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Manage Diabetes with a Diabetic Exchange List

Neil Donaghy | April 26th, 2013

Diabetes DietsThere is no single, catch-all ‘diabetic diet plan‘, because each patient has differing factors at play. Lifestyle, body weight, health issues, age, sex, ethnicity – all of these components influence the way diabetics should manage their condition.

One way in which patients can narrow down the broader guidelines for managing diabetes is to use a diabetic exchange list. Generally speaking, healthy diabetes diets are rich in nutrients and low in fat and sugar calories. The aim is to keep blood sugar levels within a certain target range. Whilst this range differs from person to person, the principles of a diabetic exchange list remain the same.

How do exchange lists work?

Foods are divided into three categories, based on the major nutrients:

  • Carbohydrates
  • Proteins
  • Fats

Most food subgroups, such as fruits, vegetables, milk, meats, sugary foods, fall within one of these groups. Some complex foods, like cake, fall into more than one category. Working these foods into a diabetic diet plan should be discussed with your dietician.

The concept is to exchange foods within a group based on the effect they have on blood sugar levels. Foods that have a similar effect can be traded for one another, so understanding the impact of the three categories on the body is vital. For instance, a serving of starch, fruit or milk contains roughly the same amount (15 grams) of carbs. Each serving of carbs is called a ‘carbohydrate choice’.

Dr. Michael Kaplan, founder of The Center for Medical Weight Loss, the biggest network of non-surgical weight loss clinics in the U.S., is one nutrition expert who supports the use of diabetic exchange lists:

“We have helped many patients achieve normal blood glucose levels through healthy, sustainable dietary modifications like exchange lists. We work with patients on a one-to-one basis to customize a program that works with a person’s lifestyle, preferences, and medical history.”

Kaplan added that it remains essential to discuss the details of any proposed diabetic diet plan with your doctor.

What does a diabetic exchange list look like?

As we’ve seen, the number of daily calories and types of allowable food will vary from patient to patient. But as an example, a typical diabetic exchange list for a 1,200 calorie diet would look something like this:

  • Five starch exchanges
  • Four lean meat exchanges
  • Two vegetable exchanges
  • Three fruit exchanges
  • Two low fat milk exchanges
  • Three fat exchanges

Establishing portion sizes is one of the most important steps toward creating effective diabetes diets. They’re often smaller than you think. A physician or dietician help you distribute your allotted servings throughout the day, in such a way that you feel full and satisfied, avoiding the sudden surges in blood sugar that can make diabetics ill.

Medical weight loss specialists help clients stabilize blood sugar levels through individualized diabetic diet plans, which can reverse symptoms of Type 2 diabetes. Find out more about physician-developed programs at