Alternatives to the exchange system for teaching meal planning to persons with diabetes

Although the most well known, exchange lists are not the only meal-planning approach for persons with diabetes. This paper outlines the steps in the nutrition education process, including initial and continued education stages, and presents six alternative approaches for individualizing meal planning. These include the High Carbohydrate-High Fiber Exchange System, Calorie/Fat Counting, Total Available Glucose, the Point System, Month of Meals, and Individualized Sample Menus. The approaches are rated according to emphasis on weight loss, glucose control, and ease of learning and according to type of diabetes. A complete resource guide is provided.