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How Does the Diabetic Exchange Diet Work?

Updated on October 26, 2015

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Have you ever traded a banana for a handful of grapes or exchanged a blueberry muffin for 3 gingersnap cookies at your school lunchroom? The diabetic exchange diet is based on a simple system similar to these lunchroom trades. Created in 1950 by the American Diabetes Association, the exchange system is a meal-planning process that has helped many diabetics maintain healthy weight and keep their blood sugar within the target range. A key principle of this diet is to group together foods that contain comparable nutrient contents and affect blood sugar in a similar way. You can exchange any food for another food within the same group, as long as it doesn't exceed your daily allotment. This strategy makes it easier to choose not only the right combination of foods but also the appropriate portion sizes. Before we take a look at the diabetic exchange list and sample diet plans, please do a short quiz to find out whether this diet strategy is right for you.

Roasted Sweet Potatoes and Green Beans Wrapped in Lean Beef
Roasted Sweet Potatoes and Green Beans Wrapped in Lean Beef | Source

Diabetic Exchange Diet - The First Step

The first thing you must do is set up a daily diet plan. You should work with your doctor or a nutritionist to create a customized program based on your weight, level of physical activity, intensity of the diabetes, and other lifestyle issues (work schedule, family, travel, etc). It is highly recommended that you seek help from a health professional in this process because every diabetic patient is different, so a diet plan that works for other diabetics may not be appropriate for you. If you'd really like to try it on your own, however, start with calculating the number of calories your body needs per day. To maintain your current weight, first multiply your weight by ten, then add more calories using the guideline below.

  • If you're sedentary, add 300 calories.
  • If you're moderately active (30 - 60 minutes of daily low-impact exercise), add 500 calories.
  • If you're very active (more than 60 minutes of low-impact exercise or 30 - 60 minutes of high-impact exercise a day), add 700 calories.

For example, I'm about 100 lbs and moderately active, so my calculation should look like this: 100 × 10 + 500 = 1500 calories / day

To lose about 1 pound of your body weight a week, you have to burn an extra 500 calories per day, or cut 500 calories from your diet plan, or come up with a combination of exercise and dieting. Keep in mind, though, that in order to make sure you consume adequate nutrients your body needs, your daily calorie intake should never be lower than 1200.

Here are some sample daily exchange plans for three different calorie targets. Again I'd like to emphasize that these are only general guidelines. To find a diabetic exchange plan that's really suitable for you, it is strongly advised that you consult a doctor or nutritionist.

General Exchange Counts for Different Calorie Targets

Food Group
1200 Calories / Day
1500 Calories / Day
1800 Calories / Day
Meat / Meat Substitutes
Starches / Other Carbs
2 or less
3 or less
4 or less

Diabetic Exchange Lists

Here comes the fun part; to succeed in this diabetes diet, you need to know the portion sizes for each exchange. The following exchange lists are adapted from Robyn Webb' s "Eat to Beat Diabetes." They are pretty much simplified versions of the original exchange lists created by the American Diabetes Association. Be aware, though, that certain foods may belong to more than one list. For instance, one serving of lentils is counted as 1 starch exchange and also 1 meat substitute exchange, as they are rich in both carbs and protein.

Breadsticks | Source

Starches and Other Carbs

One starch exchange contains approximately 15 grams of carbohydrate and 80 calories. However, if you consume high-fat starchy food, such as a square of brownie, don't forget to count it as 1 fat exchange as well.

Serving Sizes for 1 Starch Exchange

  • 1 oz or of bread product / muffin
  • 1/2 cup of cereal / cooked grain, pasta, noodles
  • 1/2 cup of starchy vegetable (corn, potato, yam, etc)
  • 1 oz of high-carb snack foods (potato chips, corn chips, pretzels, etc)
  • 2 oz of cake / donut / energy bar / candy bar
  • 1 can of soda / energy drink
  • 1/2 cup of pudding / ice-cream
  • 1 small slice of pie ( about 1/8 of an 8-inch pie)
  • 2 tbsp of syrup
  • 1 tbsp of jam / jelly / honey

Green Bean Stir-Fry
Green Bean Stir-Fry | Source

Vegetables (Non-Starchy)

One vegetable exchange equals approximately 5 grams of carbs and 25 calories. Since vegetables are low in sugar but packed with fiber and nutrients, diabetics are encouraged to substitute vegetables for starchy foods once in a while. For example, you can eat 2 cups of cooked vegetables or 3 cups of raw vegetables in one meal, and just count it as 1 starch or 1 carbohydrate exchange.

Serving Sizes for 1 Vegetable Exchange

  • 1/2 cup of cooked vegetables
  • 1 cup of raw vegetables.


One fruit exchange contains about 15 grams of carbs and 60 calories. Try to choose fresh fruits over canned and dried alternatives as often as you can. Fresh fruits are higher in fiber and lower in sugar, so they are a lot more diabetic-friendly.

Serving Sizes for 1 Fruit Exchange

  • 1 small to medium fresh fruit
  • About 3/4 cup of grapes / cherries / berries / cubed pineapple / melon
  • 1/2 cup canned fruit with no added sugar
  • 1/4 cup dried fruit


Please note that not all dairy products or all types of "milk" belong to this list. For instance, cheese is in the meat substitute and fat groups, while soy milk belongs to the meat substitute list.

Serving Sizes for 1 Milk Exchange

  • 1 cup of milk
  • 3/4 cup of plain yogurt
  • 1 cup of low-sugar or sugar-free yogurt

Protein-Rich Lunch with Meat, Egg and Miso Broth
Protein-Rich Lunch with Meat, Egg and Miso Broth | Source

Meat / Meat Substitutes

Generally, one meat exchange contains about 7 grams of protein, but the calories can vary significantly, depending on the fat content of the meat or meat substitute you consume. As diabetics are prone to heart disease, it is highly recommended that you stick with lean meat options, such as poultry and fish.

Serving Sizes for 1 Meat Exchange

  • 1 oz of cooked meat / poultry / fish
  • 1 oz of cheese
  • 1 egg
  • 3 slices of bacon
  • 1/2 cup of tofu
  • 1/2 cup of beans / legumes
  • 1 cup of soy milk

Bacon and Butter are Very High in Fat.
Bacon and Butter are Very High in Fat. | Source


One fat exchange equals about 5 grams of fat and 45 calories. To stay healthy, diabetics should avoid over-consumption of foods high in saturated fat and cholesterol.

Serving Sizes for 1 Fat Exchange

  • 1 tsp of regular butter / cooking oil / margarine / mayo / shortening
  • 1 tbsp of low-fat and trans-fat-free margarine / mayo / salad dressing / cream cheese
  • 2 tbsps of whipped cream / sour cream / shredded coconut
  • 1 tbsp of pine nuts / flax seed / sesame seed / sunflower seed
  • 1 oz of avocado
  • 6 almonds / cashews
  • 10 peanuts
  • 16 pistachios
  • 1 slice of bacon

Free Foods

The "free food" group refers to foods that are very low in carbs and calories, so diabetics can consume them in moderation without counting them as part of the exchange diet plan. Some of the foods on this list include diet soda, unsweetened tea or coffee, vinegar, mustard, fresh lemon juice, cooking spray, dried herbs and spices, non-fat broth and salad greens.


Submit a Comment

  • Om Paramapoonya profile image

    Om Paramapoonya 5 years ago

    It's a great program. Hard work but worth it. I've learned a lot from my mentor and teammates. :)

  • profile image

    jenubouka 5 years ago

    Ah thanks Om, I am far too busy with freelancing projects at the moment I have regretfully neglected writing here much lately. I thought about filling out the application when I actually see the light of the end of my projects. How it is the program anyway?

  • Om Paramapoonya profile image

    Om Paramapoonya 5 years ago

    Jen, you're too humble. I think you're very cool. But "coolness" isn't one of the requirements to join the program anyway.

  • profile image

    jenubouka 5 years ago

    Oh, I am not that cool to join that club:)

  • Om Paramapoonya profile image

    Om Paramapoonya 5 years ago

    @Jacxonthego - You're very welcome!

  • Om Paramapoonya profile image

    Om Paramapoonya 5 years ago

    @jenubouka - Hi Jen. It's great that your man is very careful with his diet. That's how diabetics should be if they want to stay healthy. I actually just noticed the "a" on my avatar after I read your comments. LOL Well, since I'm in the HP apprenticeship program, I guess it stands for "apprentice." But I don't know; maybe it just means "atrocious hubber!" hehehehe

    @healingsword - I'm glad you found this interesting, Ann. And yes, the exchange diet does require you to keep meticulous track of what you eat, which could be inconvenient sometimes. According to the American Diabetes Association, this system can really work wonders, though!

    @Simone - Glad to hear you enjoyed this hub. Please share the info if you know anyone who's diabetic!

  • Simone Smith profile image

    Simone Haruko Smith 5 years ago from San Francisco

    I was not at all familiar with the exchange before reading this- and I find the system to be absolutely fascinating! Thanks for the fantastic and thorough introduction.

  • healingsword profile image

    Ann Wehrman 5 years ago from California

    Hi Om, This is a well-written and very informative Hub. I am always interested to read about nutrition, and this is great advice. I enjoyed the quiz, too. For me, this much tight control can be hard to follow in daily life, but it's important to have the basic knowledge you present here.

  • profile image

    jenubouka 5 years ago

    This is so awesome Om! My man is diabetic and this will help a great deal with planning his diet and perhaps allow him to feel a bit more freedom when he eats. He is a very picky eater and keeps a very strict regimen when it comes to starch and other no-no's. This is going to help me immensely! Thanks so much, p.s. what does the "a" mean on your avatar?

  • Jacxonthego profile image

    Jacxonthego 5 years ago from Portland, Or.

    I am actually a diabetic! I would like to try this thanks for the info and the link.