydrates are needed. There are three carbohydrate groups:
-
Bread/starch
-
Fruit
-
Milk
One serving from each group should contain between 12 and 15 carbohydrate grams. (Patients can find the amount of carbohydrates in foods from labels on commercial foods and from a number of books and web sites.)
The dietitian creates a meal plan that accommodates the patient's weight and needs, as determined by the patient's record, and makes a special calculation called the carbohydrate to insulin ratio. This ratio determines the number of carbohydrate grams that a patient needs to cover the daily pre-meal insulin needs.
Previous Section
