Part 3: Carbohydrate counting

Which foods have carbohydrate

Carbohydrate is the part of food that turns into glucose, and it raises blood sugar faster and further than anything else. It is in roti, rice, bread, daal and chana, potatoes, fruit, milk and dahi, and anything with sugar.

Meat, fish, eggs, oil and ghee have almost none. That doesn't make them free — they carry calories — but they won't raise your sugar the way roti does.

Counting in portions of 15 g

Many diabetes teams count in 'carb choices' of 15 g. A 6-inch roti, a small apple and a small banana are one choice each. A plate of boiled rice is about four.

The carb counter on this site lists 40 local foods in these portions — roti, rice, daal, biryani, fruit, mithai — as home servings in Lahore.

A Lahore lunch, counted

• 2 rotis: 30 g
• 1 katori daal: 20 g
• 1 plate salad: 5 g
• 1 katori dahi: 8 g

Total: 63 g, about four carb choices. Swap one roti for half a plate of rice and the total becomes about 80 g.

On fixed insulin doses: keep it steady

If you take the same insulin doses every day, the ADA advises keeping the carbohydrate at each meal about the same, at about the same times, from day to day. Big swings — a light lunch one day, a biryani the next — make hypos and highs more likely.

On flexible insulin: carbohydrate sets the dose

People on mealtime insulin can match each dose to the carbohydrate they eat, using an insulin-to-carbohydrate ratio. In the UK's DAFNE trial, adults with type 1 diabetes who learned this ended six months with an HbA1c of 8.4% against 9.4%, without more severe hypos, and felt freer in what they ate.

Your ratio, and any correction for high readings, has to come from your own diabetes team. This course and the carb counter count carbohydrate; they never calculate a dose.