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 Diabetes &
Carb Counting
2nd Edition

by Sherri Shafer, RD, CDCES

Diabetes & Carb Counting For Dummies®, 2nd Edition
Published by: John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030-5774, www.wiley.com

Copyright © 2024 by John Wiley & Sons, Inc. All rights reserved, including rights for text and data mining and
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Library of Congress Control Number: 2024941176

ISBN 978-1-394-26557-2 (pbk); ISBN 978-1-394-26559-6 (ebk); ISBN 978-1-394-26558-9 (ebk)

Contents at a Glance
Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Part 1: Getting Started with Carb Counting and

Diabetes Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
CHAPTER 1: Delving into Diabetes and Carb Counting . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
CHAPTER 2: Exploring the Diabetes-Carb Connection. . . . . . . . . . . . . . . . . . . . . . . . . . . 25
CHAPTER 3: Calling All Carbs: Recognizing Carbs in the Foods You Eat . . . . . . . . . . . . 41
CHAPTER 4: Tracking Carbs through the Body . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
CHAPTER 5: Finding Your Sweet Spot: The Right Amount of Carbs for You. . . . . . . . . 73
CHAPTER 6: Timing Your Carb Consumption. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85

Part 2: Carb Counting: From Basic to Advanced. . . . . . . . . . . . 105

CHAPTER 7: Reading and Deciphering Food Labels. . . . . . . . . . . . . . . . . . . . . . . . . . . 107
CHAPTER 8: Mastering Carb Counting and Portioning Fundamentals . . . . . . . . . . . 129
CHAPTER 9: Adding Tools for Carb-Counting Ease and Accuracy. . . . . . . . . . . . . . . . 149

Part 3: Going Beyond Counting Carbs. . . . . . . . . . . . . . . . . . . . . . . . 155

CHAPTER 10: Accounting for Variations in Digestion and Absorption Rates . . . . . . . 157
CHAPTER 11: Rethink That Drink . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171

CHAPTER 12: Let Me Call You Sweetie: Sugars and Substitutes. . . . . . . . . . . . . . . . . . 191

Part 4: Embracing Whole Health and Happiness. . . . . . . . . . . 207

CHAPTER 13: Eating for Health and Happiness. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209
CHAPTER 14: Reaping the Rewards of Fitness. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225
CHAPTER 15: Getting a Handle on Hypoglycemia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 249
CHAPTER 16: Keeping the Beat with a Healthy Heart. . . . . . . . . . . . . . . . . . . . . . . . . . . 273
CHAPTER 17: Living with Diabetes throughout the Life Cycle. . . . . . . . . . . . . . . . . . . . 291
CHAPTER 18: Going Gluten-Free: Does the Batter Matter?. . . . . . . . . . . . . . . . . . . . . . 309

Part 5: Sampling Menus Complete with Carb Counts. . . . . 323

CHAPTER 19: Beginning with Breakfast Menus. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 325
CHAPTER 20: Looking for Lunch Menus. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 331
CHAPTER 21: Delving into Dinner Menus. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 339
CHAPTER 22: Surveying Snack Ideas. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 347
Part 6: The Part of Tens. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 355
CHAPTER 23: Ten Tips for Monitoring Your Blood Glucose. . . . . . . . . . . . . . . . . . . . . . 357
CHAPTER 24: Ten Tips for Controlling Carbs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 367
CHAPTER 25: Ten Worthwhile Websites to Help You Manage Diabetes. . . . . . . . . . . 375
CHAPTER 26: Ten Things to Add to Your Healthcare Checklist. . . . . . . . . . . . . . . . . . . 381

Part 7: Appendixes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 389

APPENDIX A: Exchange Lists. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 391
APPENDIX B: Conversion Guide. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 405

Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 407
Table of Contents
INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
About This Book. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Foolish Assumptions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Icons Used in This Book. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Beyond the Book. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Where to Go from Here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

PART 1: GETTING STARTED WITH CARB COUNTING

AND DIABETES MANAGEMENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
CHAPTER 1: Delving into Diabetes and Carb Counting. . . . . . . . . . . . . 7
Getting Up to Speed on Diabetes Basics . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Checking out concerning trends in the diabetes epidemic. . . . . . . . 8
Improving outcomes and preventing complications. . . . . . . . . . . . . 8
Building your diabetes team . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Staying up to date with advances in diabetes care . . . . . . . . . . . . . 10
Examining the Carb-Glucose Connection . . . . . . . . . . . . . . . . . . . . . . . . 11
Getting Acquainted with Carbs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Introducing the so-called simple carbs . . . . . . . . . . . . . . . . . . . . . . . 13
Catching up on complex carbs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Noting the nutrition in carb food groups. . . . . . . . . . . . . . . . . . . . . . 13
Acknowledging that staying healthy isn’t just about carbs. . . . . . . 14
Making the Case for Carb Counting: To Count or Not to Count?. . . . . 15
Counting carbs with type 1 diabetes: An essential tool. . . . . . . . . . 15
Gaining tighter control over blood-glucose levels with
type 2 diabetes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Sticking with consistent carb counts when you’re on
set insulin doses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Managing weight with carb counting and portion precision . . . . . 17
Regulating Carb Intakes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Figuring out how much carb you need. . . . . . . . . . . . . . . . . . . . . . . .18
Timing your carb intake . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Counting Carbs Successfully . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Looking at the label lingo. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Gathering carb-counting resources . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Increasing carb-counting accuracy. . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Living Well with Diabetes: The Seven Pillars of Diabetes
Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Eating a healthy diet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Staying fit with exercise . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Taking your medication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

Table of Contents v
 Monitoring your blood-glucose levels . . . . . . . . . . . . . . . . . . . . . . . . 22
Managing stress. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Learning how to problem-solve . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Reducing risk with healthy behaviors and regular
medical checkups . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

CHAPTER 2: Exploring the Diabetes-Carb Connection. . . . . . . . . . . . . 25

Wrapping Your Brain around Diabetes and Related Conditions . . . . . 26
Seeing how the body is supposed to process carbs. . . . . . . . . . . . .26
Discovering what causes diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Noticing the symptoms of diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Distinguishing the types of diabetes . . . . . . . . . . . . . . . . . . . . . . . . . 29
Recognizing Diabetes Risk Factors and Getting Diagnosed . . . . . . . . . 32
Type 1 diabetes risk factors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Type 2 diabetes risk factors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Diagnosing diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Moving Forward with Managing Diabetes. . . . . . . . . . . . . . . . . . . . . . . . 37
Knowing that diet matters. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Keeping in touch with your diabetes team . . . . . . . . . . . . . . . . . . . . 38
Embracing your central role in your own self-care. . . . . . . . . . . . . .38

CHAPTER 3: Calling All Carbs: Recognizing Carbs in the

Foods You Eat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
Looking at the Chemical Structure of Carbohydrates . . . . . . . . . . . . . . 42
Introducing the So-Called Simple Carbohydrates. . . . . . . . . . . . . . . . . . 44
Going au naturel with glucose, fructose, and lactose . . . . . . . . . . . 45
Finding other forms of sugar: Sucrose, maltose, honey,
and syrups . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
Spotting simple carbs in the grocery aisles. . . . . . . . . . . . . . . . . . . . 47
Checking Out the Complex Carbohydrates. . . . . . . . . . . . . . . . . . . . . . . 47
Identifying the starches . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Focusing on fiber and its many health benefits . . . . . . . . . . . . . . . . 48
Spotting complex carbs in the grocery aisles . . . . . . . . . . . . . . . . . . 51
Recognizing Carb-Free Counterparts. . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
Pumping up with proteins: Meat, poultry, fish, and
other sources. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
Finding the healthiest fats and oils. . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Exploring the role of noncarb foods in diabetes management . . . 54

CHAPTER 4: Tracking Carbs through the Body. . . . . . . . . . . . . . . . . . . . . 57

Filling Your Tank and Fueling Your Cells . . . . . . . . . . . . . . . . . . . . . . . . . 58
Settling in your stomach. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58
Extracting glucose via digestion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
Traveling through your bloodstream. . . . . . . . . . . . . . . . . . . . . . . . . 60
Fueling your cells. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60

vi Diabetes & Carb Counting For Dummies

 Saving Some for Later: Glycogen, the Storage Form of Glucose . . . . . 61
Making a layover in the liver . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Maintaining the muscles’ glucose reserves. . . . . . . . . . . . . . . . . . . . 62
Noting What Happens When Glucose Levels Remain Elevated . . . . . . 62
Spilling glucose into the urine. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
Understanding A1C and glycosylation. . . . . . . . . . . . . . . . . . . . . . . . 63
Recognizing the Risks of Undereating Carbs. . . . . . . . . . . . . . . . . . . . . . 66
Depleting glucose reserves and dealing with hypoglycemia . . . . . 67
Making glucose from scratch (with possible loss of muscle) . . . . . 68
Producing ketones. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69

CHAPTER 5: Finding Your Sweet Spot: The Right Amount

of Carbs for You. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
Checking Out the Official Diet Guidelines . . . . . . . . . . . . . . . . . . . . . . . . 74
Advice from the American Diabetes Association . . . . . . . . . . . . . . . 74
The Dietary Guidelines for Americans . . . . . . . . . . . . . . . . . . . . . . . . 75
Recommendations from the National Academy of
Sciences and Health Canada . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Figuring Out Calorie and Carbohydrate Intake Targets. . . . . . . . . . . . . 75
Estimating your caloric needs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
Understanding body mass index (BMI) . . . . . . . . . . . . . . . . . . . . . . . 77
Deciding on carb intake targets. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
Distributing carb intake . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Leaving room on your plate for protein and fat. . . . . . . . . . . . . . . . 82
Tweaking Your Carb Intake Target When Conditions Change . . . . . . . 82
Changing needs throughout the life cycle. . . . . . . . . . . . . . . . . . . . . 82
Altering intake to account for activity. . . . . . . . . . . . . . . . . . . . . . . . . 83
Adjusting portions when blood glucose is out of control . . . . . . . . 83
Managing sick days. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83

CHAPTER 6: Timing Your Carb Consumption. . . . . . . . . . . . . . . . . . . . . . . . 85

Distributing Your Daily Carb Intake . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
Striving to eat three meals per day. . . . . . . . . . . . . . . . . . . . . . . . . . . 86
Opting for smaller meals with reasonably sized snacks . . . . . . . . . 87
Trying time-restricted eating. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88
Fasting for religious reasons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
Stabilizing Blood-Glucose Levels at Breakfast and Dinner . . . . . . . . . . 90
Breaking your fast: The importance of breakfast. . . . . . . . . . . . . . . 90
Considering the merits of an earlier dinner . . . . . . . . . . . . . . . . . . . 91
Understanding Insulin Action . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
Comparing insulin options. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
Checking out concentrated insulins. . . . . . . . . . . . . . . . . . . . . . . . . . 93
Looking at blended insulin preparations. . . . . . . . . . . . . . . . . . . . . . 93
Inhaling insulin. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94
Pumping insulin. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95

Table of Contents vii

 Coordinating Insulin Action with Meals. . . . . . . . . . . . . . . . . . . . . . . . . . 96
Enjoying the flexibility of insulin-to-carb ratios. . . . . . . . . . . . . . . . . 97
Keeping carbs consistent when using sliding-scale
insulin dosing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
Basing injection timing on pre-meal blood-glucose levels . . . . . . . 99
Being regimented if you use blended insulin . . . . . . . . . . . . . . . . . 100
Managing Carbs on Oral Diabetes Meds. . . . . . . . . . . . . . . . . . . . . . . . 102
Keeping the carbs appropriate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102
Knowing your limits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103

PART 2: CARB COUNTING: FROM BASIC

TO ADVANCED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105

CHAPTER 7: Reading and Deciphering Food Labels. . . . . . . . . . . . . . 107

Finding Your Way around Food Labels. . . . . . . . . . . . . . . . . . . . . . . . . . 108
Scrutinizing the Nutrition Facts. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
Sorting out Serving sizes and servings per container . . . . . . . . . . 110
Calling out Calories. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112
Focusing on the fat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112
Considering Cholesterol content. . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
Surveying the Sodium. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
Focusing on Total Carbohydrate. . . . . . . . . . . . . . . . . . . . . . . . . . . . 114
Pinpointing the Protein. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119
Taking note of other valuable nutrients. . . . . . . . . . . . . . . . . . . . . . 119
Viewing various versions of Nutrition Facts labels. . . . . . . . . . . . . 120
Investigating the ingredients. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122
Identifying allergens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122
Heading to the Grocery Store . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
Looking at label claims. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
Understanding label claims. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126
Preparing your carbohydrate cheat sheet. . . . . . . . . . . . . . . . . . . . 128
Developing supermarket savvy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128

CHAPTER 8: Mastering Carb Counting and Portioning

Fundamentals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
Estimating Carb Counts for Foods without Labels. . . . . . . . . . . . . . . . 130
Referring to food composition lists. . . . . . . . . . . . . . . . . . . . . . . . . .130
Solving carb-counting conundrums in mixed dishes
and ethnic foods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137
Calculating carbs in your favorite recipes . . . . . . . . . . . . . . . . . . . . 137
Preparing your carbohydrate cheat sheet. . . . . . . . . . . . . . . . . . . . 138
Sizing Up Servings with Measures and Weights. . . . . . . . . . . . . . . . . . 139
Measuring with standardized cups and spoons. . . . . . . . . . . . . . . 139
Weighing in on whether to use a food scale. . . . . . . . . . . . . . . . . . 140

viii Diabetes & Carb Counting For Dummies

 Dealing with Special Cases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143
Controlling carb intake when eating out . . . . . . . . . . . . . . . . . . . . . 143
Keeping track of the carbs you drink . . . . . . . . . . . . . . . . . . . . . . . . 144
Guesstimating: When Carb Counts Aren’t Critical . . . . . . . . . . . . . . . . 145
Balancing your plate with the plate model . . . . . . . . . . . . . . . . . . . 145
Handling portions with the hand model . . . . . . . . . . . . . . . . . . . . . 147

CHAPTER 9: Adding Tools for Carb-Counting Ease

and Accuracy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149
Reviewing Written Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149
Reading the fine print for carb counts. . . . . . . . . . . . . . . . . . . . . . . 150
Looking at labeling regulations for chain restaurants. . . . . . . . . . 150
Tapping into Online Resources. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
Digging up restaurant food facts . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
Foraging through Internet food databases. . . . . . . . . . . . . . . . . . . 152
Using your search engine to count carbs . . . . . . . . . . . . . . . . . . . . 153
Enlisting the Assistance of Apps: One More Reason to
Love Your Smartphone. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153

PART 3: GOING BEYOND COUNTING CARBS. . . . . . . . . . . . . . . 155

CHAPTER 10: Accounting for Variations in Digestion

and Absorption Rates. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157
Comparing Digestion Speeds for Fluids and Foods. . . . . . . . . . . . . . . 158
Looking at liquid carbs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 158
Singling out sugars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159
Figuring out fruit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159
Focusing on complex carbs and fiber. . . . . . . . . . . . . . . . . . . . . . . . 160
Recognizing the fat factor. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161
Considering other variables. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 162
Gauging the Glycemic Index and Glycemic Load . . . . . . . . . . . . . . . . . 163
Reducing Blood-Glucose Fluctuations: Tips and Tricks . . . . . . . . . . . . 164
Controlling portion sizes of foods that pack a
blood-glucose punch. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165
Adding activity for extra carbs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166
Combining foods to reduce glycemic effect . . . . . . . . . . . . . . . . . . 166
Altering the order in which you eat the components
of your meal. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166
Aligning Insulin and Digestion Rates . . . . . . . . . . . . . . . . . . . . . . . . . . . 167
Optimizing mealtime insulin coverage. . . . . . . . . . . . . . . . . . . . . . . 168
Using your insulin pump’s fine features . . . . . . . . . . . . . . . . . . . . . 169

Table of Contents ix
 CHAPTER 11: Rethink That Drink. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
Noting the Importance of Hydration . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
Exploring the Pros and Cons of Different Drinks . . . . . . . . . . . . . . . . . 173
Making water your beverage of choice . . . . . . . . . . . . . . . . . . . . . . 174
Sipping and swigging low-carb beverages. . . . . . . . . . . . . . . . . . . . 175
Mentioning the merits of milk and nondairy milk substitutes. . . 176
Facing the facts about fruit juice. . . . . . . . . . . . . . . . . . . . . . . . . . . . 177
It’s Not Just the Carbs — It’s the Calories Too. . . . . . . . . . . . . . . . . . . . 180
Using Nutrition Supplement Drinks. . . . . . . . . . . . . . . . . . . . . . . . . . . . 181
Last Call for Alcohol: What’s the Verdict?. . . . . . . . . . . . . . . . . . . . . . . . 182
Being informed about the risks. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 182
Going behind the scenes: How alcohol affects the body. . . . . . . . 183
Looking at liquor’s carbs and calories . . . . . . . . . . . . . . . . . . . . . . . 185
Drinking safely. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187

CHAPTER 12: Let Me Call You Sweetie: Sugars and

Substitutes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191
Comparing Sugars. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192
Sugar, honey, syrup, and other notables. . . . . . . . . . . . . . . . . . . . . 193
Novel sweeteners . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195
Natural fructose and agave nectar. . . . . . . . . . . . . . . . . . . . . . . . . . 196
Examining Sugar Alcohols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199
Staying Up to Date on Sugar Substitutes. . . . . . . . . . . . . . . . . . . . . . . . 201
Digging into the details of nonnutritive sweeteners . . . . . . . . . . . 202
Exploring sugar-substitute safety records. . . . . . . . . . . . . . . . . . . . 203
Using substitutes in cooking and baking. . . . . . . . . . . . . . . . . . . . . 204

PART 4: EMBRACING WHOLE HEALTH

AND HAPPINESS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207

CHAPTER 13: Eating for Health and Happiness . . . . . . . . . . . . . . . . . . . . 209

Eating a Rainbow of Fruits and Vegetables. . . . . . . . . . . . . . . . . . . . . . 209
Loading Up on Whole Grains. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
Identifying best-bet grains. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
Increasing your options and trying new grains. . . . . . . . . . . . . . . . 212
Leaning Toward Leaner Proteins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213
Choosing the healthiest options. . . . . . . . . . . . . . . . . . . . . . . . . . . . 213
Fishing for reasons to eat more seafood. . . . . . . . . . . . . . . . . . . . . 214
Vegging out with meatless proteins. . . . . . . . . . . . . . . . . . . . . . . . . 215
Daring to Do Dairy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 216
Watching the fat content . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 216
Packing in more protein. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 216
Boning up on calcium. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 216
Checking out nondairy milk substitutes. . . . . . . . . . . . . . . . . . . . . . 218

x Diabetes & Carb Counting For Dummies

 Focusing on Healthy Fats. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 218
Having Diabetes and Dessert, Too . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219
Making your own treats . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 220
Dressing up healthy fruits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 220
Enjoying dessert while controlling the carbs. . . . . . . . . . . . . . . . . . 221
Trying Cooking and Serving Tips that Support Health
and Weight Goals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 222
Opting for lower-fat cooking methods. . . . . . . . . . . . . . . . . . . . . . . 222
Controlling portion sizes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 224

CHAPTER 14: Reaping the Rewards of Fitness. . . . . . . . . . . . . . . . . . . . . . 225

Exercising Safely . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 226
Getting the green light from your healthcare provider. . . . . . . . . 226
Being prepared: What to keep handy. . . . . . . . . . . . . . . . . . . . . . . . 228
Encouraging Exercise for Everyone . . . . . . . . . . . . . . . . . . . . . . . . . . . . 229
Developing an exercise plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 230
Enjoying the benefits of fitness. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 234
Being mindful of medical limitations . . . . . . . . . . . . . . . . . . . . . . . . 235
Clarifying What’s Going on Behind the Scenes When
You Exercise. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 237
Controlling blood glucose: How hormones are
supposed to do it automatically . . . . . . . . . . . . . . . . . . . . . . . . . . . . 237
Identifying how diabetes alters fuel use . . . . . . . . . . . . . . . . . . . . . 238
Sustaining exercise by tapping into fuels. . . . . . . . . . . . . . . . . . . . . 239
Understanding hypoglycemia and delayed hypoglycemia . . . . . . 239
Exercising with Type 1: Staying Safe While Having Fun. . . . . . . . . . . . 241
Monitoring matters. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 241
Fueling up or dialing down: Fine-tuning carbs and insulin. . . . . . 242
Knowing when to postpone activity: Too high or too
low, don’t go. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 244
Exercising with Type 2: Why It’s Right for You. . . . . . . . . . . . . . . . . . . . 245
Improving glycemic control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 245
Reducing cardiovascular risks. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 245
Supporting weight-control efforts. . . . . . . . . . . . . . . . . . . . . . . . . . . 246

CHAPTER 15: Getting a Handle on Hypoglycemia . . . . . . . . . . . . . . . . . 249

Understanding Hypoglycemia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 250
Defining level 1, level 2, and level 3 hypoglycemia. . . . . . . . . . . . . 251
Identifying causes of hypoglycemia . . . . . . . . . . . . . . . . . . . . . . . . . 252
Recognizing the symptoms of hypoglycemia . . . . . . . . . . . . . . . . . 257
Losing symptoms of lows: Hypoglycemia unawareness. . . . . . . . 258
Treating Hypoglycemia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 259
Choosing quick-acting carbs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 259
Taking the right amount of carb. . . . . . . . . . . . . . . . . . . . . . . . . . . . 260
Rechecking your blood-glucose level. . . . . . . . . . . . . . . . . . . . . . . . 261

Table of Contents xi
 Watching out for rebounds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 262
Requiring assistance: Severe lows and glucagon. . . . . . . . . . . . . . 263
Strategizing for Common Hypoglycemia Scenarios. . . . . . . . . . . . . . . 265
Managing mealtime lows. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 265
Sleeping safely after a bedtime low . . . . . . . . . . . . . . . . . . . . . . . . . 267
Considering insulin action when treating hypoglycemia. . . . . . . . 267
Preventing Hypoglycemia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 269
Being prepared . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 269
Looking for patterns and problem-solving . . . . . . . . . . . . . . . . . . . 270
Reflecting on prior exercise. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 270
Remembering your carb intake. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 270
Enlisting Your Doctor’s Help. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 271
Keeping and reviewing blood-glucose logs. . . . . . . . . . . . . . . . . . . 271
Sharing your data with your doctor . . . . . . . . . . . . . . . . . . . . . . . . . 272

CHAPTER 16: Keeping the Beat with a Healthy Heart . . . . . . . . . . . . 273

Eating Smart for Your Heart. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 273
Getting the facts on cholesterol and fats. . . . . . . . . . . . . . . . . . . . . 274
Acquainting yourself with types of fats . . . . . . . . . . . . . . . . . . . . . . 275
Choosing fats wisely . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 276
Adding soluble fiber to your healthy-heart regimen . . . . . . . . . . . 280
Creating a heart-healthy grocery list . . . . . . . . . . . . . . . . . . . . . . . . 281
Cooking your foods the heart-healthy way. . . . . . . . . . . . . . . . . . . 282
Handling the (Blood) Pressure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 282
Taking a look at the DASH diet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 283
Shaking the salt habit and opting for alternate seasonings . . . . . 284
Identifying hidden sodium suspects. . . . . . . . . . . . . . . . . . . . . . . . . 285
Deciphering label claims related to sodium . . . . . . . . . . . . . . . . . . 286
Embracing Heart-Healthy Habits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 287
Managing stress and diabetes distress . . . . . . . . . . . . . . . . . . . . . . 287
Avoiding tobacco and secondhand smoke . . . . . . . . . . . . . . . . . . . 287
Staying active. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 288
Controlling weight. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 288

CHAPTER 17: Living with Diabetes throughout the Life Cycle. . . 291
Raising a Child with Diabetes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291
Touching on key concepts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 292
Addressing type 2 diabetes in youth . . . . . . . . . . . . . . . . . . . . . . . . 296
Managing Diabetes in Pregnancy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 298
Planning for pregnancy when you have type 1 or
type 2 diabetes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 298
Developing gestational diabetes. . . . . . . . . . . . . . . . . . . . . . . . . . . . 299

xii Diabetes & Carb Counting For Dummies

 Understanding blood-glucose targets and fluctuations
in pregnancy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 300
Employing eating tips for diabetes during pregnancy. . . . . . . . . . 301
Keeping the Golden Years Golden When You Have Diabetes . . . . . . 304
Evaluating seniors’ dietary concerns . . . . . . . . . . . . . . . . . . . . . . . . 304
Keeping physically fit. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 306

CHAPTER 18: Going Gluten-Free: Does the Batter Matter? . . . . . . 309

Weighing In on the Gluten-Free Debate: Fad or Fact?. . . . . . . . . . . . . 310
Avoiding gluten fastidiously when you have celiac disease . . . . . 310
Forgoing gluten if you are allergic or have an intolerance . . . . . . 312
Choosing to go gluten-free for personal reasons. . . . . . . . . . . . . . 313
Going Against the Grain: Beginning a Gluten-Free Diet. . . . . . . . . . . . 314
Avoiding grains that contain gluten . . . . . . . . . . . . . . . . . . . . . . . . . 314
Eliminating gluten-containing foods. . . . . . . . . . . . . . . . . . . . . . . . . 316
Finding hidden gluten. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 317
Avoiding cross-contamination. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 318
Staying Gluten-Free Without Nutrient Deficiencies . . . . . . . . . . . . . . . 319
Embracing foods naturally free of gluten . . . . . . . . . . . . . . . . . . . . 320
Incorporating gluten-free grains and starches. . . . . . . . . . . . . . . . 320
Watching out for nutrient deficiencies. . . . . . . . . . . . . . . . . . . . . . . 321

PART 5: SAMPLING MENUS COMPLETE WITH

CARB COUNTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 323

CHAPTER 19: Beginning with Breakfast Menus. . . . . . . . . . . . . . . . . . . . 325

Starting Your Day Right with Breakfast . . . . . . . . . . . . . . . . . . . . . . . . . 325
Personalizing Your Breakfast Meal Plan . . . . . . . . . . . . . . . . . . . . . . . . 329

CHAPTER 20: Looking for Lunch Menus. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 331

Loving Your Lunch Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 331
Personalizing Your Lunch Meal Plan. . . . . . . . . . . . . . . . . . . . . . . . . . . .336

CHAPTER 21: Delving into Dinner Menus . . . . . . . . . . . . . . . . . . . . . . . . . . . 339

Determining What’s for Dinner. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 339
Personalizing Your Dinner Meal Plan. . . . . . . . . . . . . . . . . . . . . . . . . . . 344

CHAPTER 22: Surveying Snack Ideas. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 347

Choosing Carb-Controlled Snacks. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 348
Picking Packaged Snacks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 353

Table of Contents xiii

 PART 6: THE PART OF TENS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 355

CHAPTER 23: Ten Tips for Monitoring Your Blood Glucose. . . . . . . 357
Picking a Meter for Your Needs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 358
Obtaining a Blood Sample. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 358
Acknowledging Margin of Error. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 359
Assuring as Much Accuracy as Possible. . . . . . . . . . . . . . . . . . . . . . . . . 359
Disposing of Lancets and Needles Properly . . . . . . . . . . . . . . . . . . . . . 360
Varying Your Blood-Glucose Check Times. . . . . . . . . . . . . . . . . . . . . . . 360
Knowing Your Blood-Glucose Targets . . . . . . . . . . . . . . . . . . . . . . . . . . 361
Keeping a Log and Reviewing Your Data. . . . . . . . . . . . . . . . . . . . . . . . 362
Getting Your A1C Done Regularly. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 363
Considering Continuous Glucose Monitoring. . . . . . . . . . . . . . . . . . . . 365

CHAPTER 24: Ten Tips for Controlling Carbs. . . . . . . . . . . . . . . . . . . . . . . . 367

Saving a Step with a Measuring Cup. . . . . . . . . . . . . . . . . . . . . . . . . . . . 367
Weighing Fruits in Advance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 368
Having a Carb-Counting Contest. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 369
Making Better Breakfast Choices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 370
Packing Your Own Lunch. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 370
Choosing Wisely at the Deli. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 371
Considering the Condiments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 371
Fitting in a Favorite Dessert. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 372
Planning and Portioning Snacks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 372
Curbing Late-Night Snacking. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 373

CHAPTER 25: Ten Worthwhile Websites to Help You Manage

Diabetes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 375
Academy of Nutrition and Dietetics . . . . . . . . . . . . . . . . . . . . . . . . . . . . 375
American Diabetes Association. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 376
American Heart Association. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 377
British Heart Foundation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 377
Diabetes Canada. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 377
Diabetes UK. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 378
MyPlate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 378
National Diabetes Prevention Program. . . . . . . . . . . . . . . . . . . . . . . . . 379
U.S. Food and Drug Administration . . . . . . . . . . . . . . . . . . . . . . . . . . . . 380
WebMD. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 380

CHAPTER 26: Ten Things to Add to Your Healthcare

Checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 381
Building Better Health and Becoming Your Best Self. . . . . . . . . . . . . . 381
Seeing Your Diabetes Team Regularly. . . . . . . . . . . . . . . . . . . . . . . . . . 382

xiv Diabetes & Carb Counting For Dummies

 Taking Your Medications as Prescribed. . . . . . . . . . . . . . . . . . . . . . . . . 383
Controlling BGs and BPs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 383
Prioritizing Mental Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 383
Taking Care of Your Feet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 384
Keeping Current with Dental Screenings and Cleanings. . . . . . . . . . . 384
Screening Annually and Having Recommended Blood Labs . . . . . . . 385
Getting Vaccinated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 386
Setting Goals and Evaluating Progress. . . . . . . . . . . . . . . . . . . . . . . . . . 386

PART 7: APPENDIXES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 389

APPENDIX A: Exchange Lists. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 391

APPENDIX B: Conversion Guide. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 405

INDEX. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 407

Table of Contents xv
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