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
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
, which is absorbed into the bloodstream. As the glucose level
rises in the blood, the pancreas releases a hormone called
. 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
type 1 diabetes
) or the body can't respond normally to the insulin that is
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
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
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
, 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.
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
- 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
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,
, 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,
or ask someone - like a waiter or chef - about unlabeled foods like
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.
Steven Dowshen, MD
Nancy Gugerty, RN, RD, CDE
Date reviewed: September 2007
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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