Gestational diabetes: Counting carbs

Carbohydrate counting is the best way to control your blood sugar when you have gestational diabetes. Carbohydrate counting involves adding up the amount of carbohydrate in the foods you eat each day and spreading carbohydrate out throughout the day.

Carbohydrate includes fruits and sweet vegetables; milk and milk products; starches (breads, cereals, rice, pasta, and vegetables such as potatoes and corn); and sugar (such as candy and desserts). All forms of carbohydrate increase your blood sugar.

• Sugary foods such as cakes and cookies have more total carbohydrate in a serving, or standard portion, than starchy foods such as bread.
• You can eat foods that contain sugar when you have gestational diabetes. But eating too many sugary foods probably means you are not eating enough healthy foods.

Test Your Knowledge

1. Carbohydrate counting helps me know how much carbohydrate I am eating during a meal.

   1. True

      This answer is correct.

      Carbohydrate counting does help you know how much carbohydrate you are eating during a meal. Carbohydrate is the nutrient that most affects your blood sugar. Counting carbohydrate allows you to spread the amount you eat throughout the day. This prevents high blood sugar after meals.

   2. False

      This answer is incorrect.

      Carbohydrate counting does help you know how much carbohydrate you are eating during a meal. Carbohydrate is the nutrient that most affects your blood sugar. Counting carbohydrate allows you to spread the amount you eat throughout the day. This prevents high blood sugar after meals.

2. Which of the following foods contain carbohydrate?

   1. Wheat bread, rice, peas, and oatmeal

      This answer is correct.

      Wheat bread, rice, peas, and oatmeal all contain carbohydrate. Carbohydrate is an essential nutrient that comes in two forms: starch and sugar. Starch is found in foods such as bread, cereal, grains, and vegetables. Sugar is found in fruit, milk, desserts, and candy. Both answers to this question are correct.

   2. Cheesecake, fat-free milk, and pears

      This answer is correct.

      Cheesecake, fat-free milk, and pears all contain sugar, a form of carbohydrate. Carbohydrate is an essential nutrient that comes in two forms: starch and sugar. Starch is found in foods such as bread, cereal, grains, and vegetables. Sugar is found in fruit, milk, desserts, and candy. Both answers to this question are correct.

Counting carbohydrate helps you know how much carbohydrate you are eating during a meal. The more carbohydrate you eat at one time, the higher your blood sugar level rises. Carbohydrate counting helps if:

• You don't take insulin. Counting carbohydrate helps you know how much carbohydrate you need to eat during each meal to prevent high blood sugar.
• You take insulin before meals, and your doctor wants to adjust the amount you take according to the amount of carbohydrate in the meal. (Often, doctors suggest that a pregnant woman take 1 unit of fast-acting insulin for every 10 grams of carbohydrate she plans to eat.)

Eating a certain amount of carbohydrate and spreading it throughout the day will help keep your blood sugar levels within a safe range and prevent a blood sugar emergency. High blood sugar can increase the risk of problems with your health or your baby's health.

Test Your Knowledge

1. Counting carbohydrate helps me regulate the amount of carbohydrate I eat to prevent harm to my baby from high blood sugar.

   1. True

      This answer is correct.

      Counting carbohydrate does help you regulate the amount of carbohydrate you eat to prevent harm to your baby from high blood sugar. The more carbohydrate you eat at one meal, the higher your blood sugar will rise after the meal. High blood sugar can lead to an emergency and can also harm your baby.

   2. False

      This answer is incorrect.

      Counting carbohydrate does help you regulate the amount of carbohydrate you eat to prevent harm to your baby from high blood sugar. The more carbohydrate you eat at one meal, the higher your blood sugar will rise after the meal. High blood sugar can lead to an emergency and can also harm your baby.

Here are some ways to help you count carbohydrate and spread carbohydrate throughout the day.

Eat regularly

Eat at least three meals a day to spread your intake of food, especially carbohydrate, throughout the day.

It is a great idea to get out your cookbooks and plan several main meals at the same time. You can double some recipes and freeze the leftovers to use for other meals. Try making a list of menus to post on your refrigerator using the menu ideas form (What is a PDF document?) .

Count carbohydrate

The following suggestions can help you count carbohydrate and control your blood sugar:

• Talk with a registered dietitian to help plan the amount of carbohydrate to include in each meal and snack.
• Get a book that lists the carbohydrate content in different foods.
• Eat standard portions of carbohydrate foods. Each serving size or standard portion contains about 15 grams of carbohydrate. You don't have to weigh and measure your food, though that may be helpful when you are first learning what makes up a standard portion.
• Count either grams or servings of carbohydrate. If you are having high blood sugar levels after breakfast, you may want to eliminate or decrease the amount of carbohydrate in that meal.
• Eat standard portions of foods that contain protein. Talk with a registered dietitian about how much protein you need.
• Talk with a registered dietitian about how much fat you need.

Other suggestions

• Read food labels for the carbohydrate content, and check the serving size on the package.
• Check your blood sugar level 1 hour after eating the first bite of each meal to see how the food affects it.
• Record what you eat and your blood sugar results in a food record. At each regular visit with your diabetes specialist, or whenever you think your meal plan needs adjusting, you can review the food record (What is a PDF document?) .
• Get more help. The American Diabetes Association offers booklets to help people learn how to count carbohydrate, measure and weigh food, and read food labels.

Test Your Knowledge

1. Calculate the carbohydrate content in the following breakfast. Use the information in carbohydrate foods and foods that contain protein to calculate the carbohydrate. The breakfast includes 2 eggs, 1 cup of milk, 1 slice of toast, and 2 teaspoons of margarine.

   1. 30 grams of carbohydrate

      This answer is correct.

      This breakfast contains 30 grams of carbohydrate. There are no carbohydrate in the eggs, 15 in the milk, 15 in the toast, and none in the margarine. If you had problems with this exercise, take the question with you on your next visit with your doctor or dietitian and ask him or her to help you learn how to calculate the carbohydrate content in food.

   2. 35 grams of carbohydrate

      This answer is incorrect.

      The breakfast (2 eggs, 1 cup of milk, 1 slice of toast, and 2 teaspoons of margarine) contains fewer than 35 grams of carbohydrate. The correct answer is a. It contains 30 grams of carbohydrate. There are no carbohydrate in the eggs, 15 in the milk, 15 in the toast, and none in the margarine. If you had problems with this exercise, take the question with you on your next visit with your doctor or dietitian and ask him or her to help you learn how to calculate the carbohydrate content in food.

   3. 22 grams of carbohydrate

      This answer is incorrect.

      The breakfast (2 eggs, 1 cup of milk, 1 slice of toast, and 2 teaspoons of margarine) contains more than 22 grams of carbohydrate. The correct answer is a. It contains 30 grams of carbohydrate. There are no carbohydrate in the eggs, 15 in the milk, 15 in the toast, and none in the margarine. If you had problems with this exercise, take the question with you on your next visit with your doctor or dietitian and ask him or her to help you learn how to calculate the carbohydrate content in food.

2. Calculate the carbohydrate content in the following lunch. Use the information in carbohydrate foods and foods that contain protein to calculate the carbohydrate. The lunch includes 1 cup of macaroni, ½ cup of grated cheese, ½ cup of carrots, and one fresh apple.

   1. 70 grams of carbohydrate

      This answer is incorrect.

      This lunch (1 cup of macaroni, ½ cup of grated cheese, ½ cup of carrots, one fresh apple) has fewer than 70 grams of carbohydrate. The correct answer is d. It contains 65 grams of carbohydrate. There are 45 grams of carbohydrate in 1 cup of macaroni, none in the grated cheese, 5 in ½ cup of carrots, and 15 in one fresh apple. This much carbohydrate in your meal is likely to raise your sugar level a lot. If you had problems with this exercise, take the question with you on your next visit with your doctor or dietitian and ask him or her to help you learn how to calculate the carbohydrate content in food.

   2. 40 grams of carbohydrate

      This answer is incorrect.

      This lunch (1 cup of macaroni, ½ cup of grated cheese, ½ cup of carrots, one fresh apple) has more than 40 grams of carbohydrate. The correct answer is d. It contains 65 grams of carbohydrate. There are 45 grams of carbohydrate in 1 cup of macaroni, none in the grated cheese, 5 in ½ cup of carrots, and 15 in one fresh apple. This much carbohydrate in your meal is likely to raise your sugar level a lot. If you had problems with this exercise, take the question with you on your next visit with your doctor or dietitian and ask him or her to help you learn how to calculate the carbohydrate content in food.

   3. 65 grams of carbohydrate

      This answer is correct.

      Yes, this lunch (1 cup of macaroni, ½ cup of grated cheese, ½ cup of carrots, one fresh apple) contains 65 grams of carbohydrate. There are 45 grams of carbohydrate in 1 cup of macaroni, none in the grated cheese, 5 in ½ cup of carrots, and 15 in one fresh apple. This much carbohydrate in your meal is likely to raise your sugar level a lot. If you had problems with this exercise, take the question with you on your next visit with your doctor or dietitian and ask him or her to help you learn how to calculate the carbohydrate content in food.

Now that you have read this information, you are ready to calculate the amount of carbohydrate you are eating.

Talk with your doctor, registered dietitian, or certified diabetes educator

If you have questions about this information, take it with you when you visit your doctor. If you need help with carbohydrate counting or menu planning, talk with a registered dietitian. If you have been keeping a diet record, take it with you when you visit your doctor or dietitian.