Transcript Let’s Count Carbs - Medical Supply Company

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
Guess Which Foods
Have Carbs?
How Many Carbs Do I Need?
Carbs per Meal
Choices
Grams
Most Women
3-4
45 - 60
Most Men
4-5
60 - 75
Portion Control
Serving Size
Item
3 oz.
Size of a deck of cards
1 cup
1 Fist
6 oz.
Light bulb
1/3 cup
Egg
½ cup
½ Baseball
1 ½ cups
1 and ½ Baseballs
Visual
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
Plate Method
How Many Carbs?
½ cup sugar free
applesauce
1 cup milk
12
15
0
3 oz. Pork Chop
Milk
12
Pork chop
0
Corn on cob 15
Broccoli
15
Applesauce + 15
grams
grams
grams
grams
grams
½ large corn on Cob
15
1-1/2 cups broccoli
TOTAL = 57 grams or 4 choices
15
How Many Carbs?
0
15
2 Tbsp.
Salad dressing
0
Wine* - 5 oz
3 meat balls
Wine
0 grams
Meat balls
0 grams
Pasta w/ tomato sauce
30 grams
Dinner roll
15 grams
Salad greens
0
30
1 small dinner roll
1 cup pasta
0
0 grams
Salad dressing + 0 grams
1 cup tossed salad greens
TOTAL = 45 grams or 3 choices
* 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
1 cup coffee
w/ 3 sugar packets
0
3 oz salmon
Coffee w/ sugar 15 grams
Salmon
15 grams
Cabbage
15 grams
Grapes
+ 15 grams
1 cup french fries
15
0 grams
French fries
17 grapes
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:
Snack Ideas
1-2 Carb choices
(15-30 grams)
¾ oz pretzels or chips
15 grams
½ cup regular ice cream or
2 “fun size” candy bars
½ cup regular pudding
5 vanilla wafers or
2 small cream filled cookies
3 cups popcorn
22 ½ grams
30 grams
15 grams
15 grams
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
What About These Foods?
•
•
•
•
•
•
•
•
•
Pizza
Chinese food
Mexican food
Movie popcorn with butter
Ribs
Burger & fries
Pancakes with butter & syrup
Buffets
Holiday meals
High-Fat
&
High-Carb
How to calculate insulin dose by
counting Carb choices
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?
3
• How many units of insulin are needed?
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?
60
• How many units of insulin are needed?
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
Goals:
Before Meals
1-2 hours After Meals
ADA
70 -130 mg/dL
less than 180 mg/dL
AACE
less than 110 mg/dL
less than 140 mg/dL
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
Other Tools
From CCS Medical:
Others:
• Let’s Count Carbs
Teaching sheet
• ADA’s Choose Your Foods
• CCS Medical
Education Book
• Bowes & Church’s
Food Values
• The Calorie King
• Healthy Options
Restaurant Guide
• ADA’s Restaurant Guide
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_c
onsistency.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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