Diabetics have many diet options for controlling blood glucose levels and maintaining overall health. The three main systems are carbohydrate counting, the exchange system and a glycemic index-based eating plan. While all of these approaches can work to help mitigate the effects of food on blood glucose, understanding the differences between these plans can help you choose which one will fit your lifestyle and diet goals best.
Carbohydrate Counting
Carbohydrate counting involves eating the same amount of carbohydrates at the same times every day to keep blood glucose from fluctuating. If you are counting carbohydrates, you will need to work with a doctor or dietitian to determine the precise amount of carbohydrates you need over the course of the entire day and how to spread these out among meals and snacks. Once you know your carbohydrate limit, you will measure and weigh all of your foods with a food scale that shows grams and calculate the amount of carbohydrates in each food item before eating it. Because you know exactly how many carbohydrates you are consuming at a given time, your doctor can use this information to help you plan exactly how much insulin you will need to take and when in the day you need to take it.
Exchange System
In the exchange system, a diabetic chooses foods based on pre-assigned categories. A doctor or dietitian can provide you with a list of foods that are equivalent in calorie, carbohydrate, fat and protein content and you can choose from this list whenever you plan a meal. Each of these foods is called an exchange. Your dietitian will assign you a specific number of servings, or exchanges, from each group. This approach is particularly useful for overweight diabetics who want to count calories in addition to controlling their blood glucose because calorie counts are the same among foods in each exchange group.
Glycemic Index
The glycemic index approach to a diabetic diet takes into account the rise in blood glucose caused by different types and amounts of carbohydrates. Foods with a high glycemic index cause a fast, high rise in blood glucose, while foods with a low glycemic index cause a slow, small rise in blood glucose. If you use the glycemic index for diabetes control, you will mainly choose carbohydrates with a low glycemic index, such as beans, whole-grain breads and most vegetables. You will avoid carbohydrates with a low glycemic index, such as white bread, potatoes and white rice. Because meats and fats contain little to no carbohydrates, they do not appear on the glycemic index and can be eaten without restriction on a glycemic index diet.
Considerations
Some diabetics fine-tune their diet by using two different systems together or by using different systems in different circumstances. For example, you may use carbohydrate counting when at home, but use an exchange system when you are traveling or out at a restaurant and can't measure the portions you eat. Another way of combining systems is to use either the exchange or carbohydrate counting method and choosing low glycemic foods from your list of options.
