Nutrition Facts Labels for Diabetics

The purpose of this article is not to let you know what to eat, it’s to help you figure out how to make sense of what you do eat.

As you can see, the nutrition label is jam-packed full of information.  Frankly, there are many details you don’t need to worry about so much. It’s less complicated than it looks – trust me.

Most Type 1 diabetics count carbohydrates to determine how much insulin they need to take to maintain good blood glucose control. Type 2 diabetics may be treated with insulin, a nutrition regimen, or medicines that increase insulin secretion so they need to match their medication, regimen or insulin dose to the amount of carbohydrates in their food.

To count Carbohydrates, we need to look at three things: Serving Size, Servings per Container and Total Carbohydrates (with special mention going to fiber and sugar alcohols).

Serving Size & Servings per Container

The nutrition label refers to ONE serving of food.  Be careful – sometimes the label will say that there is more than one serving in the container.  If you assume that the entire container is 1 serving, you will likely underestimate the amount of insulin you need. Therefore, always make sure that you compare the amount you’re actually eating to the serving size to figure out nutritional values.  If you eat more than one serving, you will need to multiply the nutritional information accordingly.

Total Carbohydrates

Total carbohydrates refers to how many grams of carbohydrate are in one serving. The total carbohydrate value includes carbohydrates from sugar, fiber and sugar alcohols.

Carbohydrates impact blood glucose and help determine how much insulin is needed.  Pay attention to how much fiber and sugar alcohol is also in the food. Both fiber and sugar alcohol digest more slowly (or not at all), so glucose absorption from those is less efficient. This is important when calculating insulin doses for foods that contain a lot of fiber or sugar alcohols.

Fiber: Because fiber is a type of carbohydrate that your body can’t digest, it does not affect your blood sugar levels. You may subtract the grams of fiber from the total carbohydrate.

Sugar Alcohols:  Sugar alcohols may be found in products that are labeled “sugar-free” or “no sugar added.” However, sugar alcohols are still a form of carbohydrate, and they still affect your blood sugar levels. Examples of sugar alcohols include

• Sorbitol
• Xylitol
• Mannitol
• Isomalt
• Maltitol
• Lactitol
• Hydrogenated Starch Hydrolysates

Sugar alcohols are difficult for your body to digest therefore the effect on your blood sugar is notably less than standard sugars. When counting carbohydrates for foods made with sugar alcohols, it’s recommended that you subtract half of the grams of sugar alcohol listed on the food label from the total grams of carbohydrate to determine your Carbohydrate count.

Caution: because sugar alcohols are harder for your body to digest, eating too many sugar alcohols may cause digestive complaints like gas, cramping and diarrhea.

To determine your Carbohydrate Count, subtract the Fiber (g)  and 50% of the Sugar Alcohols (g) from the Total Carbohydrate value (g) displayed on the nutrition label, per serving.

Other important considerations:

High Fat foods slow down how fast the stomach empties. Therefore, if you take your insulin based on the number of Carbohydrates you consume, your blood sugar may drop immediately after your meal, until the Carbohydrates can be absorbed. You may notice that your blood sugar may later rise when there is little insulin activity present. If you wear an insulin pump, you may use enhanced features to release your insulin at a varied rate so that this does not happen.

Other factors that may cause consideration when calculating insulin doses include stress, illness, activity level, menstruation and more.  To determine your Carbohydrate:Insulin ratio, work closely with your medical team.

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