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Carbohydrate exchange system
This method uses food groups called exchange groups. One exchange with carbohydrate has about 15 grams of
carbohydrate.
1 bread exchange
1 fruit exchange 1 milk exchange
15 grams carbohydrate 15 grams carbohydrate 12 to 15 grams carbohydrate
Foods with carbohydrates include:
• starches and starchy vegetables
• fruits and fruit juices
• milk and milk products
• sugars and foods with sugar
Facts on the nutrition labels on packaged food will help you to figure how much carbohydrate is in a certain food.
There are a number of paperback books that list the grams of carbohydrates in many foods. These books are very
helpful when you are eating foods without labels or are eating out. Also, if you know the exchange system, you can
count carbohydrate exchanges.
Your healthcare professional will give you an insulin to carbohydrate ratio at the start. This will be a place to begin.
It may need to be changed based on the results of your blood glucose readings after you eat.
Determining your meal bolus based on carbohydrate counting is not an exact science. Sometimes it takes trial and
error to come up with the correct meal bolus for certain foods. If you are not sure how some foods affect your blood
glucose, test your blood glucose 2 hours after eating. If your reading is too high or too low, adjust your meal bolus
the next time you make that food choice.
As you start to learn carbohydrate counting, try to assess the carbohydrates in the food you are eating. Then look
at the food labels to see how close you are.
Reading a food label
Use the Serving Size and Total Carbohydrates information on the food label to determine how many total grams of
carbohydrate you will be eating. Then, use the insulin to carbohydrate ratio prescribed by your healthcare
professional. This allows you to figure out how much insulin to take for the foods you eat.
The food label below shows 12 grams of carbohydrates for each 1 piece serving. If your carbohydrate ratio is 1 unit
of insulin for every 12 grams of carbohydrate, you would need 1 unit of insulin for each 1 piece serving of this food.
20 Introduction to pump therapy