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Diabetes: Helping your Child Carbohydrate Count (342)

Diabetes: Helping your Child Carbohydrate Count (342) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Nutrition


Helping Your Child Carbohydrate Count

The carbohydrate (carb) counting meal plan matches insulin to the food you eat. This gives you more
freedom to choose the foods you want while keeping your blood sugar levels in control.

What is a carbohydrate (Carb)?
ξ Carbs are the body’s best source of energy because they are the easiest to use.
ξ Carbs, or glucose, is the only form of energy that the brain can use.
ξ It is not healthful to cut carbs out of your diet. It is best to choose healthful sources of carb.

Where can I find Healthy Carbs?
ξ There are three types of carbs: sugar, starch, and fiber.
ξ Sugars are the simplest form of carb and the easiest for the body to use. They are often called
“quick carbs.”
ξ Starches are the largest form of carb and take the body longer to use.
ξ Healthy sources of carbs are high in fiber. Try to choose grains that have at least 3 grams of fiber
per serving.
ξ Non-starchy vegetables like lettuces, tomatoes, broccoli, cauliflower and many others have small
amounts of carb. They are also great sources of fiber.
ξ The amount of carb that your body needs is based on your height, weight, and activity level.

Sugars Choose this… Limit this…
ξ Whole fruit
ξ Vegetables
ξ Low-fat dairy, yogurt and cheese
ξ Fruit juice and
ξ Fruit-flavored drinks
ξ Sports drinks
ξ Soda
ξ Chocolate milk
ξ Candy
ξ Desserts
Starches Choose this… Limit this…
ξ Whole grains (100% whole
wheat bread, brown rice, whole
grain pasta, quinoa, buckwheat,
ξ Whole grain cereals (oatmeal,
cold cereals with < 8 grams of
ξ Beans, lentils, and split peas
ξ Starchy vegetables (potatoes,
peas, winter squash and corn)
ξ Refined grains (white bread,
white rice)
ξ Sweetened cereals with > 8
grams of sugar)
ξ Chips
ξ Desserts (Cakes, Pies, Cookies)

How do carbs affect blood sugar levels?
ξ Carbs increase blood sugar levels more than protein and fat.
ξ Almost all (90-100%) of carbs eaten affect the blood sugar within 20 minutes. Sugars affect the
blood sugar faster than starches. Some starches will take almost an hour to affect the blood sugar.
ξ A general rule is that 1 gram of carb will raise blood sugar levels 3-4 mg/dl.

How do protein and fat affect blood sugar levels?
ξ Protein and fat eaten without carbs have little effect on blood sugar levels.
ξ When they are eaten with carbs, they can help the blood sugar to rise and lower more slowly.
ξ Meals that are high in fat and protein, like pizza, may cause the blood sugar level to rise and stay
high for 2-3 hours after eating.

STEP 1: Carb Identification
The food label is a great place to get carb information. For homemade foods or foods without a label, use
the following resources to estimate the amount of carb in those foods:
ξ Carbohydrate counting books/food list
ξ Fast food and restaurant menu nutrition information
ξ Websites and smart phone apps
ξ The resources found on pages 4-5

STEP 2: Reading a food label for carb content
The Nutrition facts label is a great place to find how many carbs and what time type of carbs are in a

Where can I find lean protein? Where can I find healthy fat?
ξ Fish
ξ Skinless chicken, turkey
ξ Dairy (milk, cheese, yogurt)
ξ Lean beef, bison and venison
ξ Lean pork
ξ Tofu and soy products
ξ Beans and split peas
ξ Nuts and seeds
ξ Nuts and seeds
ξ Peanut butter and other nut butters
ξ Olive oil and olives
ξ Avocado
The Serving Sizes tells you how much of the
food has 37 grams of Total Carb
The Total Carbohydrate tells you how
much carb is in one serving size. This food
has 37g Carb in 2/3 cup.

STEP 3: Practice carbohydrate counting
1. Practice carbohydrate counting by keeping a food log for 1-2 weeks. Use the Food Record for Carb
Counting form at the end of the handout.

Keeping track will show you how foods affect your blood sugar.
ξ Are there carbs that affect your blood sugar more than others?
ξ How does exercise affect your blood sugar?
ξ How long do you go without eating in between meals?
ξ Is there a pattern of low or high blood sugars?

2. Measure the food you eat. Use measuring cups and spoons or a food scale to help you figure out the
amount of food you eat. Write down the portion sizes in your food log. To make this easier, consider
measuring your glasses and bowls so you know how much they will hold.

3. Check your blood sugar before you eat and 2 hours after the start of your meal. Write down these blood
sugar levels in your Food Log.

Food Record for Carb Counting – Example

Write down every food you eat and drink, along with the amount, and the grams of carb for each item. Add
up the grams of carb for each meal. Check your blood sugar (BG) before meals, and two hours after meals.
Record the foods and number in the food record for Carb Counting table.

Time BG Food Amount
g carb Insulin

BG ~ 2
hrs later
Time you
tested after
112 Whole wheat toast 2 slices 30 g Humalog

156mg/dl 9:05AM
Margarine 2 tsp --
Poached eggs 2 --
Fresh strawberries 1 ½
17 g
Coffee (w/Splenda®) 2 cups --
Skim milk (in coffee) 4 Tbsp 3 g
Total=50g Divide total by ratio to get units of
insulin and then add for correction if
10AM Medium apple 1 25g
String cheese 1oz 1g
Total=76g Let long acting insulin cover snacks
of 15-30 grams of carb.

STEP 4: Fine tuning

Consistency with Carbs
ξ It is important to feed your body energy (carbs) throughout the course of the day.
ξ Eating carbs throughout the day helps to keep blood sugar levels stable. It also helps to keep you
satisfied between meals.

Fiber in Meals
ξ The amount of fiber in a food can affect your blood sugar because it is not completely digested, delaying
your rise in blood sugar.
ξ Foods that have 2-3 grams of fiber will not affect your blood sugar levels much.

Sugar Alcohols
ξ Sugar alcohols like maltitol, mannitol, sorbitol, and xylitol are used in “sugar-free” foods.
ξ They have calories and can raise your blood sugar slightly, but not like regular sugar does.
ξ Eating more than 10 grams of sugar alcohols can cause gas, bloating, and/or diarrhea.

Everyone is Different
ξ Your body will respond in its own way to food that you eat. That response may be different compared
with someone else who has diabetes.
ξ Keep a food log with your blood sugars to find out which foods affect your blood sugar the most. Foods
to watch out for are casseroles, fried foods, and high fat desserts.

American Diabetes Association Complete Guide to Carb Counting: 2nd Edition by Hope Warsaw and Karmen
Kulkami. 2004
The Diabetes Carbohydrate & Calorie Counter: 3rd Edition, by Annette B. Natow and Jo-Ann Heslin. 2006.
The Ultimate Guide to Accurate Carbohydrate Counting by Gary Scheiner, 2006
American Diabetes Association Guide to Healthy Restaurant Eating by Hope S. Warshaw. 2009.
The Calorie King Calorie, Fat, & Carbohydrate Counter 2011, by Allen Borushek. 2011.

EatSmart Digital Nutritional Scale (www.amazon.com)
Nutri-Way Dietary Computer Scale (www.intergrateddiabetes.com)
Salter Digital Nutritional Scale (available at Williams-Sonoma)

Diabetes Nutrition Websites


There are websites that offer food tracking and recipe analysis tools. These are great tools if you would like to
know the carbohydrate and nutrition facts for common foods, meals or favorite recipes. These same sites may
also have free recipes to try, or to compare to your favorites. All of these tools are free, except Calorie King.
Calorie King requires a subscription.

ξ My Food Advisor from the American Diabetes Association (see http://tracker.diabetes.org/)
Your Food Advisor can help you set specific goals for calories, carbohydrates and other nutrients. It can
also track what you eat with great detail. This site also offers Create A Dish. This can help you calculate
the nutrition content of favorite recipes. The recipe information includes carbohydrate grams per serving.

ξ ChooseMyPlate.gov offers Super Tracker, a free food, fitness and recipe tool. See
https://www.supertracker.usda.gov/default.aspx. You can use Super Tracker to see how your daily meal
choices compare to food group targets and daily limits. The section My Recipe allows you to build and
analyze your favorite recipes to find out carbohydrate content and more.

ξ NutritionData.com also has free food search, meal tracking and recipe analysis functions. See

ξ The American Heart Association also offers recipes that include nutrient content in their Nutrition Center.

ξ CalorieKing.com (http://www.calorieking.com) has a free food search function. It does require a
subscription to use their Food Diary, goal setter, activity planner and charts and graphs.

Phone/Tablet Apps

iPhone Apps Android and iPhone Apps Android Apps Blackberry Apps
Diabetes Companion
Cost: Free
Carb Counting with Lenny
Cost: Free
On Track Diabetes
Cost: Free
Cost: $5.99
Diabetes Log
Cost: Free
Cost: $1.99-2.99

Cost: Free
Calorie Counter
Access at Fat Secret.com
Cost: Free

Go Meals, by CalorieKing
Cost: Free
WaveSense Diabetes Manager
Cost: Free

Islet—Diabetes Assistant
Cost: $0.99
Blue Loop
Cost: Free

Carb Master
Cost: $0.99

Lose It! by Fitnow
Cost: Free

Nutrition Database for iPhone
Cost: $4.99

FOOD RECORD for Carbohydrate Counting

Write down every food you eat and drink. Include the amount, and the grams of carbohydrate your foods
have. Total up the grams of carb for each meal. Check your blood glucose (BG) before meals, and about two
hours after meals. In this way you begin the process of understand the effect of medicine, carbs and activity on
your blood sugar.

Time BG Food Amount
(e.g. cups,
g carb Insulin
BG ~ 2 hrs
Time you
tested after


Teach Back:
What is the most important thing you learned from this handout?

What changes will you make in your diet/lifestyle, based on what you learned today?

If you are a UW Health patient and have more questions please contact UW Health at one of the phone numbers
listed below. You can also visit our website at www.uwhealth.org/nutrition.

Nutrition clinics for UW Hospital and Clinics (UWHC) and American Family Children’s Hospital (AFCH) can
be reached at: (608) 890-5500.

Nutrition clinics for UW Medical Foundation (UWMF) can be reached at: (608) 287-2770.

Your health care team may have given you this information as part of your care. If so, please use it and call if you have any questions. If
this information was not given to you as part of your care, please check with your doctor. This is not medical advice. This is not to be
used for diagnosis or treatment of any medical condition. Because each person’s health needs are different, you should talk with your
doctor or others on your health care team when using this information. If you have an emergency, please call 911. Copyright 3/2015
University of Wisconsin Hospital and Clinics Authority. All rights reserved. Produced by the Clinical Nutrition Services Department and
the Department of Nursing HF#342