Diabetic Exchange Diet

What is it? A diabetic exchange diet is a list of serving sizes of foods that you can choose to eat every day. These foods are divided into 6 groups. You need to eat the right number of servings from each food group every day to control your diabetes (di-uh-b-tees).

  • Carbohydrates from food become blood sugar (glucose) in the body. In diabetes, the body does not make enough insulin, or the insulin it makes does not work properly. This causes the blood sugar to be too high.


  • You can help control your blood sugar by limiting the carbohydrate and total calories in your diet. You may prevent kidney, eye, nerve, or heart problems by keeping your blood sugar within normal range.


Care:

Meal Plans

  • Your dietitian will give you a meal plan. This plan tells you the number of servings to eat from each food group. And when to eat them during the day.


  • You will need to measure your food while on this diet. Most people on a diabetic exchange diet need to eat 3 meals and 1 to 3 snacks every day. You can exchange or trade one food for another from the same food group. For example, 1 slice of bread can be exchanged for 3/4 cup dry cereal. Or you can exchange 1/2 cup fruit juice for 1/2 of a 9 inch banana.


Carbohydrate Intake

  • Your dietitian (di-uh-tih-shun) will explain how many servings or grams of carbohydrates you can eat during the day. Check with your dietitian before changing your food plan or switching 1 kind of carbohydrate for another. Read the labels of packaged foods to find out how many grams of carbohydrate a serving has in it. Check with your dietitian or caregiver before eating foods with the following:


    • added sugar


    • corn syrup


    • honey


    • molasses


    • maple syrup


    • jams and jellies


  • Talk with your dietitian before eating any foods on the "Carefully Use the Following Foods" section. These foods contain sweeteners that can make your blood sugar too high. You should eat healthy foods with your meals if you eat foods or drink liquids that contain sugar.


  • The lists below tell you how much carbohydrate is in each food group. Eat only the amount that is on the food list. You also need to eat foods from the meat/meat substitute list and the fat's list to have a balanced diet.


Other Concerns

  • Increase your activity level to help control your blood sugar. Talk to your dietitian about your exercise plan so your diet can be changed, if needed. You may need extra carbohydrate before exercise to keep your blood sugar from getting too low.


  • Choose high fiber foods to help control your blood sugar. Examples of high fiber foods are fresh fruits and vegetables, whole grain breads, cooked dried beans, and bran cereals.


  • Talk with your caregiver if your blood sugar levels are too low or too high. Make sure your cholesterol and other blood lipids (fats) are checked at least once a year. A balanced diabetic diet will also help control the amount of cholesterol and other fat substances in your blood.


Serving Sizes: Use the list below to measure foods and serving sizes. A serving size means the size of food after it is cooked or prepared.

  • 1 pint or 2 cups (16 fluid ounces) of liquid is the size of 1-1/3 soda-pop cans.


  • 1-1/2 cup (12 fluid ounces) of liquid is the size of a soda-pop can.


  • 1 cup of food is the size of a large handful, or 8 fluid ounces of liquid.


  • 1/2 cup of food is about half of a large handful, or 4 fluid ounces of liquid.


  • 2 tablespoons (Tbsp) is about the size of a large walnut.


  • 1 tablespoon (Tbsp) is about the size of the tip of your thumb (from the last crease).


  • 1 teaspoon (tsp) is about the size of the tip of your little finger (from the last crease).


  • 3 ounces of cooked meat, fish, or poultry is about the size of a deck of cards.


  • 1 ounce of cooked meat, fish, or poultry is about 1/4 cup (c).


  • One ounce of hard cheese is about a 1 inch cube.


  • A serving of vegetables is 1/2 cup (1/2 handful) cooked, or 1 cup (1 handful) raw.


Breads and Starches: Each serving below has about 15 grams carbohydrate. Eat ____ servings a day from this list. Most people need 6-11 servings a day.

  • 1 slice bread (4-inch square) or small (2-inch square) dinner roll


  • 1/2 cup cooked cereal


  • 1/2 cup corn or 1 medium corn on the cob


  • 6 saltine crackers or three 2-1/2 inch squares graham crackers


  • 8 animal crackers


  • 1/2 cup cooked dried beans (like kidney, pinto, lentils, chick peas, white, or navy)


  • 1/2 of an English muffin, or hot dog bun, hamburger bun, or frozen 3-inch bagel


  • 1/2 cup cooked green peas or lima beans


  • 4 slices melba toast or 24 oyster crackers


  • 1/2 cup cooked pasta, mashed potatoes, winter squash, or corn


  • 1/2 of 6-inch piece pita bread or 1 6-inch tortilla


  • 3 cups popped popcorn without added oil or butter


  • 1 3-inch baked potato


  • 3/4 ounce pretzels or 1 ounce low fat potato chips


  • 1/3 cup cooked rice


  • 2 rice cakes (4-inches across)


Fruit: Each serving below has about 15 grams carbohydrate. Eat ____servings a day from this list. Most people need 3-5 servings per day.

  • 1 medium (3 inch) apple, peach, or orange


  • 1 small (5-inch) banana or 1/2 of a large (9-inch) banana


  • 17 small or 12 large grapes (any kind)


  • 1 kiwi fruit


  • 1 cup cubed melon (cantaloupe, honeydew, or others)


  • 1/2 of a large (4-1/2 inch) pear


  • 1/2 cup pineapple or other fruit canned in water


  • 2 small plums or 3 dried prunes


  • 2 Tbsp raisins (any kind) or 1/4 cup dried fruit


  • 1-1/4 cup whole strawberries


  • 1-1/2 cup cubed watermelon


Vegetables: Each serving below has about 5 grams carbohydrate. Only count a vegetable as carbohydrate if you have more than 2 servings per meal. Eat ____ servings per day from this list. Most people need 3-5 servings per day. One serving is 1 cup raw or 1/2 cup cooked of most vegetables.

  • Asparagus


  • Beets or turnips


  • Broccoli, cabbage, cauliflower


  • Carrots


  • Celery, radishes, or cucumbers


  • Eggplant


  • Green beans or wax beans


  • Kale, mustard, turnip, or collard greens


  • Mixed vegetables (without corn or peas)


  • Mushrooms


  • Onions (all kinds)


  • Pea pods


  • Peppers (all kinds)


  • Salad greens (lettuce, romaine, spinach)


  • Summer or zucchini squash


  • Tomatoes (fresh or canned)


Dairy: Each serving below has about 12 grams carbohydrate. Eat ____ servings per day from this list. Most people need 2-4 servings per day.

  • 1/3 cup nonfat dry milk


  • 1/2 cup evaporated milk


  • 1 cup skim, 1%, or 2% milk


  • 1 cup plain or sugar-free yogurt


  • 1 cup skim or low fat buttermilk


Meat / Meat Substitutes: These foods do not count as carbohydrates. The amounts listed below mean cooked serving sizes. Eat ____ portions per day from this list. Most people need 4-8 ounces or portions from this list per day.

  • 1 ounce chicken or turkey without skin


  • 1/4 cup low fat cottage or ricotta cheese


  • 1 inch cube or 1 ounce low fat solid cheese


  • 1 large egg or 1/4 cup egg substitute (no more than 3 eggs each week)


  • 1 ounce fish (not breaded or fried)


  • 1 ounce lean beef, pork, or lamb


  • 1/4 cup canned tuna or salmon


  • 1/2 cup tofu


Fats: These foods do not count as carbohydrates. Eat ____ servings per day from this list. Most people need 2-4 servings per day.

  • 6 almonds or cashews, 10 peanuts, or 4 pecan halves


  • 1/8 of a medium avocado


  • 1 Tbsp regular cream cheese or 2 Tbsp low fat cream cheese


  • 1 tsp oil, like safflower, canola, corn, or olive


  • 1 tsp regular margarine or 2 tsp low fat margarine


  • 1 tsp regular mayonnaise or 1 Tbsp low fat mayonnaise


  • 8 ripe olives or 10 green stuffed olives


  • 2 tsp peanut butter


  • 1 Tbsp regular salad dressing or 2 Tbsp low fat salad dressing


  • 2 tsp sesame butter or tahini


Combination Foods: Each serving contains about 15 grams carbohydrate. Eat ____ servings per day from this list. Most people need 1-3 servings per day.

  • 1/2 cup of any casserole, like tuna or chicken noodle, macaroni and cheese, chili with meat, or spaghetti and meat sauce


  • 1 cup cream, bean, tomato, or vegetable soup


  • 1/8 of a 10-inch pizza


  • 1/2 of a store-bought pot pie, like chicken, turkey, or beef


  • One 3 ounce taco


Free Food Lists: The foods on this list have very few calories and should not change your blood sugar if you do not eat too much of them. You may have 3 servings a day from this list. Eat only the amount listed and count it as 1 serving.

  • 1 Tbsp catsup


  • 1 Tbsp unsweetened cocoa powder


  • 1 Tbsp fat-free cream cheese


  • 1-1/2 large dill pickles


  • 2 tsp low sugar or light jam or jelly


  • 4 Tbsp fat-free margarine or fat-free mayonnaise


  • 1 Tbsp fat-free salad dressing or fat-free sour cream


  • 1/4 cup salsa


  • 2 Tbsp sugar-free syrup


  • 1 Tbsp taco sauce


You may have these foods as often as you want.

  • Artificial sweeteners that contain aspartame (ah-spar-tame) or saccharin (sah-kuh-run)


  • Bouillon or fat-free broth


  • Bubbly or mineral water


  • Horseradish


  • Lemon or lime juice


  • Mustard


  • Seasonings, like herbs, spices, garlic, and flavor extracts (vanilla, almond, and others)


  • Sugar-free drink mixes or gum


  • Sugar-free gelatin without added fruit


  • Sugar-free soda pop


  • Vinegar


Carefully Use the Following Foods: Do not use these foods until you have talked to your dietitian. Eat only the amounts that your dietitian has said are OK. These foods contain simple sugars and will increase your blood sugar if you eat too much of them.

  • Cake, cookies, and candy


  • Corn sugar or corn syrup


  • Dextrose, glucose, fructose, maltose, and sucrose


  • Frosting


  • Granola bars


  • Honey, molasses, and syrups


  • Ice cream


  • Jelly and jam


  • Pie, pastries, sweet rolls, and donuts


  • Powdered, brown, or granulated sugar


  • Regular soda pop


  • Sugar-covered cereals


CALL YOUR CAREGIVER IF:

  • You have questions about the serving sizes on this diet.


  • You have questions about how to prepare or cook foods on this diet.


  • You have questions about how or where to buy foods on this diet.


  • You have questions or concerns about your illness, medicine, or this diet.


Care Agreement

You have the right to help plan your care. To help with this plan, you must learn about your diet. You can then discuss the treatment options with your caregivers. Work with them to decide what care will be used to treat you. You always have the right to refuse treatment.

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