Calderdale and Huddersfield NHS Trust

Dept of Nutrition and Dietetics

Carbohydrate
Counting Food Diary

Name………………………………………………
Dietitian: Mandy Stock
Emma Ward-Tilley
Contact No. O1422 222033

Diary to be kept for …… days

Date issued ………………………………
Date Received ………………………………
Tips for completing your food diary

• Write down all you eat and drink

• Use a different page for each day

• Try to describe the amount/ weight of food actually

eaten in one of the following ways:

 Actual weight e.g. 2oz ham or 26g packet of crisps etc.

 House hold measures e.g. 1 level teaspoon, 1 teacup, 1 mug
full, a match box size piece of cheese, an egg size potato
etc
 Per item e.g. 3 ginger biscuits, 2 weetabix etc

• Try to be specific about the description e.g. is it

white, wholemeal or granary bread

Example
Time Before meal Food/Drink Carbohydrate Insulin After meal
blood Content (g) Units blood
glucose level Given glucose level
Early
morning
Breakfast 6.6 Branflakes (30g) 25 5 9.0 mmols
with 220ml semi
7 am skimmed milk 10
200ml glass orange
juice 20
Mid 5.8 mmols 1 medium banana 15 2 Not taken
morning

10.30am
Date………………..

Time Before Food/Drink Carbohy Insulin 2hr post Activity

meal drate Units meal
blood Content Given blood
glucose (g) glucose
level level
Early
morning
Breakfast

Mid
morning
Lunch

Mid
afternoon

Evening
Meal

During
evening

Supper

Extras
Date………………..

Time Before Food/Drink Carbohy Insulin 2hr post Activity

meal drate Units meal
blood Content Given blood
glucose (g) glucose
level level
Early
morning
Breakfast

Mid
morning
Lunch

Mid
afternoon

Evening
Meal

During
evening

Supper

Extras
Date………………..

Time Before Food/Drink Carbohy Insulin 2hr post Activity

meal drate Units meal
blood Content Given blood
glucose (g) glucose
level level
Early
morning
Breakfast

Mid
morning
Lunch

Mid
afternoon

Evening
Meal

During
evening

Supper

Extras
Date………………..

Time Before Food/Drink Carbohy Insulin 2hr post Activity

meal drate Units meal
blood Content Given blood
glucose (g) glucose
level level
Early
morning
Breakfast

Mid
morning
Lunch

Mid
afternoon

Evening
Meal

During
evening

Supper

Extras