Diabetes in Children: Counting CarbsWhy count carbohydrates for my diabetic child?

Carbohydrate counting is a skill that can help you and your child plan his or her meals to manage diabetes and control blood sugar. Carbohydrate counting also can allow your child to eat a variety of foods, just like other kids, and to increase his or her sense of control and confidence in managing diabetes.

Diabetes in Children: Counting Carbs

When you and your child know how much carbohydrate is in food, you can spread it throughout the day and control portion sizes. This helps to keep your child’s blood sugar in his or her target range after meals. High blood sugar can make your child feel tired and thirsty and, over time, can damage many body organs and tissues.

Carbohydrate is the nutrient that makes blood sugar rise the most.

Foods that contain carbohydrate include:

Fruits and starchy vegetables (such as potatoes and corn).
Milk and yogurt.
Starchy foods (such as breads, cereals, rice, and pasta).
Sugary foods (such as candy and cakes).
Using this method to provide consistent carbohydrate at each meal helps a child keep blood sugar at his or her target level.
You need to consult a registered dietitian or certified diabetes educator to help you and your child understand and use carbohydrate counting.

How do you count carbohydrates?

Here are some ways to help you and your child count the carbohydrate content of his or her food and spread the amount throughout the day. Your child will have the best chance of success if you and other members of the family also eat a variety of healthy foods. For diabetes in children, counting carbs is a must!

Establish a meal plan

Talk with a registered dietitian or certified diabetes educator to help you plan the amount of carbohydrate to include in your child’s meals and snacks. You can use a carbohydrate counting form ( What is a PDF document? ) .
Learn what makes a standard portion of carbohydrate foods. Each serving size or standard portion contains about 15 grams of carbohydrate. It might be helpful to measure your food portions when you are first learning what makes up a standard portion.
Learn how to count either grams or servings of carbohydrate.
Counting grams: For example, if you want to eat 45 grams of carbohydrate, you would choose three servings (3 servings x 15 grams per serving = 45 grams). So for breakfast, you could choose three servings of different foods (such as oatmeal, milk, and half of a banana) or three servings of the same food (such as a larger serving of oatmeal).

Counting servings: In this system, 15 grams equals 1 carbohydrate serving. Instead of counting 45 grams of carbohydrate at breakfast, you would count 3 carbohydrate servings.
Learn the standard portions of foods that contain protein. Protein foods, such as meat and cheese, are an important part of a balanced diet.
Limit saturated fat. Talk with a registered dietitian about how much fat to include in your child’s meals.

Start counting

Use the meal plan to select food for your child’s meals and snacks. Remember, high-sugar foods or sweets should be eaten only sometimes and in smaller servings than starches, fruits, and milk.
Serve standard portions. It might be helpful to measure your food when you are first learning what makes up a standard portion.
Check your child’s blood sugar level often. If you check it before and 1 to 2 hours after a meal, you will be able to see how the food your child eats affects his or her blood sugar.
If your child needs mealtime insulin, you might be taught to adjust the amount of insulin needed to cover the amount of carbohydrate your child eats.
Record what your child eats and his or her blood sugar results in a food record. At each regular visit with a certified diabetes educator or a registered dietitian, or whenever you think the meal plan needs a change, you can review your food record.

Other helpful suggestions

Read food labels for carbohydrate and calorie content. Notice the serving size on the package.
Get more help. The American Diabetes Association offers booklets that can help you learn how to count carbohydrates, measure and weigh food, and read food labels.

Medical Review: John Pope MD – Pediatrics & Adam Husney MD – Family Medicine & Kathleen Romito MD – Family Medicine & Rhonda O’Brien MS, RD, CDE – Certified Diabetes Educator & Colleen O’Connor PhD, RD – Registered Dietitian