Carbohydrate Counting for Diabetes Mellitus, Pediatric

Carbohydrate counting is a method of keeping track of how many carbohydrates your child eats. Eating carbohydrates increases the amount of sugar (glucose) in the blood. Counting how many carbohydrates your child eats improves blood glucose control, which can help you manage your child's diabetes.

Carbohydrates are measured in grams (g) per serving. It is important to know how many carbohydrates (in grams or by serving size) your child can have in each meal. This is different for every child. A dietitian can help you make a meal plan and calculate how many carbohydrates your child should have at each meal and snack.

What foods contain carbohydrates?

• Grains, such as breads and cereals.
• Dried beans and soy products.
• Starchy vegetables, such as potatoes, peas, and corn.
• Fruit and fruit juices.
• Milk and yogurt.
• Sweets and snack foods, such as cake, cookies, candy, chips, and soft drinks.

How do I count carbohydrates in foods?

There are two ways to count carbohydrates in food. You can read food labels or learn standard serving sizes of foods. You can use either of the methods or a combination of both.

Using the Nutrition Facts label

• The serving size.
• Information about nutrients in each serving, including the grams of carbohydrate per serving.

To use the Nutrition Facts, decide how many servings your child will have. Then, multiply the number of servings by the number of carbohydrates per serving. The resulting number is the total grams of carbohydrates that your child will be having.

Learning the standard serving sizes of foods

• Measure the foods that your child will eat with a food scale or measuring cup, if needed.
• Decide how many standard-size servings your child will eat.
• Multiply the number of servings by 15. For foods that contain carbohydrates, one serving equals 15 g of carbohydrates.
  • For example, if your child eats 2 cups or 10 oz (300 g) of strawberries, he or she will have eaten 2 servings and 30 g of carbohydrates (2 servings x 15 g = 30 g).
• For foods that have more than one food mixed, such as soups and casseroles, you must count the carbohydrates in each food that is included.

• 1 slice of bread.
• 1 six-inch (15 cm) tortilla.
• ⅓ cup or 2 oz (53 g) cooked rice or pasta.
• ½ cup or 3 oz (85 g) cooked or canned, drained and rinsed beans or lentils.
• ½ cup or 3 oz (85 g) starchy vegetable, such as peas, corn, or squash.
• ½ cup or 4 oz (120 g) hot cereal.
• ½ cup or 3 oz (85 g) boiled or mashed potatoes, or ¼ or 3 oz (85 g) of a large baked potato.
• ½ cup or 4 fl oz (118 mL) fruit juice.
• 1 cup or 8 fl oz (237 mL) milk.
• 1 small or 4 oz (106 g) apple.
• ½ or 2 oz (63 g) of a medium banana.
• 1 cup or 5 oz (150 g) strawberries.
• 3 cups or 1 oz (28.3 g) popped popcorn.

What is an example of carbohydrate counting?

To calculate the number of carbohydrates in this sample meal, follow the steps shown below.

Sample meal

• 3 oz (85 g) chicken breast.
• 1 cup or 8 fl oz (237 mL) milk.
• 1 cup or 5 oz (150 g) strawberries.
• 1 slice of toast.

Carbohydrate calculation

1. Identify the foods that contain carbohydrates:
   • Milk.
   • Strawberries.
   • Toast.
2. Calculate how many servings your child has of each food:
   • 1 serving milk.
   • 1 serving strawberries.
   • 1 serving toast.
3. Multiply each number of servings by 15 g:
   • 1 serving milk x 15 g = 15 g.
   • 1 serving strawberries x 15 g = 15 g.
   • 1 serving toast x 15 g = 15 g.
4. Add together all of the amounts to find the total grams of carbohydrates eaten:
   • 15 g + 15 g + 15 g = 45 g of carbohydrates total.

What are tips for following this plan?

Shopping

• Develop a meal plan and then make a shopping list.
• Buy fresh and frozen vegetables, fresh and frozen fruit, dairy, eggs, beans, lentils, and whole grains.
• Look at food labels. Choose foods that have more fiber and less sugar.
• Avoid processed foods and foods with added sugars.

Meal planning

• Aim to give your child the same number of grams of carbohydrates at each meal and for each snack time.
• Plan to have regular, balanced meals and snacks.

Where to find more information

• American Diabetes Association: diabetes.org
• Centers for Disease Control and Prevention: www.cdc.gov
• Academy of Nutrition and Dietetics: eatright.org
• Association of Diabetes Care &Education Specialists: diabeteseducator.org

Summary

• Carbohydrate counting is a method of keeping track of how many carbohydrates your child eats.
• Eating carbohydrates increases the amount of sugar (glucose) in the blood.
• Counting how many carbohydrates your child eats improves your child's blood glucose control, which can help you manage your child's diabetes.
• A dietitian can help you make a meal plan and calculate how many carbohydrates your child should have at each meal and snack.