Carbohydrate Counting in the Hospital
Carbohydrate counting is a method of meal planning used to help control your blood sugar levels. The total grams of carbohydrate you eat for a meal will determine the insulin you receive. Having the right balance will keep your blood sugars in goal range.
Foods that have carbohydrates (“carbs”):
• Grain products such as breads, rice, pasta, cereals
• Legumes such as kidney beans, split peas, lentils
• Starchy vegetables such as potatoes, sweet potatoes, corn, green peas, and winter squash
• Fruit and fruit juices
• Milk and yogurt
• Items that use refined sugar such as regular soda, corn syrup, jelly, candies, sweets and desserts.
Your calorie needs are based on your height, weight, and activity level. The American Diabetes Association suggests eating at least 130 grams of carbohydrate per day.
The diabetes meal plan at UW Hospital includes 45-60 grams of carbohydrate at each meal for women and 60-75 grams for men.
Carbohydrates Effect on Blood Sugar Levels
• Carbohydrate, when compared to protein and fat, has the greatest effect on blood sugar levels.
• 90-100% of carbohydrate enters the blood stream as sugar 20-90 minutes after eating.
• As a general rule, 1 gram of carbohydrate raises blood sugar levels 3-4 mg/dL.
STEP 1: To begin, you have to know how much insulin is needed to cover the amount of carbs you eat. This is called the insulin-to-carbohydrate ratio (ICR). Your health care team will decide which ratio is best for you.
Your ICR: 1 unit insulin for every _____ grams of carbohydrate.
STEP 2: Order your meal. To help you figure out how many carbs are in your meals, use the carbohydrate counting guide that will be given to you. Your nurse, dietitian and food service staff can help you as needed. Your meal tray will arrive with a tray ticket that shows the total carbs for the meal you ordered. The meal ticket below is a sample of what you will see on your meal tray.
|1 Grilled Chix Sandwich Each (Carb 36 gm)|
|1 Lettuce Leaf for Hot Sandwich|
|1 Sliced Tomato for Hot Sandwich (Carb 1 gm)|
1 FF Mayonaise 1 pkt (Carb 2 gm)
1 Mustard Each
1 Ranch FF Dressing Each (Carb 4 gm)
1 Creamer Each
1 Splenda Each (Carb 1 gm)
1 Tossed Salad Each (Carb 4 gm)
1 Apple Each (Carb 28 gm)
1 Regular Coffee 6 oz
Diet Order: DMM Current Meal: (76 gm)
Delivery Time: Clerk:yhz
Print Date/Time: 10/2/2012 10:23
STEP 3: Call your nurse after you finish eating. We will count up the total grams of carbohydrates you ate. Your nurse will then give you your insulin.
If you have any questions, let your nurse know. If you would like to do carbohydrate counting at home, please let us know.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 11/30/2012
Copyright © 11/27/2012 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#527
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