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Let’s Count Carbs ™. Speaker: (Local CDE name) (CDE work location) Sponsored by: CCS Medical. What is a Carbohydrate (Carb)?. Body’s main energy source 4 calories per gram 45-65% of calories Cereal, grains, fruit, milk and starchy vegetables 100% turns to glucose. Why Count Carbs?.
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Let’s Count Carbs™ Speaker: (Local CDE name) (CDE work location) Sponsored by: CCS Medical
What is a Carbohydrate (Carb)? • Body’s main energy source • 4 calories per gram • 45-65% of calories • Cereal, grains, fruit, milk and starchy vegetables • 100% turns to glucose
Why Count Carbs? • Helps stabilize blood glucose levels • To feel better and have more energy • No more “dieting” • Gives you more flexibility to enjoy all foods
Portion Control Serving Size Item Visual 3 oz. 1 cup 6 oz. 1/3 cup ½ cup 1 ½ cups Size of a deck of cards 1 Fist Light bulb Egg ½ Baseball 1 and ½ Baseballs
Two Ways to Count Carbs • Carb Choices • 1 Carb Choice = 15 grams of Carb • 1 Starch = 1 Fruit = 1 Milk • Grams of Carb • Add up the total grams of Carb for all foods 1 cup milk& 1 small apple 15 grams + 15 grams = 30 grams
How Many Carbs? 1 cup milk ½ cup sugar free applesauce 12 15 0 15 3 oz. Pork Chop ½ large corn on Cob Milk 12 grams Pork chop 0 grams Corn on cob 15 grams Broccoli 15 grams Applesauce + 15 grams 15 TOTAL = 57 grams or 4 choices 1-1/2 cups broccoli
How Many Carbs? 0 15 2 Tbsp. Salad dressing 0 Wine* - 5 oz 30 0 1 small dinner roll 1 cup pasta 3 meat balls Wine 0 grams Meat balls 0 grams Pasta w/ tomato sauce 30 grams Dinner roll 15 grams Salad greens 0 grams Salad dressing + 0 grams 0 TOTAL = 45 grams or 3 choices 1 cup tossed salad greens * According to the ADA, “If adults with diabetes choose to use alcohol, daily intake should be one drink per day or less for adult women and two drinks per day or less for adult men”.
How Many Carbs? 15 15 15 17 grapes 1 cup coffee w/ 3 sugar packets 0 3 oz salmon 1 cup french fries Coffee w/ sugar 15 grams Salmon 0 grams French fries 15 grams Cabbage 15 grams Grapes + 15 grams 15 1 ½ cups cooked red cabbage TOTAL = 60 grams or 4 choices
Carb Counting vs. Carb Guessing • Carb Guessing • Hypoglycemia • Hyperglycemia • Carb Counting • Use measuring cups 1 time per week • Use references: • Calorie King book • Food Exchange Lists for Diabetes • www.caloriecount.about.com • Food labels
Combination Foods • Casseroles: 1 cup = 2 Carbs (30 grams) + 2 meats • Soup / stew: 1 cup = 1 Carb (15 grams) + 1 meat + 0-3 fats • Sandwiches: 1 = 2 Carbs (30 grams) + 2-4 meats
More Combination Foods • Submarine Sandwich: 6 inch = 3 Carbs (45 grams) + 2 meats • Pizza: Thin crust, ¼ of a 12 inch (6 oz) = 2 ½ Carbs (37 ½ grams) + 2 meats + 1 ½ fats
Snacks • For in-between meal snacks:
Not All Carbs Are Created Equal • Healthy eating is an important part of Carb counting • Whole wheat pastas, breads, grains and fruits • High fiber foods may slow the rise of blood glucose after eating • Some fiber is not digested or absorbed • Some fiber can be subtracted from the Total Carbohydrate on the nutrition label • Low-fat dairy for heart health
Fiber and Sugar Alcohols • For example: Total Carbohydrate 30 grams Dietary Fiber 10 grams 30 grams (Total Carbohydrate) - 5 grams (half of dietary fiber) 25 grams of Carb to count • The same rule applies for sugar alcohol
Pizza Chinese food Mexican food Movie popcorn with butter Ribs Burger & fries Pancakes with butter & syrup Buffets Holiday meals High-Fat & High-Carb What About These Foods?
Insulin prescribed by a Doctor: “1 unit of insulin for every Carb choice” ¾ cup cereal + ½ banana + 1 cup milk How many Carb choices are in this meal? How many units of insulin are needed? How to calculate insulin dose by counting Carb choices 3 1 unit x 3 Carb choices = 3 units of insulin
How to calculate insulin dose by counting Grams of Carbs Insulin prescribed by MD: “1 unit of insulin for every 15 grams of Carb” 1 burger patty + 1 hamburger bun + ½ cup peas + 1 small apple • How many grams of Carb is in this meal? • How many units of insulin are needed? 60 60 grams of Carb ÷ 15 = 4 units of insulin
How Do I Know If I Counted Right? • Check blood glucose before meals and 1-2 hours after meals • Before meal blood glucose shows if basal insulin or long-lasting insulin is sufficient • After meal blood glucose shows how different amounts of Carb and insulin affect blood glucose ADA - American Diabetes Association AACE - American Association of Clinical Endocrinologists
What If I Counted Wrong? • Blood glucose too high – too many Carbs • Blood glucose too low – not enough Carbs • Check portion sizes • Rate of digestion/absorption: • Simple sugars = 15 - 30 minutes • Complex Carbs = 1 - 1 ½ hours or more • Fat and protein take several hours
What Can I Do Better Next Time? • Importance of keeping records • To recall how different foods effect blood glucose levels • Individual effects • Learn from your mistakes • Review what you ate • Check blood glucose to see if it was too much or too little
Tools You Can Use • CCS Medical Log book
From CCS Medical: Let’s Count Carbs Teaching sheet CCS Medical Education Book Healthy Options Restaurant Guide Others: ADA’s Choose Your Foods Bowes & Church’s Food Values The Calorie King ADA’s Restaurant Guide Other Tools
Thank you! Questions?
Local Resources • CDE Name: Contact info: Location: Classes offered: Support Groups:
References • American Diabetes Association and American Dietetic Association, “Choose Your Foods: Exchange Lists for Diabetes”, 2008. • www.dce.org/pub_publications/files/ReadySet Start_ final.pdf • www.dce.org_publications/files/Carb_counting_focus_consistency.pdf • Hope S. Warshaw, MMSc, RD, CDE; Karmeen Kulkarni, MS, RD, CDE. Complete Guide to Carb Counting, 2001.
References • “American Diabetes Association: Diabetes Care,” volume 32, Supplement 1, January 2009, S 22 . • “Endocrine Practice,” volume 13, Supplement 1, May/June 2009, p. 16 • CCS Medical educational materials: • Let’s Count Carbs™ • Diabetes Nutrition Placemat • Healthy Options Restaurant Guide
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Who is CCS Medical? • 2nd largest home delivery service of medical supplies • One of the largest insulin pump/pump supplies distributor • 5 major distribution centers nationwide • Servicing about 375,000 patients
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