Diabetes Exchange Lists

The major objective of diabetes exchange lists is to maintain a balance between carbohydrates, proteins and fats. The lists can be obtained at American Diabetes Association.

It is recommended that people with diabetes should consult their doctors or dietitians first to establish their individual dietary requirement. The diabetes exchange lists should be used to set up a menu to fulfill the optimum number of calories and proportion of carbohydrates, proteins and fats. The diabetic exchange lists are six different lists of foods grouped according to similar calorie, carbohydrate, protein, and fat content; these are starch/bread, meat, vegetables, fruit, milk, and fat. A person is allowed a certain number of exchange choices from each food list per day.

The amount and type of these diabetes exchange lists are based on a number of factors, including the daily exercise program, timing of insulin injections, and whether or not an individual needs to lose weight or reduce cholesterol or blood pressure levels.

Foods can be substituted for each other within an list but not between lists even if they have the same calorie count.

In all diabetes exchange lists (except in the fruit list) choices can be doubled or tripled to supply a serving of certain foods. (For example 3 starch choices equal 1.5 cups of hot cereal or 3 meat choices equal a 3-ounce hamburger.)

On the diabetes exchange lists, some foods are "free." These contain less than 20 calories per serving and can be eaten in any amount spread throughout the day unless a serving size is specified.

Categories on the exchange lists

  • Starches and Bread. Each exchange under starches and bread contains about 15 grams of carbohydrates, 3 grams of protein, and a trace of fat for a total of 80 calories. A general rule is that a half-cup of cooked cereal, grain, or pasta equals one exchange and one ounce of a bread product is one serving.
  • Meat and Cheese. The exchange groups for meat and cheese are categorized by lean meat and low fat substitutes, medium-fat meat and substitutes, and high-fat meat and substitutes. High fat exchanges should be used at a maximum of 3 times a week. Fat should be removed before cooking. Exchange sizes on the meat list are generally one ounce and based on cooked meats (three oz of cooked meat equals 4 oz of raw meat).
  • Vegetables. Exchanges for vegetables are 1/2 cup cooked, 1 cup raw, and 1/2 cup juice. Each group contains 5 grams of carbohydrates, 2 grams of protein, and between 2 to 3 grams of fiber. Vegetables can be fresh or frozen; canned vegetables are less desirable because they are often high in sodium. They should be steamed or microwaved without added fat.
  • Fruits and Sugar. Sugars are now included within the total carbohydrate count in the exchange lists. Sugars still should not be more than 10% of daily carbohydrates. Each exchange contains about 15 grams of carbohydrates for a total of 60 calories.
  • Milk and Substitutes. The milk and substitutes list is categorized by fat content similar to the meat list. A milk exchange is usually one cup or 8 oz. For those who are on weight-loss or low-cholesterol diets, the skim and very low-fat milk lists should be followed, and the whole milk group avoided. Others should use the whole milk list very sparingly. All people with diabetes should avoid artificially sweetened milks.
  • Fats. A fat exchange is usually 1 teaspoon but it may vary. People, of course, should avoid saturated and trans fatty acids and choose polyunsaturated or monounsaturated fats instead.

Diabetes Exchange Lists and Meal Planning


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