Getting Started with Carbohydrate Counting

Managing Your Child's Food and Insulin By Counting Carbs

peanut butter on bread
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Carbohydrate counting is not as difficult as it might seem at first, and the benefits are worth the slight learning curve at the beginning. It important to know a little about the benefits of carbohydrate counting before you start. If you already know these, then the next step is to begin the practice of counting carbohydrates.

How Many Carbs?

The starting point is to ask how many carbohydrates are in any given food your child might eat. Carbohydrates are measured in grams (g). Virtually all packaged foods carry a nutrition label that will tell you the number of grams of carbohydrates per serving. Be sure to distinguish the difference between a single serving and the entire contents of the container. Package labeling is not typically provided for whole foods, such as fruits and vegetables. These you will have to look up, although they'll likely stick to memory after a while.

Adding up the Carbs

Adding up the carbohydrates is relatively easy when choosing simple foods. For example, let’s assume your child is having a lunch that includes a peanut butter sandwich, apple, ​and glass of milk. You simply add the carbohydrates of each item:

  • 2 slices of wheat bread = 25g carb
  • 2 Tablespoons of peanut butter = 6g carb
  • 1 small apple (about one cup chopped) = 17g carb
  • 1 8 oz. glass of 2% milk = 11g carb

Total carbohydrates for this lunch would be 59g.

In order for the carbohydrate total to make sense, you must compare it to your child’s meal plan. All children with type 1 diabetes need to have a customized meal plan developed by a registered dietician to establish a target range of carbohydrates. This target range will guide you as to the ideal number of carbohydrates per meal or snack, and also give you a specific total for each day.

Meal Preparation

Calculating carbs when you are having a homemade casserole or a dish with a mixture of foods can be a little more challenging.

First, calculate the number of carbs in a single serving of each of the individual ingredients. You may need to adjust your math if you have less than a serving of an ingredient. For example, if you are serving chili with kidney beans, you might have to adjust a full serving (1 cup of kidney beans equals 40g of carbs) to what you child will actually eat (1/4 cup or 10g). Know that you'll often have to take your best guess as to how much your child will eat since children often do not eat what we expect or hope they will. Take an educated guess based upon past eating behavior.

Balancing Food With Insulin

Counting carbs is only one part of the equation. The other important piece is how much insulin is needed to balance the intake of carbohydrates. A general starting point is 1 unit of insulin for every 15 grams of carbohydrate. But, because insulin works a little differently for each person (especially children who are at all different developmental stages), it is critical that you work this calculation out with your doctor before you begin.

Putting it All Together

The hardest part about learning to count carbohydrates is starting out. It can seem overwhelming at first. But remember: Once you know the number of carbohydrates in a single serving of your child’s most common foods, the mental calculations become second nature. You can even keep a running list of these common foods with the corresponding carbohydrate numbers near your recipes for easy reference.

Finally, keep in mind that counting carbs is not an exact science. Whether a piece of wheat bread is 12 or 13 carbohydrates is not going to make much difference in how your child’s blood sugar responds. But a level of accuracy does count.

If you are like most parents, balancing carb counting with insulin is a skill that improves over time. With the help of your child’s healthcare team, carb counting can become a valuable tool in your overall diabetes management strategy.

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