Advanced Carb Counting

You've mastered basic carb counting and portion sizes, and you monitor your blood glucose, keep accurate records, and take multiple daily injections of insulin. You may be ready for the next step: advanced carb counting.


Advanced carb counting, as the name suggests, is a more detailed way of counting carbohydrate to maintain good glucose control. It works by matching mealtime insulin doses to the amount of carbohydrate you eat.

The Perks

"Advanced carb counting is the closest we can get to mimicking what the body would do on its own if it could," says Linda Yerardi, M.S., R.D., LDN, CDE, diabetes consultant in Frederick, Maryland. "You don't have to stay in a certain box and eat 35 carbs at breakfast every day. There are more choices, versatility, and flexibility."

Sandy Gillespie, MMSc, R.D., L.D., CDE, a diabetes nutrition consultant, offers more advantages of advanced carb counting:

  • More flexible food choices

  • Focus on only one nutrient

  • A sense of feeling in charge

  • Potential for improved blood glucose control

  • More precise way to match food and insulin

"As we learned from the DCCT (Diabetes Control and Complications Trial) many years ago, intensive management, including advanced carb counting, improves A1C without increase in severe hypoglycemia and improves quality of life."

With Freedom Comes Responsibility

The flexibility of food choices makes advanced carb counting very appealing. You can adjust your insulin based on whatever you add to your plate, but you should be careful not to overdo it.

"When changing from fixed insulin doses to boluses, you can easily start overeating because you can eat anything and just take more insulin," Yerardi says. "You may be getting great glucose control but gaining weight."