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      P R A C T I C A L

      Carbohydrate

      Counting2nd Edition A How-to-Teach Guide for Health Professionals

      Hope S. Warshaw, MMSc, RD, CDE, BC-ADM, and

      Karen M. Bolderman, RD, LDN, CDE

      Director, Book Publishing, Robert Anthony; Managing Editor, Book Publishing, Abe Ogden; Acquisitions Editor, Professional Books, Victor Van Beuren; Production Manager, Melissa Sprott; Composition, American Diabetes Association; Cover Design, Koncept, Inc.; Printer, Worzalla Publishing.

      ©2008 by the American Diabetes Association, Inc. All Rights Reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including duplication, recording, or any information storage and retrieval system, without the prior written permission of the American Diabetes Association.

      Printed in the United States of America

      1 3 5 7 9 10 8 6 4 2

      The suggestions and information contained in this publication are generally consistent with the Clinical Practice Recommendations and other policies of the American Diabetes Association, but they do not represent the policy or position of the Association or any of its boards or committees. Reasonable steps have been taken to ensure the accuracy of the information presented. However, the American Diabetes Association cannot ensure the safety or efficacy of any product or service described in this publication. Individuals are advised to consult a physician or other appropriate health care professional before undertaking any diet or exercise program or taking any medication referred to in this publication. Professionals must use and apply their own professional judgment, experience, and training and should not rely solely on the information contained in this publication before prescribing any diet, exercise, or medication. The American Diabetes Association—its officers, directors, employees, volunteers, and members—assumes no responsibility or liability for personal or other injury, loss, or damage that may result from the suggestions or information in this publication.

      

The paper in this publication meets the requirements of the ANSI Standard Z39.48-1992 (permanence of paper).

      ADA titles may be purchased for business or promotional use or for special sales. To purchase more than 50 copies of this book at a discount, or for custom editions of this book with your logo, contact Lee Romano Sequeira, Special Sales & Promotions, at the address below, or at [email protected] or 703-299-2046.

      For all other inquiries, please call 1-800-DIABETES.

      American Diabetes Association

      1701 North Beauregard Street

      Alexandria, Virginia 22311

       Library of Congress Cataloging-in-Publication Data

      Warshaw, Hope S., 1954-

       Practical carbohydrate counting : a how-to-teach guide for health professionals / by Hope S. Warshaw, Karen M. Bolderman. -- 2nd ed.

       p. ; cm.

      Includes bibliographical references and index.

      ISBN 978-1-58040-282-8 (alk. paper)

      1. Diabetics--Nutrition--Study and teaching. 2. Diabetes--Diet therapy--Study and teaching. 3. Food--Carbohydrate content--Study and teaching. 4. Patient education. I. Bolderman, Karen M., 1954- II. American Diabetes Association. III. Title.

      [DNLM: 1. Diabetes Mellitus--diet therapy. 2. Diabetic Diet--methods. 3. Dietary Carbohydrates--

      analysis. 4. Patient Education as Topic. WK 818 W295p 2008]

      RC662.W3153 2008

      616.4’620654071--dc22

      2008020554

      eISBN: 978-1-58040-360-3

      Table of Contents

       Introduction

       Chapter 1. What, Why, Who, and How Much?

       Section 1: Basic Carbohydrate Counting

       Chapter 2. Assessing Knowledge and Skills

       Chapter 3. Concepts to Teach—From Basic Nutrition to Meal Planning

       Chapter 4. Concepts to Teach—Counting Carb, Reading Food Labels, and Measuring Portions

       Chapter 5. Basic Carbohydrate Counting Case Studies

       Section 2: Advanced Carbohydrate Counting

       Chapter 6. Concepts to Teach—Advanced Carbohydrate Counting

       Chapter 7. Advanced Carbohydrate Counting and Continuous Subcutaneous Insulin Infusion

       Chapter 8. Pattern Management for Glycemic Control

       Chapter 9. Advanced Carbohydrate Counting Case Studies

       Section 3: Related Topics

       Chapter 10. Impact on Glycemia of Dietary Components Beyond Carbohydrate

       Chapter 11. Impact on Glycemia of Non-Dietary Factors

       Chapter 12. Blood Glucose—Lowering and Related Medications

       Chapter 13. Process to Develop and Maintain Personal Carbohydrate Counts

       Appendices

       Appendix I. Resources for Carbohydrate Counting and Insulin Pump Therapy

       Appendix II. Blood Glucose—Lowering Medications

       Appendix III. Sample Record-Keeping for Basic and Advanced Carbohydrate Counting

       Reference List

       Index

      Introduction

      According to the American Diabetes Association (ADA), Medical Nutrition Therapy (MNT) is an integral component of diabetes management and diabetes self-management training (DSMT) (ADA 2008b). MNT has been

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