needs within the group. Consider using one or more of these assessment options:
• Develop a few written questions that allow you to quickly assess whether people know the foods (as food groups) that do and do not contain carbohydrate (see box Questions to Ask).
• Ask people to complete a one-to-three day food record and have them circle the foods that contain carbohydrate. Ask them to include the amount of food and, if possible, the amount of carbohydrate each food provides. If people haven’t determined the carbohydrate counts of these foods, they can demonstrate their ability to do this using a variety of carbohydrate counting resources and tools provided by the educator in class (see box Tools and Resources Every Educator Needs). Finally, have them provide a total carbohydrate count for meals and for the day.
• To assess a person’s measuring skills, consider having a box of dry cereal, nuts, or dried fruit (foods that can be reused and aren’t perishable), and ask them to measure out a specific amount or one serving of the food.
• Provide people with different Nutrition Facts panels from common packaged foods. Create a brief questionnaire that can demonstrate their knowledge of where to find the serving size and total grams of carbohydrate. Determine if they can calculate the total grams in a serving if the serving is different from the serving size on the Nutrition Facts panel.
• Use food models to ask people to estimate the carbohydrate count of a variety of foods, including commonly eaten mixed dishes.
• Develop a brief questionnaire with which to assess a person’s ability to find and determine a total for the grams of carbohydrate in a fast food meal. Use the nutrition facts for fast food restaurants (see Appendix I).
Ongoing assessment
In addition to assessing initial carbohydrate counting skills, it is important to be able to assess the progression of a person’s knowledge and skills as well. Educators can use many of the same questions and tools suggested above for this purpose.
Assessment Checklist
Below is a list of knowledge and skills a person using Basic Carbohydrate Counting should obtain. Some of the skills may be present from the beginning; most will probably be acquired through carbohydrate counting education. Use this checklist as an ongoing assessment tool. Strategies for teaching this knowledge and these skills are addressed in chapters 3 and 4.
Covered in Chapter 3. Concepts to Teach—From Basic Nutrition to Meal Planning:
Covered in Chapter 4. Concepts to Teach—Counting Carb, Reading Food Labels, and Measuring Portions:
Progression to Advanced Carbohydrate Counting
A person who is ready to progress to learning and using Advanced Carbohydrate Counting should be able to perform all the tasks listed above in the Assessment Checklist. However, not all diabetes self-management regimens are suited to Advanced Carbohydrate Counting. The mastery of Basic Carbohydrate Counting—with the simple goal of eating a consistent amount of carbohydrate throughout the day—can be an endpoint for some people with diabetes. For others, the mastery of Basic Carbohydrate Counting skills and knowledge will serve as a base upon which they can progress to acquire and master Advanced Carbohydrate Counting skills.
A person who has type 2 diabetes and follows a healthy eating plan integrated with regular physical activity and no blood glucose—lowering medications has no need to progress to Advanced Carbohydrate Counting with their current regimen. They may need to progress as their diabetes management plan becomes more complex, often with the addition of oral or injectable medications and/or insulin that can be adjusted based on blood glucose levels and/or carbohydrate intake. Until that time (or if that complexity never becomes necessary), Basic Carbohydrate
