Carb Counting

Some people with diabetes use carbohydrate counting to balance their food and insulin. Carbohydrates, or "carbs," are what our bodies use for fuel. The more carbs your child eats, the higher her blood glucose goes and the higher her blood glucose, the more insulin she needs to move the sugar into her cells.

Carb Counting Basics

People who use carb counting add together all the carbohydrates in the meal they plan to eat. Then they inject enough rapid- or short-acting insulin to process that amount of carbohydrates. So it's a great system in that it gives you more flexibility. But it also takes more time and attention to track the carbs throughout the day. Generally, though, more kids with diabetes count carbs than use other methods of meal planning. The flexibility wins families over!

To do carb counting, you need to know how many carbs are in different kinds of food. You and your child's doctor also have to figure out how much insulin your child needs to "cover" a certain amount of carbohydrates. A good place to start may be 1 unit of insulin for every 15 grams of carbohydrate. But insulin works a little differently for each person. Your child may need 1 unit of insulin for every 10 grams or 1 unit for every 25 grams of carbohydrate. Talk to your child's doctor to find out the amount that's right for her.

Carbohydrate counting is pretty easy to learn and practice. Keep in mind though, that counting carbs is not the same as eating well. Sure, you can inject the right amount of insulin to cover a meal of cheeseburgers, fries, and a hot-fudge sundae. If your child takes enough insulin, her blood glucose may even stay in her target range. That doesn't mean the meal was good for her! People who use carb counting still follow a healthy meal plan.

How to Count Carbs

You may be thinking "Sheesh! I have to memorize how many carbs are in everything my child eats?!" That sounds pretty hard. But no, you don't have to quiz yourself every night on how many carbs are in a glass of milk, a granola bar, and a peanut butter sandwich. You can get books that list carb counts for thousands of foods and most packaged foods are required to list their carb counts right on the label. So, after a while you probably will know a lot of counts by memory, but in the meantime, there are plenty of ways for you to find out how many carbs are in your child's favorite foods.

1. Start with the Nutrition Facts label that’s on most packaged foods. The most important information you need for carb counting is the (1) Serving Size, and (2) Total Carbohydrate. Start with the serving size. For our example, chili with beans, a serving equals one cup. One cup of this chili with beans contains 22g of carbohydrate.



2. Next, guess how much your child will probably eat. Is it about 1 cup, more like ½ cup, or even 2 cups for a hungry teen? Then do the math for the carbohydrate in the serving size your child is likely to eat. 11g for ½ cup, or 44g for 2 whole cups.



3. Now think about the other foods your child is likely to eat with her chili. Cheddar cheese or sour cream? How about a handful of oyster crackers? Carbs in these foods count too. For example, an average serving of oyster crackers is about ¼ cup. But some manufacturers list serving sizes in # of pieces (for example, 35 crackers), or even in weight (15g). You may want to invest in a good digital kitchen scale.



4. Check the total carbs for the cracker serving your child is likely to eat. One serving (1/4 cup) of oyster crackers might be about 10g. Then add that number to the total carbs for the chili with beans If your child will have a cup of chili (1 serving) but 2 servings of oyster crackers, your total is 42g.

The good news is that all of this information is usually right on the package. And if your child is eating fresh foods that don't come packaged -- like fruits or vegetables -- you can usually get the carb information online or in books.

What About Recipes?

You may be thinking, what about recipes? How do I count the carbs in homemade foods? Do I have to add together the carbs for each separate ingredient?  Well, for some foods, that may be the easiest way. A peanut butter and jelly sandwich, for example. Two slices of bread, a couple tablespoons of peanut butter, and a tablespoon of jelly. Check the serving sizes and carb counts for your favorite brands of bread, peanut butter, and jelly, add them together, and you’re done. You’ll want to be careful the first few times you try it. Do you typically make a sandwich with 2 tablespoons of peanut butter or 4? You’ll probably have to get out the measuring spoons to figure out how big a glob 1 tablespoon is. But after a while, you’ll be able to “eyeball” the serving size pretty well.

Now, what about more complicated foods, like lasagna? Well, you can get books that list approximate carb counts for homemade foods. This would be a good starting point. Or you can get cookbooks and software that will give you carb counts for all kinds of foods. Some software will calculate nutrition facts after you add or subtract ingredients from recipes, or even enter your own recipes.