Carbohydrates have a major effect on a person’s glucose (blood sugar). It is crucial that diabetic individuals keep track of their carbohydrate consumption as a means of avoiding high glucose (hyperglycemia) or low glucose (hypoglycemia).

Most of the health complications associated with diabetes, such as kidney disease (diabetic nephropathy), heart conditions and diabetic coma, are related to glucose problems. Several dietary techniques can improve control of glucose, including:

• Dietary exchange system. A method of categorizing foods into groups that share similar carbohydrate, calorie, protein and fat content. Established by the American Diabetes Association and the American Dietetic Association, it consists of three groups:
  
• • Carbohydrate group
  • Meat and meat substitutes group
  • Fat group
    
    
  The carbohydrate group contains foods in the following subgroups:
  
• • Starches
  • Fruits
  • Milk
  • Vegetables
  • Other carbohydrates (such as table sugar, yogurt, fruit snacks and jelly)
    
    
  The American Diabetes Association recommends that carbohydrates should make up 50 percent to 60 percent of daily calorie consumption for most individuals.
  
  
• Carbohydrate counting. Also known as “carb counting,” this is a method in which people with diabetes carefully count the number of carbohydrates they consume to make sure they do not exceed their recommended levels. Various products can help patients track carbohydrate consumption.
  
  To do this accurately, individuals need to determine how many carbohydrates are in a single serving of the food they are eating. “Nutrition facts” labels are good sources for this information. Patients should remember that a single serving size as displayed on these lists is based on weight, and not just how much food a person eats in a single meal. Once patients have this information, they need to weigh and measure the food to calculate carbohydrate intake based on serving size.
  
  There are five basic steps in carbohydrate counting:
  
• • Step 1: Carbohydrate count goals. These goals will depend on the type of antidiabetic agents or insulin used. There are two considerations:
    
  • • Consistency in the amount of carbohydrate consumed at snacks and meals. If insulin is used, or an antidiabetic agent that increases the amount of insulin produced by the body, the same amount of carbohydrate needs to be consumed at meals and snacks each day to maintain consistent levels of blood glucose.
      
      
    • Maximum amounts of carbohydrates to be consumed at each snack and meal. The kind of medication used by a diabetic individual is an important factor in this amount. Patients who use rapid-acting insulin can adjust the amount of insulin taken to match the amount of carbohydrate eaten.
      
      

      

Another method that can be used, the glycemic index, accounts for how the various carbohydrates affect glucose. Other diet tools include the diabetes food pyramid and the “rate your plate” system.