Carb-Counting Worksheet for Mealtime Insulin - Accu-Chek

Carb-Counting Worksheet
for Mealtime Insulin
Use the food reference tools inside to help you calculate
your insulin dose when using the ACCU-CHEK® Aviva
Expert or ACCU-CHEK Combo system.
Breakfast
Food item
Bagel Toast with butter Toast with jelly Donut, glazed Orange juice Milk Food item
Breakfast sandwich (English
muffin with egg and cheese) Cheerios® with ½ cup milk Hash browns Banana Strawberries, fresh Portion size
Carb grams
Medium (3.5 inch) 56
1 slice 15
1 slice with 1 tbsp jelly 28
1.7 oz.
21
1 cup 26
1 cup 12
Portion size
Carb grams
1
1½ cups cereal 2 oz. 7 inch 1 cup Food item
Vanilla latte Peanut butter, smooth Ham Fried egg Turkey sausage Bacon 32
36
15
27
12
Portion size
16 oz. 2 tbsp 3 oz. slice 1
1 link 3 medium slices Carb grams
37
6
2
1
0
0
My Breakfast (write in foods you eat as a meal for breakfast and then add up the carb grams.)
Food item
Portion size
Total:
Reference calorieking.com. Accessed June 13, 2014.
Carb grams
Use this number
to dose your insulin
as directed by your
healthcare provider.
Lunch
Food item
Sub sandwich with meat and cheese Potato chips Hamburger with bun Hotdog with bun French fries (fast food) Chicken nuggets (fast food, no sauce) Portion size
8 inch 1 oz.
1
1
Medium 6 nuggets Food item
Grilled chicken wrap with ranch Hard-shell taco Bean burrito Grilled chicken Caesar salad Raw baby carrots Regular soda Diet soda Sweet tea Food item
String cheese Apple Orange Brownie Cookie, oatmeal Carb grams
55
15
31
27
52
18
Portion size
1 (4.2 oz.)
2 (2.8 oz. each) Medium (6.7 oz.)
Entree size 0.4 oz. 20 oz. 20 oz. 20 oz. Carb grams
25
24
55
19
1
67
0
54
Portion size
Carb grams
1 oz. 1
Medium, 3 inches 25
Medium, 2.5 inches
15
2-inch square 12
3.5 inches 17
My Lunch (write in foods you eat as a meal for lunch and then add up the carb grams.)
Food item
Portion size
Total:
Reference calorieking.com. Accessed June 13, 2014.
Carb grams
Use this number
to dose your insulin
as directed by your
healthcare provider.
Dinner
Food item
Pizza Fried chicken Grilled chicken Spaghetti with meat sauce Fish, tilapia, broiled Fish, fried Meatloaf Food item
Steak, sirloin
Roast beef Boiled shrimp Ribs, Dave’s Family BBQ Green beans
Dinner roll
Portion size
/8 th of 12-inch medium 1 breast
1 breast
15 oz.
4 oz. One fillet, 3 oz.
3 oz. 1
Portion size
4 oz. 4 oz.
5 large
4 ribs
1 cup
2 inch, small
Carb grams
22
13
0
108
0
7
10
Carb grams
0
0
0
18
8
13
Food item
Baked potato
Mashed potatoes
Tortilla, flour
Rice, cooked
Ice cream, vanilla
Portion size
1 large, 10.5 oz. 1 cup
10 inch
1 cup
1 cup
Carb grams
63
36
36
45
31
My Dinner (write in foods you eat as a meal for dinner and then add up the carb grams.)
Food item
Portion size
Total:
Reference calorieking.com. Accessed June 13, 2014.
Carb grams
Use this number
to dose your insulin
as directed by your
healthcare provider.
This tool provides examples of foods with estimated carb amounts rounded to the nearest
whole number. Individual carb amounts listed can vary. For more exact information on food items
not found here, please check food labels, restaurant nutrition guides, or other accurate sources.
Snacks
Food item
Trail mix Gelatin, sugar free Gelatin, regular Pudding, regular Pudding, sugar free Almonds Beef jerky Food item
Pretzels Granola bar (crunchy
oats n’ honey)
Granola Popcorn Fruit smoothie Saltine crackers Portion size
1 oz. 1 bar ½ cup 5 cups 20 oz. 5
Portion size
½ cup ½ cup ½ cup
½ cup
½ cup
½ cup 1 piece Carb grams
23
15
35
16
87
10
Carb grams
34
0
19
25
14
9
2
My Snacks (write foods you eat as a snack and enter the carb grams.)
Food item
Portion size
Carb grams
Use the number
in each box to
dose your insulin
as directed by your
healthcare provider.
Reference calorieking.com. Accessed June 13, 2014.
When needed, measure your food’s portion size using this ruler.
0"1"2"3"4"5"6" 7"
Interested in enjoying the meal without worrying about the math?
Check out the ACCU-CHEK Aviva Expert and the ACCU-CHEK Combo systems.
Both have built-in insulin calculators to make calculating a bolus much easier. To calculate
your insulin dose, simply enter your total carbs, and the meter does the rest.
To learn more about these innovative products, visit accu-chek.com.
Roche thanks the following contributing authors for their time and expertise in developing this
worksheet for you: Penny Atkinson, MSEd, RD, LD, CDE; Barb Crishi, MS, RD/LD, CDE; Kenna
Morgan, MS, RD, CDE; and Leslie Weller, RD, CDE.
Content was developed in the summer of 2014 by Roche employees that have extensive diabetes
management experience as evidenced by their credentials.
CCU-CHEK, ACCU-CHEK AVIVA EXPERT, ACCU-CHEK AVIVA COMBO,
A
ACCU-CHEK SPIRIT COMBO, and COMBO are trademarks of Roche. All other
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© 2014 Roche. 348-53723-0714