Dietary Exchanges

If you have been diagnosed as a diabetic you may have heard about dietary exchanges. Dietary exchanges help you develop an eating plan to control your diabetes. With the dietary exchanges you can ensure you are getting all of the nutrients you need every day without overdoing it in certain areas such as carbs or sugars.

Dietary exchanges pay close attention to food nutrients. The plan encourages you to focus on nutritious foods and avoid foods that are high in fats and calories. You can plan delicious meals using the exchange lists.

There are specific goals for dietary exchanges for diabetics: [1]

How It Works

The dietary exchange system is based on food groups:

  • Starches
  • Meats
  • Milk
  • Sweets
  • Fats
  • Free foods

When you begin to utilize the dietary exchange system you will learn what foods from each group you can eat to equal your needed caloric intake for the day. You will quickly see that you can consume different amounts of foods from different groups with the same caloric results. The key will be learning to exchange foods in each group due their similar nutrient makeup in order to stabilize your blood sugar.

Learning to utilize dietary exchanges will take practice and require you to learn the basics of the food groups and get into the habit of counting carbs and other nutrients that can negatively affect your blood sugar. For example, every item in the dietary exchange starch category has around the same number of carbs – 15 grams – per serving. As you become familiar with the dietary exchanges you will recognize this as one serving of a carb.

Why It Works

Dietary exchanges will help you control your glucose, or your blood sugar level. As an added bonus it will help you maintain a healthy weight. When you consume more fat than you should or if you eat a diet high in calories your glucose levels rise. In diabetics this can be dangerous – it can lead to hyperglycemia and other problems associated with high sugar.

The ABCs of Dietary Exchanges

As you learn to eat a healthy diet, including dietary exchanges, you will discover the delicious foods you can eat. Let’s look at some of the great choices you can include in your meal planning every day:

  • Healthy Carbs – fruits, veggies, whole, grains, and legumes are excellent choices for healthy carbs.

You must always be aware of the carbs you consume. Some carbs are very unhealthy, especially for a diabetic. As carbs are absorbed they can significantly raise your blood glucose. Stay away from simple carbs such as sugars and an overabundance of complex carbs or starches which become glucose.

  • High Fiber Foods – Fiber is well known to control the levels of your blood sugar. Your diet should include dietary fibers such as veggies, fruits, nuts, beans, peas, and lentils. Whole grains are also a good source of dietary fibers.
  • Health Fats – these are sometimes called good fats. You will want to include monounsaturated fats and polyunsaturated fats in your diet. You can get these from natural sources such as avocados, almonds, pecans, other nuts, and olive oil.

Learning to eat following dietary exchanges also means avoiding certain foods:

  • Saturated fats from such food products as animal proteins and some dairy, (high fat), should be limited in your diet.
  • Trans fats are abundant in processed food and you should try to keep them out of your diet.
  • Cholesterol comes from animal proteins, high fat dairy products, and other foods such as egg yolks. As with saturated fats, these should be limited in your diet.
  • Sodium is not healthy for your heart and can also be a problem for diabetics. Limit your sodium intake to 2,000 mg per day.

A note about carbs: a recent study details that people with Type 1 diabetes underestimate the amount of carbs they consume at each meal.[2] Accurately estimating your intake of carbs greatly improves your chances of medically managing your diabetes with proper nutrition. The study suggests proper nutrition training and discovered that the degree of correctly estimating the amount of carbs per meal increased by up to 83 percent in study subjects.

The Dietary Exchange System

With the dietary exchange system each portion in each group is deemed an exchange. Every exchange has, on average, equal amounts of carbs, proteins, fats, and calories. This means an exchange will have the same effect on your blood sugar as each serving in the group.

Why use the word exchange? When planning a meal you can exchange one apple for 1/3 cup of linguini and have the same amount of carbs.

Tips to keep in mind:[3]

  • You will be allowed a particular number of exchanges from the dietary exchanges every day
  • Exchanges are supported by a variety of issues including amount of exercise, insulin dependence, weight, and other health factors
  • Exchanges take place within a food group, not between food groups
  • There are freebies that can be eaten as snacks or with meals

Dietary Exchange Categories

Starches. Dietary exchanges equal 15 grams of carbs, 3 grams of protein, and some fat. ½ cup of grains or pasta equal one exchange.

Meat and cheese. The exchanges list differentiates between high fat and low fat proteins. You can add high fat proteins as an exchange up to three times a week. A serving size is one ounce of protein.

Vegetables. Vegetable exchanges equal ½ cooked vegetables, 1 cup raw vegetables, or ½ cup vegetable juice.

Fruit and sugar. Sugar is incorporated into the carb exchanges. Keep sugars to less than ten percent of your carb intake.

Milk. An exchange is equal to 1 cup. This normally equals 8 ounces.

Does it sound confusing? It may be at first, but once you begin to understand the exchange factor you will learn that eating a healthy diet can considerably lower your need for more invasive diabetic interventions.

One of the main keys is keeping exchanges within a certain range of calories. Let’s look at a simple chart:[4]

Exchanges and Caloric Values

Calories 1,200 1,500 1,800 2,000 2,000
Starch(including bread) 5 8 10 11 13
Meat 4 5 7 8 8
Veggies 2 3 3 4 4
Fruit 3 3 3 3 3
Milk 2 2 2 2 2
Fat 3 3 3 4 5

As you learn to incorporate the dietary exchanges into your meal planning also keep an eye on the exchange charts. Recipe books have known to get it wrong. It is up to you to ensure you keep a close watch on your daily exchanges. The important thing to keep in mind is to control portion size.[5]

Can you make it work? Dietary exchanges are a healthy and easy way for you to manage your nutrition. Many diabetics find that they can follow the dietary exchanges and avoid medicine for their disease. Other diabetics follow the dietary exchanges and lessen their dependence of diabetic medicines

You can use the dietary exchanges to create healthy and delicious meals. Your health will improve as will the health of your entire family!


[1] The Exchange List System for Diabetic Meal Planning. (n.d.). Retrieved from University of Arkansas:

[2] Tucker, M. (2007). Carbs Often Undercounted by Diabetic Patients. Family Practice , 17.

[3]  Diabetics Diet – Diabetic Exchanges List. (n.d.). Retrieved from University of Marylnd Medical Center:

[4] Diabetics Diet – Diabetic Exchanges List. (n.d.). Retrieved from University of Marylnd Medical Center:

[5] Carter, K. (2009). QuestioningFat and Carbs. Diabetes Forcast , 18.

[6] This article was originally published July 12, 2012 and last revision and update of it was 9/10/2015.