What's carbohydrate counting and should my dad do it?

A fellow caregiver asked...

My father, recently diagnosed with type 2 diabetes, is beginning to make changes in his diet. What's carbohydrate counting and could it be helpful for my dad?

Expert Answer

Theresa Garnero is clinical nurse manager of Diabetes Services at California Pacific Medical Center in San Francisco.

Carbohydrate counting is a method of meal planning based on estimating how many carbohydrates, measured in grams, are in a food. Carbohydrates include sugar, foods high in starch such as potatoes and pasta, and fiber-filled foods such as grain-based breads and cereals. Carbs are also found in fruits, vegetables, dairy products, and many beverages. These nutrients are a major energy source for the body and have the greatest impact on raising blood glucose of any food group.

People with type 1 diabetes use carbohydrate counting to figure out how much insulin they need to take. For people with type 2 diabetes like your dad, counting carbs may be helpful in making certain his diet stays balanced, but it's something he should discuss with his doctor or diabetes educator before attempting on his own.

That said, it's a great way to analyze blood sugar patterns, because it helps your dad understand the effect different foods have on his blood glucose level. On a practical level, here's how it works: Your dad will discover, say, that a typical cheese sandwich has 30 grams of carbs, whereas a 6-inch sub sandwich may have 45 grams of carbs, so maybe he'll opt for the simple cheese sandwich. Or when he's eating spaghetti and meatballs, he'll learn to factor in that one cup of pasta equals 45 grams of carbs.

I recommend carb counting to anyone who has diabetes, but not everyone is able to do it. Whether or not it's a worthwhile practice for your father depends on a few factors. If he's fairly uninformed about the nutritional content of food, perhaps because he's never paid much attention to what he eats, and his idea of a good meal is a TV dinner, then introducing this somewhat complex concept may be beyond his abilities right now.

On the other hand, if your dad is the kind of person who's very detail oriented, he may quickly and easily incorporate carb counting into his diabetes treatment plan, and it would likely be beneficial for him. His doctor can probably give him a guide that lists carb counts for thousands of foods, or he can easily buy one. I use a pocket-sized guide called the "CalorieKing Calorie, Fat & Carbohydrate Counter." Compiled by a dietician and health educator, this handy tool can be [link}ordered online[LINK http://www.calorieking.com/shop/item.php?product_id=11].

Carbohydrate counts can be found on the nutrition facts labels of most packaged foods. If your father wants to learn more about the benefits of carbohydrate counting and whether it could help, bring it up next time you and he meet with his diabetes educator or dietician.