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Carb counting for a child with type 1 diabetes

Carb counting means working out how much carbohydrate is in your child’s food and drink so that you can work out how much insulin they need to take.    
Content last reviewed and updated: 15.08.2023

Pasta that includes a nutrition label to see how much carbohydrate is in the food as part of carb counting for a child with type 1 diabetes

How do you count carbs?

You will usually count carbs by using food labels and weighing your child’s portions so you can work out how many carbs are in their food. You will need some kitchen scales for this, so pick some up if you don’t already have some.

There are also apps, like Carbs and Cals and My Fitness Pal, which have databases of the nutritional information for thousands of foods.

What types of carbs are there?

There are two main types of carbohydrate that you need to count when you have type 1 diabetes:

  • Starches (potatoes, peas, beans, rice and grains) which release slowly over time
  • Sugars (natural sugars in fruit or milk or added sugar in cakes and cookies) which release more quickly and will cause a spike in glucose levels

Working out how much insulin to take

Once you know how many carbs are in your child’s food you will then have to work out how much insulin they will need.

To do this you need to know your child’s insulin to carbohydrate ratio. This ratio is different for different children so your Diabetes Healthcare Team will tell you what your child’s ratio is.

As an example of how to work out how much insulin is needed, we’ll use a ratio of 1:10. This means your child would have to take 1 unit of insulin for every 10 grams of carbohydrate they eat. So if a portion of pasta had 40 grams in it, you would divide it by 10 (the number of grams in the ratio) and multiply it by 1 (the units of insulin). So your child would need 4 units of insulin for the portion of pasta.

Carb counting and making calculations can be tricky at first. Don’t worry if you’re not good at maths – over time you will get used to how many carbs are in certain foods, especially if they’re your child’s favourites and they eat or drink them often.

Find out more about counting carbs.

Carb counting and insulin pumps

Insulin pumps and hybrid closed loop systems can make carb counting easier because you can enter the amount of carbs you’re going to eat and it calculates how much insulin you need. Find out more about type 1 tech for children.

How do I know if I’m getting it right?

A good way to see if you’re on the right track is to check your child’s blood glucose before they eat and then several hours after eating. This will help you see if your estimate was right.

Don’t worry too much if you’re not getting everything right all the time – you’re only human and carb counting is not always an exact science. Remember that other things can affect your child’s blood glucose levels as well as carbs, like doing exercise, being unwell or being too hot or cold.

Where can I get help?

If you’re struggling with carb counting – or any aspect of your child’s type 1 management – ask for help. Speak to friends, family and your child’s Diabetes Healthcare Team.

The Roche Accu-Chek Carbohydrate Counting Tool provides free online training on counting carbs (you don’t have to use an Accu-Chek pump or meter to use the tool).

How do I work with my child’s nursery, preschool or school to count carbs?

You child doesn’t have to follow a special diet or have different meals at nursery, pre-school or school but you will need to know how many carbohydrates are in their meals.

This should be included in their Individual Healthcare Plan, which is a document that outlines how their type 1 should be managed when they’re in childcare or at school.

Talk to the school or the school meals provider to see if they can share a menu with you.

Some parents and carers prefer to make pack lunches for children with type 1 diabetes because it means that you can count carbs more easily.

Find out more about managing type 1 at nursery and pre-school and school.

Explore other topics in this section

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Managing your child’s blood glucose levels

Learn about blood glucose levels, how they’re measured, what affects them, how to check them – and what you should do if they are too high or low.

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Managing your child’s hypos

Hypos can be dangerous – but the good news is they’re simple to treat and there is technology available to help you see when one is about to happen.

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Managing your child’s hypers

Hypers don’t hold an immediate risk to your child’s health like hypos do, but they can make them feel unwell and can be serious if they’re not treated.

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Working with your child’s healthcare team

Your child will be seen regularly by a team of diabetes specialists. Learn about the different professionals involved and how to best work with them.