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Diabetic Food Exchange


Diabetic food exchange is a system of food categorization to make food planning easier for diabetic patients. The system consumes foods according to their nutritional value, helping diabetics to eat carb-consistent, nutritionally balanced foods to achieve glucose control (blood sugar) and overall health.

The American Diabetes Association and the American Dietetic Society devise methods. It categorizes foods into three groups based on their carbohydrate content:

  • A group of carbohydrates

  • Meat and meat substitute groups

  • Fat group

In addition, foods can be categorized into six groups based on their nutritional value:

  • Starch / bread

  • Fruit

  • Milk

  • Vegetables

  • Meat and meat substitutes

  • Fat

Each exchange (meal) of a food group has the same amount of carbohydrates. The amount of protein, fat and calories can vary. Patients on special diets can use this group of foods to change foods on the same list knowing that each meal will have the same effect on their glucose levels.

About diabetic food exchange

Dietary exchange is a method of categorizing foods into groups that share the same carbohydrate content. Calories, protein content and fat content can vary. This can help people with diabetes develop a balanced diet that helps maintain their glucose levels (blood sugar) within normal range.

Established by the American Diabetes Association and the American Dietetic Society, the system categorizes foods into the following groups according to their carbohydrate content:

  • Carbohydrates

    • Weed / bread

    • Fruits

    • Milk

    • Other carbohydrates

    • Rootless vegetables

  • Meat and meat substitutes

    • Very thin

    • Lean

    • Medium fat

    • Fat high

    • Fat (including non-saturated, non-saturated and saturated mono)

Patients with diabetes may choose items on their diet list that know they are consuming certain amounts of carbohydrates, proteins, fats and calories. This way, patients can substitute certain foods in their diet for other foods from the same list.

Most foods are allowed as part of an exchange diet, as long as they are consumed within certain limits and servings daily. Patients should work with their doctor and registered dietitian to plan their diet. The ideal plan combines different types of foods from different food groups and lists the appropriate amount of exchange for three meals and two or three snacks a day.

Types and differences

The diabetic dietary list allows patients to create a balanced diet that offers a variety of options. The foods that make up this list are divided into several categories, and any item in the category can be replaced by other foods on that list.

The number and types of exchanges that people can have at each meal will be determined by their doctor and registered dietitian. Patient age, gender, weight, height, consistent activity level and personal diet will be considered.

Exchange vs. carb counting

People with diabetes should plan their diet by consulting with a doctor and a registered dietitian. Once a meal plan has been established, the main method used by patients to track their carbohydrates is to list diabetes or carbohydrate ("carbohydrate") diets.

There are pros and cons to each method. Diabetes exchange offers patients an easy way to plan a balanced diet with a variety of options, while ensuring proper carbohydrate intake. They may appeal to patients who prefer the structure built into their meal plans.

On the other hand, some people may find the options on the exchange list too restrictive. This is especially true for those who love to experiment with cooking, although many diabetic cookbooks break down recipes into one-volume exchanges.

The carbohydrate counting method is used to calculate the amount of insulin needed to convert food to energy. This is done by increasing the amount of carbohydrates - in grams - in the meal the patient is preparing to eat. The extra numbers come from the carbohydrate column in the diabetes exchange list.

Meanwhile, people who use carbohydrate counters can experiment with a wider variety of foods and often find it more flexible than diabetic. However, patients who use this method instead of diabetic diet should be more careful when planning a balanced diet. Calculating carbohydrates also involves math, which may be a disadvantage to some. For more information on calculating carbohydrates, see carbohydrates.

Other methods used by some people include the glycemic index and burden, the diabetes food pyramid and the "your plate rate" system.

Questions for your doctor

Asking questions in advance can help patients have more meaningful discussions with their healthcare providers about their condition. Patients may want to ask their doctor the following questions about diabetic diet:

Best method for me to use: carb list or carbohydrate counting?

Can any of the methods be used with my favorite recipes?

Does carbohydrate counting have more flexibility for me than an exchange list?

If I misuse the carbohydrate counting method and intentionally consume too much insulin, what should I do?

What should I do if I take too little insulin?

I noticed all the meat was grouped in one category. Does that mean that they're all the same?

I noticed that three types of milk are grouped together in one category. Does that mean they are all together?

How are "natural" sugars found in fruits different from refined sugars added to desserts?

Should I include or avoid other categories of carbohydrates?

Will you help me find a qualified dietitian to help explain my dietary guidelines?

What other resources are available to me to learn about diabetes exchange?


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