The Diabetes Québec Exange System

The exchange system developed by Diabetes Québec is a tool that lets you estimate the amount of carbohydrates in the foods you eat.

We have classified foods into seven groups:

Milk and Alternatives
Other Foods
Meat and Alternatives

In each group, foods are ranked according to their carbohydrate (sugar), protein and lipid (fat) content.

What is one exchange?

Foods in the same group, eaten in the amounts indicated in Meal Planning for People with Diabetes, represent one exchange for this group. For example, a starch exchange equals one small potato or one slice of bread.

To see examples of serving sizes that equal one exchange in each of the food groups, consult Meal Planning for People with Diabetes at a Glance or Meal Planning for People with Diabetes.

How to use this system

A dietitian will evaluate your nutritional needs and develop a personalized daily meal plan with you based on the exchange system.

Your daily meal plan will help you plan your meals based on the recommended number of exchanges for each of the food groups.

Furthermore, this plan will take your carbohydrate needs into account and distribute them properly throughout the day.

A bit of flexibility

Sometimes, you can exchange foods from two different groups; for example, by eating a starch instead of a fruit. However, you must pay attention to the carbohydrate content of the substituted food.

Your total carbohydrate intake must stay the same to avoid large fluctuations in your blood glucose (sugar) levels. To help you do this, use the average carbohydrate content provided for each food group.

Average carbohydrate content of the food groups

The table below indicates the average amount of carbohydrates equal to one exchange, for each food group:

Food group Amount of carbohydrates for 1 exchange (g) Number of sugar cubes 
Starches 15 3
Fruits 15 3
Vegetables* 5 1
Milk and Alternatives 12 to 15 3
Other foods* 15 3
Meat and Alternatives 0 0
Fats 0 0

*Since they are very low in carbohydrates, vegetables (except for starchy vegetables) can be eaten in unlimited amounts.

**Other Foods contain added sugar. They are less nutritious than foods containing natural carbohydrates (starches, fruits, milk and alternatives).

Sugar cubes

To help you easily visualize the amount of carbohydrates in foods, you can also use the sugar-cube method.

Each sugar cube represents 5 grams of carbohydrate, or the equivalent of one teaspoon of sugar.

1 serving = 15 g of carbohydrate = 3 sugar cubes = 1 exchange


Research and text: Diabetes Québec Team of Dietitians

July 2014 (updated on July 2018)

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