Carb Counting
Topics:
What Needs to be Counted | Carb Counting Tools | Let's Talk About Fiber | High Fat | Milk Choices | Cereal
Counting carbs is always a challenging task, but it can be especially difficult with tons of high-carb foods around. Here at the U-M Pediatric Diabetes Clinic, we are ready to help! Check out our carb counting tools and milk and cereal tips so you can still enjoy the foods you love while keeping your blood sugar levels in check.
What needs to be counted
A sample list of foods that contain carbohydrates or 'carbs' include grains, legumes, bread, cereal, pasta, crackers, fruits, juices, milk, yogurt, sweets and snack foods. Identifying the number of carbs is often found on the package label and is calculated by determining the serving size. For foods that do not have labels, using a food scale and a reference list such as Calorie King can help to determine the portion size and the amount of carbs.
The ADA offers a free guide on carb counting that can be found here.
Carb Counting Tools
Do you know how many carbs you ate today at lunch? Was your last snack closer to 20 grams or 30 grams of carbs? Some people with T1D find carb counting easy, while others may struggle with finding the right answers. Some use apps like Calorie King, Fooducate, or mySugr (check our favorites under Digital Tools!) to keep track of all their numbers, and others find it easier to do the math (and it can be a lot of math!) in their heads. Whether you’re newly diagnosed with T1D, a pro at living with diabetes, or just someone trying to stay healthy, everyone can always use a refresher on carb counting.
One of the most important steps in carb counting is being sure you know how to read the labels on your favorite foods. Our diabetes educators go over this essential skill in our Beyond the Basics class, but if you need a refresher, check out our Reading Food Labels handout to review the key pieces of information you need to read in the Nutrition Facts. The American Diabetes Association also breaks down this information on their website here. It's a great resource for anyone who wants to learn more about how different ingredients can impact T1D.
Helpful Hack: Counting Carbs Like a Pro!
Are you a parent trying to carb count for a young child with diabetes? Check out this parent’s guide to counting carbs like a pro. Also, talk to your diabetes educator if you're having trouble keeping your child's blood sugars in range. Need help with the insulin dosing math? Be sure to download our Calculation Sheet for Insulin Doses.
Let's Talk About Fiber
You probably have heard fiber is good for our health, and most people know fiber as the nutrients that helps us have more regular bowel movements. And for those of us with diabetes, fiber is even more important.
In general, there are two types of fibers: soluble and insoluble. Let's talk about the benefit of each of them!
Soluble Fiber:
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Great for making our stool softer and easier to pass.
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Could lower our cholesterol (cholesterol can build up waxy substances that can clot your arteries).
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Usually found in oats, peas, beans, apples, citrus fruits, carrots, and barley.
Insoluble Fiber:
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Increase the bulk of your stool so that your guts would get stimulated to move the stool along.
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Keeping us feeling full for longer.
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Usually found in whole grain products (whole wheat bread, whole wheat pasta, corn, brown rice, etc.), vegetables, beans, peas, avocados, and some starchy vegetables.
Both soluble and insoluble fibers are great for lowering blood sugar spikes, and that's why our blood sugar typically doesn't go as high when you have fresh apples compared to apple juice, where the fiber has been filtered out.
How can we eat more fiber?
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Switch out refined grains, such as white bread, regular pasta, and white rice, to whole grains, such as whole wheat bread, whole wheat pasta, and brown rice
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Have old fashion oats (rolled oat) for breakfast.
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Have fruits or vegetables or both at all meals.
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Snack on some nuts
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Eat the skin of certain fruits and vegetables: cucumber, apples, pears, grapes, potatoes, and sweet potatoes.
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Have more plant protein. Most plant-based protein products are made from beans and peas, which are high in fiber.
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Add chia seed or ground flax seed to your hot cereal or yogurt.
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When shopping for packaged food, aim for having at least 5 g of fiber in each serving.
So how much fiber does my child need?
A good way to figure out is by adding 5 to 10g to your child's age. For example, if your child is 10 years old, they would need 15 to 20 g of fiber per day. 10+5=15g, 10+10=20g.
Pro tip! If you plan to increase fiber in your meals and snacks, please increase it slowly and drink plenty of water. Otherwise, you may temporarily experience more bloating and gas, as well as worsening constipation.
High Fat = BG Confusion
Have you ever had pizza and wondered why after two hours your blood sugar reading was still 200+?
It’s because pizza is not only a high carb meal, but it’s also high in fat. During the holidays, we need to be extra diligent with these high fat, high carb dishes -- they’re everywhere. From baked casseroles to pizza; burgers to Auntie Marla’s famous bread pudding. If you're looking for some helpful advice to tackle the "pizza problem," check out this article by Certified Diabetes Educator Gary Scheiner.
Milk Choices
There are so many dairy and non-dairy milk options available in grocery stores nowadays, it might feel overwhelming to choose. Taste is definitely personal, but we may be able to help you choose a higher protein and lower carb milk to lessen blood sugar spikes after having milk. Especially if you're an avid milk drinker or like to have milk with other higher carb foods like cereals, cookies, or pasta.
Let’s take a look at the options!
For dairy options, the American Academy of Pediatrics recommends full fat milk for children 1-2 years old and then switching to skim or low-fat (1%) milk at the age of 2.
Ultra-filtered milk (such as Fairlife or Kroger's CarbMaster) can also be a great option for those with diabetes because it has half the amount of carbs and more protein compared to regular milk. It’s also lactose free for those who are lactose intolerant.
Non-dairy options are great for those who are vegan, have dairy allergies, or simply prefer the taste of plant-based milk over cow’s milk.
By comparing protein and carbohydrates, the best choices for non-diary milk would be soy milk and pea milk, but since pea milk tends to be harder to find and more expensive, soy milk would be the winner.
We hope this helps you find a milk that also fits your taste and budget!
Morning Breakfast: Cereal
Cereals are a popular breakfast choice especially for school days because they are quick and easy, but many parents also notice cereals spike their child's blood sugar.
Cereals spike blood sugar because they are often made with highly processed grains and a lot of added sugar. The process of making grains into cereals takes away the fiber from the grain, and the lack of fiber makes cereals much easier and quicker to digest and increase blood sugar. Additionally, cereals are usually low in protein and fat causing us to feel hungry before lunchtime.
Most sugary cereals are similar to desserts based on the amount of carbs and sugar they contain. For example, one cup of Froot Loops has about the same amount of carbs and sugar as a frosted cinnamon bun! If we think of cereal as basically a breakfast dessert, we can try to balance it the same way we do with desserts. Yes, blood sugar can be more challenging to manage, but it doesn't mean we can't have sweet treats!
Here are some ways to deal with cereal highs:
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Have cereal less often. Eating a dessert as breakfast every day is likely to make blood sugar harder to manage. Maybe try having cereal only on the weekend when parents have more time to correct high blood sugar if needed.
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Have a smaller portion. Instead of only eating cereal for breakfast, try making a part of the breakfast along with other higher protein foods. For instance, pair 1/2 cup of cereal with some scrambled egg or a few turkey sausages. Another way to have less cereal is to use yogurt instead of milk and eat it as a yogurt parfait. This results in smaller portion of cereal and helps balance the amount of carbs and protein.
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Try lower-carb milk with cereal. Consider having a highly-filtered, lower carb milk like Fairlife, which has 6g of carbs per cup instead of 12g in regular cow's milk, plus more protein. Or try unsweetened soy milk, which has only 3g of carb per cup and about the same amount of protein as cow's milk.
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Try adding nuts and seeds to increase the fiber and protein content. Chia seed, ground flaxseed, or hempseed are great options.
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Try lower-carb cereals. There are many low-carb and keto cereals available on the market. Feel free to explore different options to see which one your child prefers. You can also try mixing sugary cereal with keto cereal. For example, Froot Loops and Kashi Go Keto are both loop shape cereal. Mix them in 50/50 ratio to lower the overall amount carb while increasing fiber and protein.
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Dose insulin sooner. Without enough fiber and protein, cereals can raise blood sugar quickly. If your child does not have a low blood sugar before eating cereals, try dosing insulin a little sooner than normal, at least 15-25 minutes before eating.
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Adjust your insulin to carb ratio. Talk to your diabetes team about adjusting your child's breakfast insulin to carb ratio to decrease blood sugar spikes from cereals.
