Carb Counting With Type 2 Diabetes

More than 9%¹ of people in the US have type 2 diabetes. The condition is characterized by high blood sugar caused when your body doesn’t produce or use insulin correctly.

If left untreated, type 2 diabetes can lead to serious health problems like kidney and heart disease, vision loss, and an increased risk of stroke. Most people can manage the harmful effects of type 2 diabetes through diet and exercise. In some cases, they may also need medication to help keep their blood sugar levels in a healthy range.

If you have type 2 diabetes, carb counting can help you maintain healthy blood sugar levels. Doing so can help prevent or delay the development of complications. Learn more about how carbs affect your blood sugar levels, how to count them, and the best foods to add to a diabetes-friendly diet.

Understanding how carbs affect type 2 diabetes

The carbs you eat significantly impact your blood sugar levels. When you ingest carbohydrates, your body breaks them down into glucose (sugar). Glucose then enters your bloodstream, which raises your blood glucose levels.

In a non-diabetic person, insulin helps move glucose out of the bloodstream into the cells, where it’s used for energy.

When you have type 2 diabetes, you may be insulin resistant or unable to produce it sufficiently to remove glucose from your bloodstream. This keeps your blood sugar levels elevated, which can lead to serious health complications.

Limiting your carb intake can be helpful. By monitoring how many carbs you consume, you can avoid blood sugar spikes which put extra demand on your insulin supply. You may also be able to control your blood sugar levels and keep them in a healthy range more effectively.

Tracking carbs can also help you monitor how your diet impacts the effect of oral diabetes medications or insulin injections.

How do I count carbs for type 2 diabetes?

Carbohydrates can be simple or complex. Your body breaks down simple carbs like table sugar and baked goods quickly, which leads to blood sugar spikes.

Complex carbs take longer for your body to break down and help you feel fuller for longer. You should stick to complex carbs as much as possible.

There are three types of carbohydrates:

Sugar

These include natural sugars found in foods like milk and fruit, and added sugars found in processed foods and baked goods. Sugars can quickly raise blood glucose levels, and processed sugar should be consumed in strict moderation.

Starches

There are two types of starch carbohydrates based on their structure: amylose and amylopectin.

You’ll find starches in certain vegetables, such as potatoes, corn, and peas. You’ll also find starches in grains like wheat.

While you should eat plenty of vegetables and whole grains as part of a well-balanced diet, foods high in starches can also cause spikes in blood sugar, especially amylopectin. You should only eat these foods in moderation.

Fiber

Fiber is a type of carbohydrate your body doesn’t digest, but it still has high nutritional value. Fiber helps you feel full for longer, which may help you make healthier food choices and avoid too much snacking.

Foods high in fiber include beans, broccoli, avocados, and apples. Like starch, it can also be classified into two types: soluble and insoluble.

To count carbs, you should track how many grams of carbohydrates are in the foods you eat. You can do this for most foods by reading the product’s nutrition facts label. The label will list the total number of carbohydrate grams per serving, including all three carb types.

You should pay attention to your serving size when calculating how many grams of carbs you consume. For example, you will need to make an adjustment if the serving size for your favorite cereal is one cup on the nutrition label, but you eat a cup and a half.

If you are eating something that doesn’t have a nutrition label, such as an apple or whole grains, you can use the USDA’s FoodData Central database to look up the nutritional information.

The easiest way to track your carbs is to keep a food diary. You can do this in a notebook or by using an app on your smartphone.

How many carbs should I eat in a day if I have type 2 diabetes?

There is no fixed formula to determine how many carbs you should eat each day with type 2 diabetes. The amount differs from person to person and depends on several factors, including your activity level, your weight, and how your body responds to insulin.

Finding the right balance is important. Eating too many carbs can cause a blood sugar spike, while eating too few could cause your blood sugar to drop — a condition called hypoglycemia.

Tracking your blood sugar levels before and after meals can help your doctor determine the amount of carbs you should eat.

Some common recommendations include: 

• Moderate carb diets, where 26–44% of your daily calorie intake comes from carbs

• Low-carb diets, where less than 26% of your daily calorie intake come from carbs

• Very low-carb or ketogenic diet, where less than 10% of your daily calorie intake comes from carbs

Health professionals usually recommend a low-carb diet to help manage type 2 diabetes. Low-carb diets have been shown to improve blood sugar control and decrease the need for medication. Some people who stick to a low-carb diet experience diabetes remission.

Depending on your doctor’s advice, you can determine the amount of carbs to eat each day based on how many calories you typically consume.

For example, if you usually eat around 2,000 calories a day and your doctor recommends sticking to a low-carb diet, fewer than 520 calories a day should come from carbs. One gram of carbs contains four calories, so you can consume 130 grams of carbs per day.

Foods to eat and avoid

You should consume a healthy, well-balanced diet focused on whole foods.

Your diet should include:

• Lean meats (including fish, chicken, turkey, and some pork cuts)

• Complex carbohydrates (vegetables and beans)

• Whole grains (found in brown rice, oatmeal, and popcorn)

Try to avoid processed foods like baked goods, crackers, pasta, chips, soda, and alcoholic beverages, as these often contain added sugar. Use the nutrition label to find out if there is added sugar.

If you are struggling to control your blood sugar levels by making changes to your diet, or if you feel you need additional support in managing your type 2 diabetes, ask your doctor to refer you to a dietician.

The lowdown

Type 2 diabetes is a health condition characterized by high blood sugar levels. It can lead to serious complications if left untreated.

One of the best ways to manage type 2 diabetes is by making dietary changes, including limiting the amount of carbohydrates you consume each day. Your body breaks down carbs and turns them into glucose which raises your blood sugar levels.

Following a low-carb diet is usually recommended to people with type 2 diabetes, where carb consumption is limited to 26% of your daily calorie intake. This means consuming less than 130 grams of carbs per day if you typically eat 2,000 calories. 

Try to eat complex carbs which take longer to break down, versus simple carbs like those found in table sugar and baked goods. Eating a well-balanced, nutritious diet rich in lean meats, whole grains, fruits, and vegetables is a good place to start.

If you are struggling to manage your blood sugar through dietary changes or want additional support, working with a registered dietician may help.