Patient education: Carb counting for children with diabetes (The Basics)

What is carb counting? — Carb counting is a type of meal planning that many people with diabetes (or "diabetes mellitus") use. It is a way for people to figure out how many "carbs" they eat. "Carbs" is short for "carbohydrates."

Our body breaks down the food we eat into 3 main types of nutrients: carbohydrates, proteins, and fats. Carbohydrates are sugars and starches that come from food. The body uses carbohydrates for energy.

People with diabetes need to watch how many carbs they eat, because carbs raise a person's blood sugar level.

Which foods have carbs? — Foods with a lot of carbs include:

●Bread, pasta, rice, and cereal

●Fruits and starchy vegetables

●Milk and other dairy foods

●Foods with added sugar (such as many cookies and cakes)

How is carb counting helpful? — Carb counting helps you:

●Choose the right amount of insulin to give your child before meals and snacks – The insulin dose depends on different factors, including what your child eats (especially the amount of carbohydrates) and how much they exercise.

●Plan your child's meals and snacks for the day – You can use carb counting to figure out how many carbs your child should eat at each meal and snack.

●Keep your child's blood sugar level under control – Spreading out the carbs your child eats over a whole day can help keep their blood sugar from getting too low or too high. Eating about the same amount of carbs every day also helps. This can help control your child's diabetes better and prevent medical problems that diabetes can cause.

How do I count carbs? — To count carbs, you need to look at the food's nutrition label (if it has a nutrition label). You will need to look at the:

●"Total carbohydrate" number – This tells you how many carbs are in 1 serving size of the food. If your child eats 1 serving, then the number of carbs your child eats will be the same as this number.

●"Serving size" – This tells you how much food is in 1 serving. If your child has 2 servings, the number of carbs will be 2 times the number of carbohydrates listed.

●"Dietary fiber" – Fiber is a carbohydrate that is not digested and so does not raise blood sugar. Foods with a lot of fiber can help control your child's blood sugar. If a food has more than 5 grams (g) of fiber, less insulin is needed for that food. So, you should count only the carbs that are not from fiber (figure 1).

If your child's food doesn't have a nutrition label, talk with your dietitian (food expert), diabetes nurse, or doctor. They can give you information about the usual serving sizes of different foods and the number of carbs in 1 serving size.

How can I plan my child's meals? — Your child's dietitian will tell you how many carbs your child should eat in one day. It will depend on your child's age, size, and how active they are.

You can spread out the total number of carbs over your child's meals and snacks for the day. That way, your child can eat some carbs at each meal or snack. Writing down the number of carbs your child eats at each meal and snack can help you keep track of the total number.

Does my child need special foods? — No. Your child can eat the same foods as your family. But, if possible, your family should eat a healthy diet with low-fat foods and lots of vegetables. It's best for your child to get carbs from fruits, vegetables, whole grains, and low-fat milk and dairy products. Whole grains are found in foods such as whole wheat bread, whole grain cereals, and brown rice.

What if my child is a picky eater? — If your child is a picky eater, try to be creative. Ask your dietitian, doctor, or nurse for ideas for new snacks. If your child refuses to eat at meal or snack time, try to have them eat or drink something else that has about the same amount of carbs. Otherwise, their blood sugar could get too low or too high.

Your diabetes team can also tell you how to adjust the timing and amount of your child's insulin dose when they are sick or their appetite changes.

What if my child eats food without telling me? — If your child eats extra snacks, remind them that eating extra food can raise their blood sugar level and lead to serious problems. Your child should always let you know if they want to eat extra food. That way, you can make sure they get the right amount of insulin.

More on this topic

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Patient education: Diabetes and diet (The Basics)
Patient education: Diet and health (The Basics)
Patient education: Giving your child insulin (The Basics)
Patient education: Checking your child's blood sugar level (The Basics)
Patient education: Controlling blood sugar in children with diabetes (The Basics)
Patient education: Managing diabetes in school (The Basics)
Patient education: The ABCs of diabetes (The Basics)

Patient education: Type 1 diabetes and diet (Beyond the Basics)
Patient education: Type 1 diabetes: Insulin treatment (Beyond the Basics)