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What are carbohydrate exchanges in diabetes?

The truth about carbohydrates and diabetes

MYTH: If you live with diabetes, you can't eat sweets or sugar.

TRUTH: A food do not have to be sweet or sugary to raise your blood sugar.

Understanding carbohydrates and carbohydrate counting exchanges is important in diabetes.

We want to separate the myth from the truth. Carbohydrate counting exchanges can sound intimidating.  But, they are essential for good meal planning.

In this article, we’ll look at the role of carbohydrates in more detail. We'll look at portion sizing and how to exchange one carbohydrate for another.

What foods contain carbohydrates?

When you are thinking about how to lower blood sugar, look at your diet in a bit more detail. Anything with carbohydrates will affect your blood glucose. This can include white potatoes, pasta or bread1.

However, different foods may affect you differently. Why? Because eating protein, fat, or fiber along with your carbohydrates may lead to slower carbohydrate absorption.

This is why the fiber present in whole-grain foods helps. It can avoid a big spike in blood glucose. It’s also one of the ways you can lower blood sugar.

Including fat and protein in larger meals alongside carbohydrates is also helpful in avoiding a spike2.

Foods without carbohydrates!

There are many foods that do not contain carbohydrates that you can incorporate into your diet. Some foods that do not include carbohydrates are:

  • green and leafy vegetables,
  • meat and fish,
  • tofu,
  • cheeses,
  • eggs,
  • nuts
  • and fats3

When you consume foods that do not have carbohydrates, they do not need to be counted unless:

  • You’re eating extremely large quantities of the food.
  • The food is mixed with carbohydrates such as crumbs, sauces, and marinades, etc2.

There are other reasons to limit sugary foods in favor of other types of carbs. You'll feel much more satisfied after eating a small potato, for example, than a tablespoon of jam. Plus, you'll take in added fiber, vitamin C, and potassium your body needs.

Just remember, whether it's from milk, peas, apricots, or a biscuit, a carb doesn't have to be loaded with sugar to count.

What is carbohydrate exchange in diabetes?

Using the carbohydrate exchange system is grouping together foods with a similar amount of carbohydrates per serving. You can exchange foods out for one another without increasing the amount of carbohydrates consumed4.

Why is this important? Because carbohydrates are still an essential part of a diet. Understanding the amount of carbs in each food can help you plan meals better.

You can switch different types of food in and out as needed to ensure you have a balanced diet.

Try using an online carb counter or an app for carbohydrate exchange. This can be useful if you are not sure that you are fully accounting for your carbohydrate exchange.

Once you know the amount of carbohydrates in each serving, you can plan. You can easily replace food and create more balanced meals.

Carbohydrate exchange list.

Bear in mind that approximately 15 grams of carbohydrate = One carbohydrate exchange2,3.

This means that your meals can have up to 15 grams of carbohydrates. You can decide what that 15 grams is made up of based on the amount of carbohydrates per serving size4.

Here is a short list that includes just some of the foods you can use in your carbohydrate exchange.

  • 1 slice of bread or small chapati
  • 125g of pasta or couscous
  • 75g of cooked rice
  • 125g of lentils or pulses/dried beans
  • 1 small banana
  • 20 grapes
  • 250 ml of milk
  • 100g yogurt
  • 3 teaspoons of honey
  • 3 teaspoons of sugar
1 Diabetes Quebec (2018). Carbohydrates. Retrieved from: Accessed July 23 2021.
2 (n.d). What Factors Slow the Absorption of Carbohydrates?. Retrieved from: Accessed July 23 2021.
3 Queensland Health (2018). Understanding the carbohydrate portion. Retrieved from: Accessed July 23 2021.
4 University of San Francisco (n.d). Diabetes Education Online. Retrieved from: Accessed July 23 2021. 

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