Carbohydrate Counting Handbook

Table of Contents
Page
Introduction2
Why count carbohydrates? 2
Healthy Eating Guidelines ..2
Is this food a carbohydrate !rotein or fat? ."
#iabetic $ood Guide Pyra%id.&
'eading $ood (abels...)
*easuring +er,ing +i-es. .
+ources of Carbohydrate./01
+ources of Protein2$at..3
+ugar0free ,ersus Carbohydrate0free45
+nacks44
$ree $oods.42
(o6 Carb $oods4"
Guidelines for #ining 7ut4&
$ast $ood $acts.......... 4)04.
E8ercise Guidelines. 4/041
Heart Healthy (o60$at #iet Guidelines 43025
+ick #ay Guidelines. 24
+ources of Carbohydrate 9ui-... 22
+ources of Carbohydrate 9ui- :;ns6er <ey=..2"
*eal Planning 9ui-.. 2&
*eal Planning 9ui- :;ns6er <ey=... 2)
>our Carbohydrate *eal Plan2.
<ee!ing a $ood #iary.. 2/
I%!ortant Phone ?u%bers.. 21
Carbohydrate Counting 'esources23
;dditional 'esources to Hel! >ou ...."5
www.chkd.org/services/diabetes
Introduction
The eating regi%en for so%eone 6ith diabetes is a healthy 6ay of eating fro% 6hich the entire
fa%ily can benefit. This handbook 6ill !ro,ide you 6ith the basic sur,i,al skills to count
carbohydrates 6hile eating a healthy diet.
Why Count Carbohydrates???
$ood is %ade u! of %any different nutrients@
Carbohydrate
Protein
$at
Aita%ins and %inerals
Water
$iber
7ur bodies need a little bit of each of these nutrients. But 6hen so%eone has diabetes they
need to !ay close attention to the a%ount of carbohydrate that they consu%e. Carbohydrate
is the nutrient that breaks do6n to sugar in our bodies as 6e digest it. 7ur bodies use
carbohydrate for energy. In order to utili-e that energy ho6e,er insulin %ust be a,ailable to
carry sugar :glucose= into cells. Because !eo!le 6ith diabetes ha,e i%!aired insulin
!roduction and2or utili-ation sugar can build u! in their blood causing hy!erglyce%ia if they
take in too %uch carbohydrate at one ti%e. This is 6hy it is ,ery i%!ortant to count the gra%s
of carbohydrate in the foods that you eat. It 6ill allo6 you to control your diabetes better by
eating the correct a%ount of carbohydrates for the a%ount of insulin that your doctor
!rescribes. Carbohydrates and insulin are a balancing act.
Healthy Eating Guidelines
Guidelines for %eal !lanning@
Eat a ,ariety of foods to %ake sure your diet is 6ell balanced.
(i%it intake of s6eets fats and salt to %ake your diet healthier.
Increase intake of fiber.
Eat %eals and snacks at the sa%e ti%e each day.
Eat the sa%e a%ount of carbohydrates at %eals and snacks.
www.chkd.org/services/diabetes 2
Is this food a carbohydrate, protein, or fat?
?o6 that you 6ill be counting carbohydrates you 6ill need to deter%ine if the food that you are
eating contains carbohydrates. If any food contains %ore than ) gra%s of carbohydrate !er
ser,ing you 6ill need to include it in your %eal !lan. $oods can be a co%bination of
Ccarbohydrate !rotein and2or fatD. >ou can use the food guide !yra%id to hel! you deter%ine
if a food is a carbohydrate !rotein or fat or a co%bination.
Carbohydrate Grou!@
Grains dried beans starchy ,egetables
$ruit
*ilk E yogurt
Protein Grou!@
Beef !ork !oultry fish
Eggs cheese
?uts
Tofu
$at Grou!@
Butter
*argarine
7ils
(ard
+our crea%
*ayonnaise
+alad dressingsF :see !age 3 =
www.chkd.org/services/diabetes 3
Diabetic Food Guide Pyramid
www.chkd.org/services/diabetes 4
eading Food !abels
There are t6o ste!s to follo6 6hen reading food labels to count carbohydrates@
4. (ook at the ser"ing si#e for the food. This is located at the to! of the label.
2. (ook at the total carbohydrate a%ount. This is located to6ards the %iddle of the label.
These t6o !arts of the label tell you 6hat you need to kno6. The a%ount of total
carbohydrates listed is for the !articular ser,ing si-e listed. ;lso kee! the follo6ing infor%ation
in %ind 6hen reading food labels@
C+ugarsD reflect both added sugars and those that naturally occur in foods. It is
i%!ortant to look at the total a%ount of carbohydrate rather than the source.
If sugar alcohols are listed on the food label di,ide that nu%ber by 2 and
subtract it fro% the total carbohydrate. :+ugar alcohols only !ro,ide half the calories
as sugar.=
If dietary fiber is listed on the food label you can subtract the full a%ount of fiber
fro% the total carbohydrate. :$iber is not digested as sugar and therefore 6ill not ha,e
an effect on our blood sugar.=
www.chkd.org/services/diabetes 5
$easuring %er"ing %i#es
*easuring the ser,ing si-e of the ite%s that you are choosing to eat is ,ery i%!ortant. The
total a%ount of carbohydrates de!ends on the ser,ing si-e. Therefore it is ,ery i%!ortant that
you ha,e %easuring cu!s s!oons and2or a food scale. The follo6ing is a list of descri!tions
to hel! you ,isuali-e 6hat a ser,ing si-e %ight look like in case %easuring cu!s are not
a,ailable.
Easy Ways to Esti%ate Portion +i-e
" o- boneless %eat G deck of cards
4 o- slice cheese G " HD co%!uter disk
*ediu% !iece of fruit G baseball or tennis ball
2 Tbs! !eanut butter G golf ball
I cu! dried fruit G golf ball
4 !ancake G co%!act disk :C#=
4 ser,ing of chi!s :4 o-= G 4 s%all cu!!ed hand
www.chkd.org/services/diabetes 6
%ources of Carbohydrate
Each ite% listed 6ith its acco%!anying ser,ing si-e contains about &' grams of carbohydrate
or 4 ser,ing:e8change= of carbohydrate.
(reads
4 slice bread
2 slices reduced0calorie bread
4 4o-. dinner roll
H ha%burger2hot dog bun
H bagel
H English %uffin
4 2 H 0inch biscuit
4 20inch cube cornbread
H .0inch !ita
4 .0inch tortilla
2 .0inch taco shells
4 & H 0inch 6affle
2 &0inch !ancakes
4 slice $rench toast
4 cu! croutons
42" cu! stuffing bread :!re!ared=
Cereals and Grains
H cereal bar
H unfrosted !o!tart or toaster !astry
H cu! bran cereal
J cu! uns6eetened cereal
H cu! sugar0frosted cereal
4 H cu! !uffed cereal
H cu! +hredded Wheat
I cu! Gra!e0?uts
H cu! oats
H cu! cooked cereal :grits oat%eal=
42" cu! couscous
" Tbs! flour :dry=
" Tbs! corn%eal :dry=
" Tbs! 6heat ger%
H cu! !asta :cooked=
42" cu! rice :6hite or bro6n= :cooked=
H cu! rice %ilk
%tarchy )egetables
H cu! corn
4 corn on cob .0inch
H cu! !eas
4 "o- !otato !lain :baked or boiled=
H cu! %ashed !otatoes
H cu! ya% s6eet !otato !lain
4 cu! sKuash 6inter :acorn butternut=
42" L 422 cu! to%ato or s!aghetti sauce
4 H cu! ,egetable Muice
(eans, Peas, and !entils
42" cu! baked beans
H cu! beans2!eas cooked :garban-o
!into kidney 6hite s!lit black0eyed=
22" cu! li%a beans
H cu! lentils cooked
Crac*ers and %nac*s
/ saltine crackers
4)025 tortilla or !otato chi!s
2& oyster crackers
1 ani%al crackers
" 20H 0inch sKuare graha% crackers
J o- !ret-els
I 0 H soft !ret-el
" cu!s !o!!ed !o!corn
2 &0inch rice cakes
H cu! cho6 %ein noodles
" cheese or !eanut butter crackers
&" Goldfish crackers
24 Cheese ?i!s
$il* and +ogurt
4 cu! :1 o-= %ilk :ski% 4N 2N 6hole=
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H cu! :& o-= chocolate %ilk
J cu! :. o-= !lain lo60fat yogurt
H cu! e,a!orated %ilk
42" cu! nonfat dry %ilk
4 cu! goatOs %ilk
$ore %ources of Carbohydrate
Each ite% listed 6ith its acco%!anying ser,ing si-e contains about &' grams of carbohydrate
or 4 ser,ing:e8change= of carbohydrate.
Fruit
H cu! canned fruit :uns6eetened in its
o6n Muice=
H cu! a!!lesauce :uns6eetened=
4 s%all banana :&H inch=
4 s%all a!!le orange
4) s%all gra!es
4 I cu! stra6berries 6hole
4 I cu! 6ater%elon :cubed=
4 cu! cantalou!e honeyde6 !a!aya
:cubed=
2 Tbs! raisins
I cu! dried fruit
H cu! Muice :a!!le orange gra!efruit
!inea!!le=
42" cu! Muice :gra!e cranberry !rune
blends=
Combination,-ther Food
H cu! Ice crea%
H cu! Ice crea% no added sugar
42" 0 422 cu! fro-en yogurt
I cu! sherbet
H cu! !udding sugar0free
40 inch sKuare cake frosted
20 inch sKuare cake unfrosted
H #oughnut !lain cake
4 Tbs! honey
4 Tbs! sugar
4 Tbs! regular syru!
4 Tbs! light syru!
4 Tbs! Ma% Melly
" Tbs! ketchu!
H cu! Mello regular
42" L 422 slice %ediu% !i--a
Fibrous )egetables
Each ite% listed contains about ' grams of carbohydrate per ser"ing.
What is a ser,ing of fibrous ,egetables? . cup coo*ed 7' & cup ra/
;rtichoke2artichoke hearts
;s!aragus
Beans :green 6a8 Italian=
Bean s!routs
Beets
Broccoli
Brussels s!routs
Cabbage
Carrots
Cauliflo6er
Celery
Cucu%ber
Egg!lant
Greens :collard kale %ustard turni!=
<ohlrabi
(eeks
(ettuce
*i8ed ,egetables 6ithout corn !eas !asta
*ushroo%s
7kra
7nions :6hite green scallions=
Pea !ods
Pe!!ers all ,arieties
'adishes
+alad greens
+auerkraut
+!inach
+u%%er sKuash
To%ato
Turni!s
www.chkd.org/services/diabetes 8
Water chestnuts
Watercress
Pucchini
Protein,Fat 01 grams carbohydrate2
Each ite% listed is considered a !rotein and2or fat unless you add carbohydrate to it
Beef
Poultry
$ish2+eafood
Pork
Aeal
*eat sticks
(uncheon2deli %eats
Eggs
Cheese
?uts
Crea% cheese
Crea%er non0dairy
*ayonnaise
*argarine
Butter
7il
(ard
+alad dressings@ FFFranch oil and ,inegar
Caesar
+our crea%
FFFThe follo6ing are salad dressings that can be high in carbohydrate !er ser,ing. Please read
the food label to deter%ine the a%ount of carbohydrate@
Catalina
$rench
Honey #iMon
Honey %ustard
Po!!y seed
'ussian
'ed 6ine ,inaigrette
'as!berry ,inaigrette
Thousand island
FFFIte%s that are Cfat0freeD Clo60fatD CliteD or Creduced0fatD %ay actually ha,e
sugar2carbohydrate added to the% to %ake the% taste better since the fat 6as taken out.
Therefore you should al6ays read the food label for the total carbohydrate.
www.chkd.org/services/diabetes 9
%ugar3free "ersus Carbohydrate3free
Qust because a food is labeled C+ugar0$reeD or C?o +ugar ;ddedD doesnOt necessarily %ake it
a Cfree foodD it %ay contain carbohydrate. The carbohydrate %ay co%e fro% other ingredients
in the food such as flour. >ou still need to read the label for the total carbohydrate and include
it in your %eal !lan. The reason that an ite% can be labeled C+ugar0$reeD or C?o +ugar
;ddedD is because the %anufacturer is not adding Ctable sugar.D +ugar co%es in %any for%s
other than Ctable sugar.D ;ll ty!es of sugar contain carbohydrate that 6ill affect your blood
sugar.
C+ugar0freeD %eans less than 5.) gra%s of Ctable sugarD !er ser,ing.
C?o added sugarD %eans that no sugar 6as added but it %ay be found naturally in the food.
4he follo/ing is a list of different types of sugar5
?utriti,e :caloric= s6eeteners@
Glucose
$ructose
+ucrose0 table sugar :6hite sugar=
(actose
Galactose
Bro6n sugar
#e8trin
*a!le syru!
*altose
'a6 sugar
Corn s6eetener
#e8trose
Honey
*olasses
High fructose corn syru!
Corn syru!
+ugar
+ugar alcohols0 sorbitol %annitol 8ylitol
?on0nutriti,e :lo60calorie= s6eeteners@ The use of these !roducts 6ill hel! li%it sugar intake.
www.chkd.org/services/diabetes 10
+accharine0 +6eet0?0(o6
;s!arta%e0 ?utra+6eet EKual
;cesulfa%e <0 +6eet7ne
+ucralose0 +!lenda
FFF;ll are a!!ro,ed by the $ood and #rug ;d%inistration :$#;=.
FFFPeo!le 6ith !henylketonuria should not use as!arta%e.
%nac*s
+nacks are a ,ery i%!ortant !art of your %eal !lan. $or good blood sugar control you should
eat the sa%e a%ount of carbohydrate for each snack. When you count carbohydrates you are
gi,en the fle8ibility to eat 6hat you 6ant at snacks as long as it fits into your carbohydrate
%eal !lan. +nacks can contain 4)0"5 gra%s of carbohydrate. >our dietitian 6ill tell you ho6
%uch to ha,e. >ou can refer to the lists of sources of carbohydrate to hel! you !ick and
choose 6hat to ha,e or si%!ly read the food label of the ite% that you 6ant. Bedti%e snacks
should contain both carbohydrate and !rotein.
Here are so%e e8a%!les of snacks that contain about &' grams of carbohydrate@
4 s%all !iece fresh fruit
" cu!s !o!corn
. o- light yogurt
/ saltine crackers 62 cheese
H cu! ice crea%
H cu! uns6eetened a!!lesauce
2 rice cakes
H cu! sugar0free !udding
H sand6ich
Here are so%e e8a%!les of snacks that contain about 61 grams of carbohydrate@
4 granola bar
4 cereal bar
. !k crackers
. cu!s !o!corn
4 s%all bagel 62 crea% cheese
4 sand6ich :%eat and cheese=
4 cu! %ilk 62 a s%all !iece of fresh fruit
www.chkd.org/services/diabetes 11
Free Foods
+o%e foods are free only if you consu%e a %ini%al a%ount. The follo6ing guidelines 6ill hel!
you deter%ine if a food is CfreeD@
Contains less than ' grams carbohydrate
Contains less than 71 calories
$ree $oods0 The follo6ing foods contain little to no carbohydrate and2or calories and 6ill not
affect your blood sugar. 'e%e%ber...Must because a food is labeled Csugar0freeD doesnOt
necessarily %ean that it is Ccarbohydrate0free.D
#iet soda
Crystal (ight
+ugar0free <ool0aid
+ugar0free or uns6eetened iced tea
:s6eetened 6ith sugar substitute=
Coffee
Bouillon
Broth
+ugar0free Mello
+ugar0free gu%
+ugar0free !o!sicles :not %ade 6ith fruit
Muice=
#ill !ickles
*ustard
Herbs2s!ices
Cooking s!ray
+oy sauce
Ainegar
(o60Carbohydrate $oods0 These foods contain less than ) gra%s of carbohydrate !er ser,ing
but %ay ha,e %ore than 25 calories !er ser,ing. They %ay affect your blood sugar therefore it
is ,ery i%!ortant to eat the% in %oderation. >ou can find these foods in the !rotein fat and
fibrous ,egetable sections of the book on !ages 1 3 and 4" .
www.chkd.org/services/diabetes 12
!o/ Carb Foods
#eli %eat slices
0turkey ha% roast beef bologna
chicken !e!!eroni sala%i !astra%i
*eat sticks2Beef Merky
Tofu
Cheese
0;%erican Cheddar Colby *onterey
Qack *o--arella *uenster Pro,olone
+6iss
Cottage cheese H cu!
'icotta cheese
Eggs0 boiled scra%bled de,iled
?uts : H ounce L 4 ounce=
0al%onds cashe6s bra-ilnuts
%acada%ia !ecans !istachio
sunflo6er
+eafood saladF
Egg saladF
Chicken saladF
+ou! :broth0 or crea%0based=FFFread food
label for carb content
Broth0 chicken beef ,egetable
Aeggies : H cu! cooked L 4 cu! ra6=
0as!aragus artichoke hearts green
beans26a8 beans broccoli cabbage
carrots cauliflo6er celery collard
greens cucu%ber egg!lant lettuce:"
cu!s cho!!ed= %ushroo%s bell
!e!!ers radishes sauerkraut s!inach
s!aghetti sKuash su%%er sKuash
to%atoes -ucchini
Aegetable2to%ato Muice :A1= H cu!
Po!corn :4 cu!=
Pickles
7li,es
+ugar free Qell07
Whi!!ed to!!ing :2 Tbs!=
$un Ideas@
'icotta cheese0 %i8 6ith al%ond or ,anilla e8tract and a !acket of sugar substitute
+tir0fry H cu! ,eggies 6ith soy sauce
*i8 H cu! green beans E 6a8 beans 6ith 402 Tbs! Italian dressing
'a6 ,eggies 6ith ranch di!
*ake kabobs 6ith %eat cheese cubes and ,eggies enMoy cooked or cold
www.chkd.org/services/diabetes 13
*ake seafood salad egg salad or chicken salad 6ith %ayo E seasonings and use it to di!
,eggies or eat !lain
Please note5
FThe 6ay that you !re!are an ite% %ay add %ore carbohydrate. Be careful 6hen !re!aring
not to use e8tra ingredients that 6ill add carbohydrate.
F*ost lo60carb foods are lo60carb because of the ser"ing si#e. If you ha,e %ore than one
ser,ing you %ay need to count the carbs as !art of your %eal or snack.
F'e%e%ber that e,en though these foods %ay be lo6 in carbohydrate they %ay not be lo6 in
fat and2or calories. It is still i%!ortant that you %onitor your intake of these ite%s and try to
choose the lo60fat fat0free or lo60calorie ,ersion of the !roduct.
Guidelines for Dining -ut
When you eat out so%e6here other than ho%e it is still ,ery i%!ortant to follo6 your
carbohydrate %eal !lan. Here are a cou!le of ti!s to hel! you control your diabetes 6hile
dining out.
Wait until you arri,e at the restaurant to gi,e insulin there %ay be une8!ected delays. >ou
%ay need to change the ti%e you take your insulin or ha,e a s%all snack to !re,ent lo6
blood sugar.
Plan ahead. *e%ori-e your carbohydrate %eal !lan. Think about 6hat it is that you %ight
be eating.
Practice %easuring out ser,ing si-es. It is good to kno6 6hat a ser,ing si-e %ight look like
dis!layed on a !late.
7btain a co!y of the establish%entOs nutritional analysis of foods. *ost restaurants ha,e
the nutrition infor%ation on their 6ebsite.
Take charge and ask Kuestions. *ake sure you understand ho6 foods are !re!ared
because so%e foods can contain hidden carbohydrates.
-ther Healthy 4ips for Dining -ut5
;sk for a doggie bag to !ut half of the entrRe a6ay before you begin to eat.
;sk your ser,er to only bring out half the !ortion of the entrRe.
7rder the child0si-e !ortion.
www.chkd.org/services/diabetes 14
7rder an a!!eti-er and2or salad as a %eal.
+hare the entrRe 6ith so%eone that you are 6ith.
Fast Food Facts
(urger 8ing
CroissanO6ich :4= 2402" gra%s
Biscuit :4= ")0"/ gra%s
$rench Toast +ticks :)= )4 gra%s
Hash Bro6n 'ounds :s%= 2) gra%s
Who!!er +and6ich :4= &/ gra%s
Who!!er Qr +and6ich :4= 21 gra%s
Ha%burger :4= 2/ gra%s
Cheeseburger :4= 2/ gra%s
B< Big $ish +and :4= )3 gra%s
Chicken +and6ich :4= )& gra%s
Chicken Tenders :& !c= 3 gra%s
$rench $ries :s%= "2 gra%s
7nion 'ings :%ed= &. gra%s
#utch ;!!le Pie :4= "3 gra%s
Chic*3Fil39
Chicken +and6ich :4= 230"4 gra%s
Grilled Chicken +and :4= ".0"1 gra%s
Chick0n0+tri!s :& !c= 45 gra%s
Chick0$il0; nuggets :1!c= 42 gra%s
Tossed +alad :4= 4" gra%s
Carrot0'aisin +alad :s%= 21 gra%s
Cole +la6 :s%= 44 gra%s
Waffle Potato $ries :s%= &3 gra%s
Domino:s Pi##a
42D:%= Hand Tossed :221 slices= ))0)/ gra%s
42D:%= Thin Crust :221 slices= "40"" gra%s
42D:%= #ee! #ish :221 slices= ).0)3 gra%s
.D #ee! #ish Pi--a :4 !i--a= .10/5 gra%s
Breadstick :4= 41 gra%s
Wings :4= 402 gra%s
Papa ;ohn:s Pi##a
4&D 7riginal Crust :421 slices= "/0"3 gra%s
4&D Thin Crust :421 slices= 2202& gra%s
Cheesesticks :42/ order= 25 gra%s
Breadsticks :4= 2. gra%s
Pi##a Hut
*ediu% +tuffed Crust :421 slices= &)0&1 gra%s
*ediu% Thin S? Cris!y :421 slices= 2/0"5 gra%s
*ediu% Hand0Tossed :421 slices= &"0&) gra%s
*ediu% Pan Pi--a :421 slices= &&0&. gra%s
*ediu% +icilian :421 slices= "50"2 gra%s
The BIG ?e6 >orker :421 slices= &20&& gra%s
*ediu% The Edge :421 slices= 4)04/ gra%s
Person Pan Pi--a :4= 4450444 gra%s
8FC
7riginal 'eci!e breast 4. gra%s
leg & gra%s
thigh . gra%s
6ing ) gra%s
E8tra Cris!y
T*
breast 4/gra%s
leg /gra%s
thigh 4& gra%s
6ing 45 gra%s
Hot E +!icy breast 2" gra%s
leg 3 gra%s
thigh 4" gra%s
www.chkd.org/services/diabetes 15
6ing 3 gra%s
Chunky Chicken Pot Pie:4= .3 gra%s
Hot Wings :. !c= 41 gra%s
Honey BB9 Wings :. !c= "" gra%s
Cris!y +tri!s :" !c= 4102" gra%s
Po!corn Chicken :. o-= ". gra%s
BB9 Baked Beans :) H o-= "" gra%s
Biscuit :4= 25 gra%s
Cole +la6 :) o-= 2. gra%s
Corn on the Cob :4= ") gra%s
*acaroni E Cheese :) H o-= 24 gra%s
Potato +alad : ) H o-= 2" gra%s
Potatoes 62 Gra,y :) o-= 4/ gra%s
Potato Wedges :) o-= 21 gra%s
$cDonald:s
Ha%burger2cheeseburger :4= ")0"1 gra%s
Big *ac :4= &) gra%s
$ilet070$ish :4= &) gra%s
$rench $ries :s%= 2. gra%s
$rench $ries :%ed= )/ gra%s
$rench $ries :lg= .1 gra%s
$rench $ries :su!er si-e= // gra%s
Chicken *c?uggets :& !c= 4" gra%s
*c*uffin :4= 2)02/ gra%s
Biscuit :4= "&0". gra%s
Bagel :4= )/0)3 gra%s
Hot Cakes !lain :4 order= )1 gra%s
Aanilla Cone :4= 2" gra%s
+undae :4= )50.4 gra%s
*c$lurry :4= 12035 gra%s
;!!le Pie :4= "& gra%s
*c#onaldland Cookies :4 !kg= "2 gra%s
*ilkshake :s%= )30.5 gra%s
$ore Fast Food Facts

%ub/ay
.0inch cold subs :4= &&0&. gra%s
.0inch hot subs :4= &.0)4 gra%s
+alads :4= 4404. gra%s
Cookies :4= "40"" gra%s
Wendy:s
Ha%burger2Cheeseburger :4= ""0". gra%s
Breaded Chicken sand6ich :4= &"0&& gra%s
Pitas :4= &10)2 gra%s
Baked Potato :4= /401" gra%s
$rench $ries :s%= ") gra%s
$rench $ries :Biggie= .4 gra%s
Chicken ?uggets :) !c= 44 gra%s
$rosty
T*
:42 o-= ). gra%s
4aco (ell
+oft taco :4= 25 gra%s
Hard taco :4= 42 gra%s
/0layer burrito :4= .) gra%s
Bean burrito :4= )& gra%s
Big Beef burrito :4= &"0)2 gra%s
9uesadilla :4= "40"" gra%s
*e8ican !i--a "30&2 gra%s
Taco salad :salsa E shell= .3 gra%s
Taco salad :62o shell= ". gra%s
Gorditas :4= 2/0"4 gra%s
Chalu!as :4= 2/0"4 gra%s
www.chkd.org/services/diabetes 16
E<ercise Guidelines
E8ercise !lays a ,ery i%!ortant role in %anaging your diabetes. E,eryone should include
e8ercise as a nor%al !art of life.
Why is e8ercise i%!ortant for so%eone 6ith diabetes?
Hel!s control blood sugar by burning e8cess sugar.
Hel!s you feel better.
Hel!s kee! your body in good sha!e.
Hel!s kee! your heart healthy by lo6ering your heart rate and blood !ressure.
Hel!s lo6er blood cholesterol and triglycerides.
Hel!s your body be %ore sensiti,e to insulin.
Hel!s ease blood circulation throughout the body.
When should I be careful about e8ercising?
If your blood sugar is T"55 %g2dl you should check for urine ketones.
If you ha"e urine *etones, you should a"oid e<ercise=
Things to re%e%ber 6hen e8ercising@
Be a6are of !eak ti%es of insulin and re%e%ber that these ti%es %ay cause your blood
sugar to dro! e,en %ore than at other ti%es.
Carry fast0acting carbohydrates :Muice glucose tablets etc= in case of hy!oglyce%ia.
;l6ays ha,e e8tra snacks a,ailable.
E,eryone reacts differently to e8ercise so you ha,e to learn ho6 your body reacts by
%onitoring your blood sugars often.
It %ay be a good idea to check your blood sugar before during and after e8ercise.
www.chkd.org/services/diabetes 17
www.chkd.org/services/diabetes 18
Heart Healthy
!o/ Fat Diet Guidelines
Es!ecially if you ha,e Ty!e 2 diabetes it is ,ery i%!ortant to follo6 lo60fat diet guidelines to
hel! achie,e and %aintain a healthy 6eight. The lo60fat diet guidelines 6ill hel! you %ake
lo60fat choices 6hen !urchasing and !re!aring foods.
Ti!s to reduce fat intake@
'ecogni-e hidden sources of fat@ con,enience ite%s fast food easy0to0!re!are foods
'ead food labels@ choose foods that ha,e less than 6 grams of total fat per &11 calories
per ser"ing :less than "5N of calories should co%e fro% fat=
<no6 your definitions they can be ,ery %isleading@
Fat Free0 less than 5.) gra%s fat !er ser,ing
!o/ Fat0 " gra%s or less !er ser,ing
educed Fat0 at least 2)N less fat !er ser,ing :these foods could still be high in fat=
<no6 that lo60fat fat0free or reduced0fat foods %ay be high in sugar salt and calories
therefore !ortion si-es should be li%ited
E,en though you %ay be 6atching fat intake you need to also 6atch calorie intake
because e8cessi,e calories %ay lead to 6eight gain
G--D CH-ICE% P-- CH-ICE%
D9I+
P-D>C4%
+ki% or lo60fat %ilk
+ki% %ilk cheese :!art ski% %o--arella
and ricotta other nonfat2lo60fat
cheeses=
(o60fat2nonfat cottage cheese
(o60fat2nonfat yogurt
Ice %ilk2lo60fat ice crea%
Whole %ilk
Crea%
Whole %ilk cheese :cheddar colby
a%erican=
Whole %ilk cottage cheese
'egular yogurt
Ice crea%
www.chkd.org/services/diabetes 19
F>I4% ?
)EGE49(!E%
;ll fresh fro-en or canned fruits E
,egetables
Aegetables in crea% sauce 6hite sauce
butter
Aegetables %ade 6ith fatback or other
%eat fat
Breaded or dee!0fried fruits or
,egetables
Coconuts
(E9D%,
CEE9!%,
%49CHE%
(o60fat2nonfat baked goods
;ni%al crackers graha% crackers fig
ne6tons ,anilla 6afers ginger sna!s
Pasta rice !otatoes
White 6heat rye or french breads
Plain rolls or bagels
Cereal
Pret-els saltine crackers or lo60fat
snack crackers
;ir0!o!!ed !o!corn !lain or lo60fat
!o!corn
(o60fat2fat free cookies
*ost co%%ercial baked goods
Biscuits %uffins cornbread croissants
Granola
Potato chi!s %ost snack crackers
buttered !o!corn
*ost cookies danishes !astries
$rench fries
Heart Healthy 3 !o/ Fat Diet Guidelines3 cont:d
G--D CH-ICE% P-- CH-ICE%
$E94 ? $E94
%>(%4I4>4E%
*eats should be !re!ared by@
baking broiling roasting grilling
ste6ing
(ean beef :round loin cuts=
Pork :loin leg=
(a%b ,eal ,enison
+kinless turkey chicken or other ga%e
350455N fat free luncheon %eats
(o60fat hot dogs
Egg 6hites
$ish and shellfish
Tuna :!acked in 6ater=
#ee!0fat frying E !an frying %eats
High fat :%arbled= red %eats
Chicken E turkey 6ith skin
Hot dogs
'egular luncheon %eats
+ausage bacon +!a% canned %eats
Egg yolks :li%it to " !er 6eek=
DE%%E4% (o60fat2fat free fro-en yogurt
(o60fat2fat free ice crea%2ice %ilk
;ngel food cake
$at free !udding
Ice crea%
*ost baked goods
'egular !udding
F94% ? -I!%,
C-@DI$E@4%
#iet %argarine
(o60fat2nonfat crea% cheese
(o60fat2nonfat salad dressings
(o60fat2nonfat %ayonnaise
Butter or %argarine
'egular salad dressing
?on0dairy crea%er crea%
+our crea%
www.chkd.org/services/diabetes 20
(o60fat2nonfat sour crea%
(o60fat2nonfat cooking s!ray
*ayonnaise
Gra,y
Crea% or cheese sauces
7ils lard
%ic* Day Guidelines
If you are sick@
#rink 1 ounces calorie0free fluid e,ery hour 6hile a6ake to !re,ent dehydration :6ater diet
soda broth sugar0free <ool ;id=. $luids should be caffeine0free.
Increase freKuency of blood glucose %onitoring to e,ery 20& hours.
*onitor for ketones e,ery & hours.
'ecord your results fro% %onitoring.
>ou still %ay need to take your insulin and2or oral %edications e,en if you are not eating
but you %ay need to %ake a change in the a%ount that you are taking therefore you
should call your doctor.
E8tra doses of ra!id0 or short0acting insulin %ay be needed.
If you cannot eat because of nausea or cannot kee! food do6n and your blood sugar is less
than 415 %g2dl@
+i! on carbohydrate containing be,erages2soft foods to !re,ent hy!oglyce%ia :regular
soda Muices sou!s ice crea%=
;cce!table foods that contain 4) gra%s of carbohydrate@
H cu! :& o-= a!!le Muice
H cu! :& o-= regular soda
www.chkd.org/services/diabetes 21
4 cu! Gatorade
4 regular Po!sicle stick
) lifesa,ers candies
4 slice dry toast
. saltines
H cu! regular ice crea%
I cu! sherbet
I cu! regular !udding
H cu! regular Mello
When to call your doctor@
Ao%iting %ore than once
#iarrhea %ore than ) ti%es or %ore than . hours
#ifficulty breathing
Change in %ental status
2 consecuti,e blood sugars greater than "55%g2dl e,en after gi,ing e8tra insulin
*oderate or large urine ketones
If you e,er ha,e any Kuestions or concerns
%ources of Carbohydrate Aui#
Please fill in the chart by checking if the follo6ing foods are considered to be a carbohydrate
!rotein or fat or a co%bination. +o%e e8a%!les ha,e been done for you.
F--D !I%4 C9(-H+D94E P-4EI@ F94
;!!le
Hot dog 62 bun
Cheese
Butter
Baked beans
Pi--a
Baked !otato
Grilled chicken
Burger <ing Who!!er
(o6 fat %ilk
Corn
Peanut butter
'anch salad dressing
Peas
www.chkd.org/services/diabetes 22
$rench fries
Ice crea%
Po!corn
Garden salad
$rench salad dressing
Bean Burrito
;ns6ers on ne8t !age
%ources of Carbohydrate Aui# 09ns/er 8ey2
F--D !I%4 C9(-H+D94E P-4EI@ F94
;!!le
Hot dog 62 bun
Cheese
Butter
Baked beans
Pi--a
Baked !otato
Grilled chicken
Burger <ing Who!!er
(o6 fat %ilk
Corn
Peanut butter
'anch salad dressing
Peas
$rench fries
Ice crea%
www.chkd.org/services/diabetes 23
Po!corn
Garden salad
$rench salad dressing
Bean Burrito
$eal Planning Aui#
Here are so%e e8a%!le %eal !lans !lease fill in the acco%!anying carbohydrate counts@
Breakfast Carbohydrate gra%s
2 cu!s Cheerios UUUUUUUUUUUUUUUU
4 cu! :1 o-= %ilk UUUUUUUUUUUUUUUU
4 scra%bled egg UUUUUUUUUUUUUUUU
2 sausage links UUUUUUUUUUUUUUUU
H banana UUUUUUUUUUUUUUUU
4-49!BCCCC
(unch
4 turkey sand6ich UUUUUUUUUUUUUUUU
4 o- !otato chi!s UUUUUUUUUUUUUUUU
4 cu! :1 o-= %ilk UUUUUUUUUUUUUUUU
4 cu! carrot sticks UUUUUUUUUUUUUUUU
2 Tbs! ranch dressing UUUUUUUUUUUUUUUU
Crystal (ite UUUUUUUUUUUUUUUU
4-49!BCCCC
-
4 chicken sand6ich UUUUUUUUUUUUUUUU
4) $rench fries UUUUUUUUUUUUUUUU
H cu! a!!lesauce UUUUUUUUUUUUUUUU
4 cu! :1o-= %ilk UUUUUUUUUUUUUUUU
4-49!BCCCC
;fternoon +nack
4 s%all a!!le UUUUUUUUUUUUUUUU
www.chkd.org/services/diabetes 24
" !eanut butter crackers UUUUUUUUUUUUUUUU
4-49!BCCCC
#inner
4 cu! !asta UUUUUUUUUUUUUUUU
H cu! s!aghetti sauce UUUUUUUUUUUUUUUU
2 %eatballs UUUUUUUUUUUUUUUU
4 garlic breadstick UUUUUUUUUUUUUUUU
2 cu! salad :lettuce to%ato cucu%ber= UUUUUUUUUUUUUUUU
2 Tbs! $rench salad dressing UUUUUUUUUUUUUUUU
diet soda UUUUUUUUUUUUUUUU
4-49!BCCCC
Bedti%e +nack
H cu! :& o-= %ilk UUUUUUUUUUUUUUUU
H cu! che8 %i8 UUUUUUUUUUUUUUUU
4-49!BCCCC
;ns6ers on ne8t !age
$eal Planning Aui# 09ns/er 8ey2
Here are so%e e8a%!le %eal !lans 6ith acco%!anying carbohydrate counts@
Breakfast Carbohydrate gra%s
2 cu!s Cheerios &1
4 cu! :1 o-= %ilk 42
4 scra%bled egg 5
2 sausage links 5
H banana 4)
4-49!BD'
(unch
4 turkey sand6ich "5
4 o- !otato chi!s 4)
4 cu! :1 o-= %ilk 42
4 cu! carrot sticks )
2 Tbs! ranch dressing 5
Crystal (ite 5
4-49!BE7
-
4 chicken sand6ich "5
4) $rench fries 4)
H cu! a!!lesauce 4)
4 cu! :1o-= %ilk 42
4-49!BD7
;fternoon +nack
4 s%all a!!le 4)
www.chkd.org/services/diabetes 25
" !eanut butter crackers 4"
4-49!B7F
#inner
4 cu! !asta "5
H cu! s!aghetti sauce 4)
2 %eatballs 5
4 garlic breadstick 4)
2 cu! salad :lettuce to%ato cucu%ber= 45
2 Tbs! $rench salad dressing 1
diet soda 5
4-49!BDF
Bedti%e +nack
H cu! :& o-= %ilk .
H cu! che8 %i8 25
4-49!B7E
Your Carbohydrate Meal Plan
Breakfast __________grams carb
Snack __________ grams carb
Lunch __________ grams carb
Snack __________ grams carb
Dinner __________ grams carb
www.chkd.org/services/diabetes 26
Snack __________ grams carb
Your dietitian will provide you with an individualized carbohydrate meal plan that is specific to
your needs.
8eeping a Food Diary
?a%e@ UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU #r. UUUUUUUUUUUUUUUUUUUUU
#ate@ UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU
Please record e"erything that you eat or drink. Be as s!ecific as !ossible.
4ime,
$eal
(lood
%ugar
Insulin
Dose
Food,(e"erage Inta*e ?
9mount
9mount
of Carb
Comments
Breakfast
+nack
(unch
+nack
www.chkd.org/services/diabetes 27
#inner
+nack
7ther
Important Phone @umbers
CH8D $ain Phone @umber :/)/= ..10/555
Endocrine Department :/)/= ..10/2"/
#r. 'euben 'ohn
#r. *arta +atin0+%ith
#r. Eric Gyuricsko
'obin Crecink '? :/)/= ..101)/4
+!ecialty Progra%s Coordinator :Insurance ;uthori-ations=
Doctor on3call 0toll free2 :1..= 11"0311.
:e%ergencies E after0hours needs=
!ife 4hreatening Emergencies 344
(lood %ugar !ine :/)/= ..101.)&
(lood %ugar Fa< :/)/= ..10124)
Prescription efills :/)/= ..101/&/
Diabetes Center :/)/= ..101.53
www.chkd.org/services/diabetes 28
#ebi Warren
#e!art%ent +ecretary
Pa%ala +uter *+ '# C#E
#iabetes Progra% *anager
(i- 'iedel '# C#E
#ietitian2#iabetes Educator
'enee $ree%an '? C#E
#iabetes ?urse Educator
'uth Co%!o *+W
+ocial Worker
C9(-H+D94E C->@4I@G E%->CE%
General Information on Carbohydrate Counting5
The American Diabetes Association Complete Guide to Carb Counting
<ar%een <ulkarni and Ho!e Warsha6 666.diabetes.org
Carbohydrate Counting :2552=
International #iabetes Center Publishing 666.idc!ublishing.co%
Basic Carbohydrate Counting :255"=
Advanced Carbohydrate Counting :255"=
;%erican #ietetic ;ssociation 15501//04.55 E8t. )555
666.eatright.org or ;%erican #iabetes ;ssociation 15502"20./""
666.diabetes.org
Carbohydrate )alue of Foods Without @utrition !abels5
The Doctors Pocket Calorie, Fat Carbohydrate Counter :255)=
:;llan Borushek= 666.calorieking.co%
The Complete Book o! Food Counts :255"=
Corinne ?et-er #ell Publishing 666.a%a-on.co% and %aMor bookstores
Calories and Carbohydrates, 4)
th
Edition :255"=
Barbara <raus +ignet Publishing 666.a%a-on.co% and %aMor bookstores
The Diabetes Carbohydrate and Fat Gram Guide :2555=
(ea ;nn Hol-%eister ;%erican #iabetes ;ssociation 15502"20./"" or
666.#iabetes.org
Webs sites for carbohydrate counts5
666.calorieking.co% :click on food database=
666.nal.usda.go, :nutrition infor%ation for .555 basic foods= Go to
CPublications and #atabasesD. Click on C#atabasesD. Go do6n to
www.chkd.org/services/diabetes 29
CV+#; ?utrient #atabases for +tandard 'eferenceD. Go to
C$or *ore Infor%ationD. Then go to Cdo6nloadD if you choose to !rint.

Carbohydrate )alues for estaurant Foods5
E<tensions /eb site for Fast Foods
nutrition infor%ation for 4. fast food restaurants@
666.fcs.uga.edu2e8tension2nutU!ubs.!h!. Click on #inning 7ut.
Fast Food Web sites such as 666.%cdonalds.co% or 666.!i--ahut.co%
Guide to "ealthy #estaurants $ating, 2
nd
ed. Ho!e Warsha6
;%erican #iabetes ;ssociation0 15502"20./"" or 666.diabetes.org
%utrition in the Fast &ane ' The Fast Food Dinning Guide
:nutrition infor%ation for )& !o!ular chain restaurants=
$ranklin Publishing Inc. 1550."&0433" or 666.fastfoodfacts.co%
%oft/are for Personal Digital 9ssistants 0Palm Pilots2 for Carb Counts,Diabetes
$anagement
#iabetes Tracker0666.calorieking.co%
GlucoPilot diabetes %anage%ent soft6are0666.healthetech.co%
EP*anager fro% ;ni%as Cor!oration0666.ani%ascor!.co%
9DDI4I-@9! E%->CE% 4- HE!P +->
The ;%erican #iabetes ;ssociation The ;%erican #ietetic ;ssociation
?ational 7ffice 24. West Qackson Boule,ard
4/54 ?orth Beauregard +treet Chicago I( .5.5.
;le8andria A; 22"44 1550"..04.))
15502"20"&/2 666.eatright.org
666.diabetes.org
Children With #iabetes
666.children6ithdiabetes.co%
Take the (E;#0 $ounded by ?icole Qohnson *iss ;%erica of 4333
htt!@22666.diabeteslead.org
The Children 6ith #iabetes $oundation
htt!@22666.c6dfoundation.org2
The Qu,enile #iabetes 'esearch $oundation International
htt!@22666.Mdrf.org2
www.chkd.org/services/diabetes 30
#iabetes0<ids.org
htt!@22666.diabetes0kids.org2
www.chkd.org/services/diabetes 31