carb counting for diabetics
Ask the dietician: Genevieve Jardine
From our community: “My average blood sugar over the past few months was higher than it should have been, so I’m trying really hard not to eat the wrong foods. Any tips for healthy snacks?” Lynnae Daniel
Getting creative with your snacks can really help make your daily meal plan more exciting. We all get into a rut with our meal choices, and adding different (healthy) snacks can improve variety, colour, flavour and even add valuable nutrients to your daily intake.
Not every person with diabetes needs to snack. Some people are happy with three square meals a day, while others prefer small snacks throughout the day. Your unique eating style largely depends on your own natural eating patterns, medication, blood sugar control, and how active you are.
Remember: If you go for more than 4 or 5 hours between meals you may need to snack in order to prevent your blood sugar from dropping too low. But snacking on the wrong kind of food can cause blood sugar levels to rise and also cause unwanted weight gain.
So what does a healthy snack look like?
- A snack should be between 300 to 600 kilojoules otherwise it is more like a meal.
- Snacking is a good chance to increase your vegetable or fruit intake (remember, the aim is 5 servings of vegetables a day).
- Plate your snack to help control portion size: don’t eat straight out of a bag, box or packet – or straight from the fridge!
- Portion your snacks into snack-size packets, or buy suitable snack portions.
Ask yourself: are you actually hungry? Don’t snack because you’re bored, stressed or worried.
Healthy snack ideas:
- One piece of fruit (carb 15g, fat 0g, 300kj)
- 100ml low-fat flavoured yogurt (carb 16g, fat 2g, 400kj)
- 2 cups popped popcorn sprinkled with fat-free parmesan cheese (carb 15g, fat 7g, 636kj)
- 30g lean biltong (carb 0.7 g, fat 2g, 346kj)
- 3 Provitas or 2 Ryvitas with cottage cheese, tomato and gherkin (carb 20g, fat 2g, 382kj)
- ½ an apple with 20g sliced low-fat cheese (carb 8g, fat 5g, 430kj)
- Raw veggies (carrot sticks, cucumber, baby tomatoes, gherkins, baby corn, snap peas) with cottage cheese, hummus or avocado dip (carb 8g, fat 7g, 540kj)
- 30g nuts/seeds (carb 3g, fat 14g, 735kj)
Tip: Nuts and seeds are high in fat and kilojoules. However, the type of fat is much healthier than that found in a chocolate bar.
Unhealthy snack choices:
- 50g bar of chocolate (carb 30g, fat 12g and 1120kj)
- 30g packet of potato crisps (carb 24g, fat 12g, 766kj)
- 300ml bottle of drinking yoghurt (carb 45g, fat 5.6g, 1140kj)
- 25g packet of sweets (carb 18g, fat 0g, 316kj)
Tip: It might seem like this snack is within the recommended carb, fat and kilojoule allowance, but they are empty kilojoules with no fibre and very little vitamins and minerals.
Snacking for exercise:
Remember that exercise can also cause low blood glucose. It is important to check blood glucose before and after you exercise. People react differently to exercise depending on the type, duration and intensity: some people see a rapid drop and others an increase in blood sugar levels, so it is important to test and see what your individual response is.
As always, you should see a dietician to help you plan suitable snacks for different situations. Fresh snack ideas can bring a sense of fun into your daily eating plan.
In issue 10 of Sweet Life magazine, we give some great blood sugar testing tips… Here are some more tips to bear in mind from Diabetes Nurse Educator Kate Bristow:
- Your blood sugar test is your day to day monitor – use it to test and understand your diabetes and the way it affects your body. Different people react differently to foods, illness and stress. Testing helps you understand how you as an individual deal with different situations.
- When pricking your finger, the sides of the fingers towards the tip are less sensitive than the middle pad of the tip of the finger.
- If you are on a long acting and rapid acting insulin (i.e. 4 injections a day) it is better to adjust your rapid acting insulin that is given with meals, according to the carbohydrates on your plate. This is called carbohydrate counting and your dietician can teach you how to do it. It gives you better accuracy and less risk of lows and highs in your blood sugar provided you are doing it right.
- Diabetes Educators and some doctors can download blood sugar meters on to their computers giving an accurate pattern for interpretation. Of course this is only as good as the number of tests done. For example, if one is only testing at the same time every day we are not going to get as much information as someone who is testing before and 2 hours after every meal. Again your educator can help with a testing schedule which fits in with your lifestyle and is not too arduous.
Do you have any questions about blood sugar testing?
If you’re trying to find a way to put together healthy lunchboxes and snacks that still taste great, check out these great tips from Novo Nordisk:
Keeping tabs on children of any age can be a challenge, but keeping tabs on a child living with diabetes adds on to that challenge. One of the top priorities for parents of children with diabetes is to manage the condition from an early age, so that their children can lead normal, healthy lives. The treatment regime includes making sure they have a healthy diet based on foods with a low GI (Glycaemic Index); foods that digest slowly and therefore don’t play havoc with the body’s blood glucose levels. This can be enough of a challenge at home, but what about the times when children are out of the home – at school, parties or sports events?
The trick is to make carb counting for lunchboxes and snacks easy, so that it becomes a simple routine rather than a complicated chore. But counting carbs, as anyone who’s been on a carbohydrate-restricted diet will know, can be difficult – and frustrating. And who has time in the mornings to figure out whether the lunchbox they’re preparing is ‘carb-safe’ for their child?
Luckily, there are some easy techniques to use for counting carbs, and these can be really useful for busy Moms and Dads.
“The first thing is to make a list of the foods that are high in carbohydrates and to paste this onto the door of the fridge as an easy go-to reminder,” says Shelley Harris, Public Relations Manager of Novo Nordisk (SA), local division of the world’s leading diabetes healthcare company. These include fruits and starchy vegetables like potatoes and corn; foods made from refined grains like bread, crackers and pasta; and sugar or foods sweetened with sugar.
“Do this with a column next to each item to record the carbohydrate count, so that you don’t have to do it from scratch every day,” says Harris.
“If you’re packing in something like low-fat sweetened yoghurt, for instance, it’s easy to check the total carbohydrate content on the label, which includes the measure of both sugars and starches. Do that and then write it down on your checklist for easy reference.”
Another technique is to allocate average carbohydrate counts to common foods like bread and apples.
“An apple, a slice of bread or a cup of skim milk all contain around 15g of carbohydrates, so it’s easy to do quick calculations based on what the American Dietetic Association refers to as ‘food exchange groups’. The term means that foods with a standardised carb count are interchangeable, and that the total carb content of a lunchbox can be quickly calculated in this way.
For children on insulin, this methodology makes it easy for parents to calculate the insulin-to-carbohydrate ratio that determines the amount of insulin they need to take before each meal, making allowances for variables like levels of activity and individual responses to certain foods.
With over 6.5 million South Africans living with diabetes, and with approximately 45% of all new cases of Type 2 diabetes being diagnosed in children, as stated by the IDF the Diabetes Atlas and the American Diabetes Association, easy-to-use, time-saving methods like these can be invaluable to parents.
The other side of the coin, of course, is to make lunches and snacks interesting by varying the contents from day to day, and by focusing on foods that kids enjoy. A nutritious and satisfying lunch could, for instance, include a sandwich made from whole grain bread, a homemade treat like a low-fat choc chip cookie, a portion of fresh fruit, a few veggie sticks and some low-fat milk or bottled water.”
“Carb counting for children with diabetes needn’t be difficult,” concludes Harris, “and lunches don’t have to be boring. All it takes to put together a healthy, appetising lunchbox every day is a bit of forward planning and a good dose of imagination. And voila! A healthy, happy child – every day.”