Carbohydrates, like proteins and fats, are one of the three main components of food that provide energy and other things the body needs. They should be part of a healthy diet for all kids, including kids with diabetes.
But carbohydrates (carbs), which are found in foods such as bread, fruit, and candy, can affect a person's blood sugar level. So if your child has diabetes, you may need to track how many carbohydrates your child eats.
Following a meal plan can help kids balance carbs with medications and exercise so that they maintain a healthy blood sugar level. Like exercising and testing blood sugar regularly, tracking carbs is just another step many kids with diabetes take to stay healthy.
Carbohydrates and Blood Sugar
There are two main forms of carbohydrates: sugars and starches. Types of sugars include fructose (sugar found in fruit and some baked goods), glucose (the main sugar in our bodies that's also found in foods like cake, cookies, and soft drinks), and lactose (sugar found in milk and yogurt). Types of starches include vegetables like potatoes, corn, and peas; grains, rice, and cereals; and breads.
The body breaks down or converts most carbohydrates into glucose, which is absorbed into the bloodstream. As the glucose level rises in the blood, the pancreas releases a hormone called insulin. Insulin is needed to move glucose from the blood into the cells, where it can be used as a source of energy.
In people with diabetes, the pancreas does not make enough insulin (type 1 diabetes) or the body can't respond normally to the insulin that is made (type 2 diabetes). In both types of diabetes, glucose can't get into the cells normally, so a person's blood sugar level gets too high. High blood sugar levels can make people sick if they don't receive treatment.
Carbohydrates Can Be Part of a Healthy Diet
Eating carbohydrates makes blood sugar levels rise, but that doesn't mean that people with diabetes should avoid them. In fact, carbohydrates are a healthy and important part of a nutritious diet.
For everyone - including people with diabetes - some carbohydrate-containing foods have more health benefits than others. Whole-grain foods, vegetables, candy, and soda all have carbohydrates. But fruits, vegetables, and whole-grain foods are generally healthier than sugary foods like candy and soda because they provide fiber, vitamins, and other nutrients.
On the other hand, some foods containing carbohydrates - like sugary snacks - contain "empty calories." That means they have calories but the calories lack nutritional value. Eating too many empty calories can contribute to being overweight or obese and can crowd out more nutritious foods from a child's diet. These foods can also cause tooth decay.
Fiber is the one type of carbohydrate that does not raise blood sugar. Everyone needs fiber - it helps you feel full and keeps the digestive system running smoothly. Most people don't get enough of it. Some experts think that people with diabetes should have more fiber than others to help control blood sugar levels.
Whichever type of carbohydrates your child eats, remember this: Generally, the amount of sugar that gets into the blood after eating depends on the amount of carbs eaten, not the type of carbs. So basically, as far as managing diabetes is concerned, a carb is a carb. Again, the one exception to this is fiber: It is the one type of carbohydrate that does not raise blood sugar because the body doesn't digest or absorb it.
Your goal is to help your child achieve the right balance between the insulin in the body and the carbs in food.
Balancing Carbohydrates
In addition to feeding your child a balanced diet of carbohydrates, proteins, and fats, there are other things you need to do to help keep your child's blood sugar at a healthy level including:
- making sure blood sugar is tested regularly
- encouraging plenty of exercise
- making sure your child gets insulin and other medications for diabetes according to schedule and in the right amounts
Following a meal plan will help your child track his or her carbohydrate intake. When you work with your child and the diabetes health care team to create a meal plan, it will include general guidelines for carbohydrate intake. There's no right amount of carbohydrates to eat. The team will likely create guidelines based on your child's age, size, weight goal, exercise level, medications, and other medical issues. They'll also take into consideration the types of foods your child likes to eat. In general, though, it's easier for most people with diabetes to control their blood sugar levels if they eat carbohydrates in fairly consistent amounts and times from day to day.
Three general types of meal plans can help achieve the proper balance.
An exchange meal plan lists items in six food groups and sets a serving size for each food. You can mix and match the foods while keeping track of what your child is eating, including how many carbohydrates.
Another type of meal plan approach is the constant carbohydrate meal plan, in which people eat about the same amount of carbohydrates and other foods every day. This can be a good approach for people who take insulin only once or twice a day or who don't take insulin at all to control their diabetes.
With a third type of plan, carbohydrate counting, a person matches their insulin dosage to the amount of carbs they eat. This plan offers more flexibility and can be a good fit for people who take insulin with each major meal and snack.
Keeping Carbohydrates in Check
Kids may be tempted to sneak sugary snacks between meals without accounting for insulin coverage. You might discuss this with your child, even if it hasn't happened yet. It's healthier to create open communication about the foods your child eats, instead of making your child feel like he or she needs to hide dietary slipups. Emphasize that most people eat unhealthy snack food occasionally, but eating lots of sugary junk foods can make it hard to keep blood sugar levels in a healthy range especially when you don't take insulin. And it can lead to weight gain and painful cavities! Remind your child why people with diabetes - and everyone else - shouldn't overdo it when it comes to sugar intake.
If you're not sure how many carbohydrates a food contains, check the food label or ask someone - like a waiter or chef - about unlabeled foods like restaurant entrees.
Also, check the labels of diet foods. These foods may contain extra sugar as a substitute for fat calories. It's a good idea to include your child or teen as you evaluate and select healthy carbohydrate-containing foods. With your guidance and the meal plan, your child can begin to choose foods on his or her own and learn how carbohydrates affect blood sugar.
By taking a smart approach to balancing carbohydrates, medications, and activity, you can help your child enjoy food and stay healthy at the same time.
Reviewed by: Steven Dowshen, MD and Nancy Gugerty, RN, RD, CDE
Date reviewed: September 2007
