The Diabetic Exchange System

A great way for people with diabetes to manage their diet and blood sugars is by using the diabetic exchange system. It works because it’s easy. There is no calorie or carb counting, and basically any food can be included in the diet. It is called an exchange system because similar foods are grouped together. All foods in a certain group will have about the same amount of carbohydrate, protein, fat, and calories. Within each group a serving of one food can be “exchanged” for a serving of something else. This helps to provide variety in the diet and aids in blood sugar management.

How Does the Exchange System Work?

The first thing to do is to find the calorie level that is right for you. It should take into account your size, age, activity level, and whether you want to maintain or lose weight. You can figure out your general calorie level by using the formula explained in the Q and A section of this website. Your calorie level will determine how many servings of each food group you should have each day; this is called your “pattern”. Each pattern will consist of a certain number of servings of each food group. For example, an 1800 calorie pattern might contain 8 starches, 4 fruits, 3 milks, 6 meat/meat substitutes, 4 fats, and 3 vegetables. A dietitian can help you figure out your calorie level and your pattern.

Get to Know Portion Sizes

Once you know how many servings of each food group to have per day, it is important to know what the serving size is so you know how much to eat. One starch choice is one slice of bread, ½ English muffin, ¾ cup unsweetened ready to eat cereal, or 1/3 cup pasta. Starchy vegetables such as corn, peas, and potatoes are in the starch group, not the vegetable group, because of their high sugar content. Their serving sizes are ½ cup of corn or peas or 3 oz baked potato.

A serving of fruit varies, but common fruits are an apple (4 oz), banana (4 oz), and orange (6 1/2 oz). A serving of fruit juice is 1/3 to ½ cup depending on the type of fruit. A milk serving is generally 1 cup of milk or 6 oz of yogurt. A serving of nonstarchy vegetables is 1/2 cup cooked or 1 cup raw. A meat choice is 1 oz. So, if you have a 3 oz serving of chicken for dinner, this is 3 meat exchanges for the day. A serving of fat is 1 tsp of oil or margarine, 6 nuts, or 1 Tbsp of cream cheese. There are plenty of free foods to choose from, including fat free items and condiments.

Helpful Hints

The highest carbohydrate foods are starches, fruit, and milk. These will raise your blood sugar the fastest and the highest. Vegetables do have some carbohydrate, but if you get hungry beyond your daily exchanges, choose meat or vegetables as a snack. These will have the least effect on your blood sugar.

Try to watch the amount of fat you consume. Your pattern may include 3 or 4 fat exchanges for the day, but these do not take into account the fat in the meats and milk you choose. Choose low fat or fat free milk products and very lean or lean meats.

Try to eat the same amount of food at the same time each day. In addition, try not to skip meals or snacks. This will help keep your blood sugars in check.