Carb Counting for Kids with Diabetes

When your child takes insulin to manage type 1 or type 2 diabetes, balancing food, insulin, and activity becomes part of everyday life. One of the most helpful tools for staying on track is carb counting. It helps keep blood sugar steady, supports smart food choices, and allows for more flexibility at mealtimes.

What Are Carbohydrates?

Carbohydrates — or carbs — are one of the main nutrients in food, along with protein and fat. The body breaks carbs down into glucose (sugar), which gives energy to cells, organs, and tissues. Glucose can be used right away or stored in the liver and muscles for later.

Carbs are found in many everyday foods: bread, pasta, fruit, milk, candy, and even starchy vegetables.

There are three types of carbs:

• Sugars: Found in fruit, milk, and sweets. They raise blood sugar quickly.
• Starches: Found in bread, rice, pasta, and beans. They raise blood sugar more slowly.
• Fiber: Found in veggies, whole grains, nuts, and seeds. It helps digestion and slows sugar spikes.

How Many Carbs Do Kids Need?

Every child is different. Carb needs depend on age, activity level, and insulin dose. A general range is:

• 45 to 65 grams of carbs per meal
• 15 to 30 grams per snack

Your child’s care team can provide a personalized carb estimate tailored to their lifestyle and individual health needs.

Why Carb Counting Matters

Matching insulin to the carbs your child eats helps keep their blood sugar in a healthy range. This lowers the risk of highs (hyperglycemia) and lows (hypoglycemia), supports better energy and focus, and promotes overall well‑being.

It also gives your child more food options. With the right approach, they can enjoy favorite meals and treats while staying on track.

Tools like continuous glucose monitors (CGMs) and blood sugar meters can help you see how different foods affect blood sugar—and make smarter choices together.

Who Benefits from Carb Counting?

Carb counting is helpful for:

• Kids and teens who take insulin with meals
• Children on insulin pumps or multiple daily injections (MDI)

Younger kids will need help, but older children can learn to take more responsibility over time.

Tips for Getting Started

• Learn which foods contain carbs
• Read food labels for carb info
• Use measuring cups or compare with your hand (a fist = about 1 serving) to know how much your child is eating
• Try a tracking app like the Dario Health app
• Know your child’s insulin-to-carb ratio (ICR) — for example, 1 unit of insulin for every 10 grams of carbs

Bring a food log to appointments with your child’s healthcare provider, so they can help determine appropriate ICR for your child. Work with your care team to adjust the ICR as your child grows.

If Exact Counting Feels Too Hard…

There are simpler ways to manage carbs:

1. Follow a meal formula: Use similar carb amounts at each meal.
2. Diabetes Plate method: Fill half the plate with veggies, one-fourth with protein, one-fourth with carbs.
3. Visual estimates: A fist-size portion of fruit or pasta = about 30 grams of carbs.
4. Lower glycemic options: Choose whole grains, beans, and non-starchy veggies, which won’t cause blood sugar to spike quickly.
5. Group carbs based on portion size: Learn to estimate how many carbs are in foods your child eats based on whether the serving size falls into small, medium, or large carb portion categories.

Here’s how you might group some common foods:

Small Carb Portion: Approximately 15 grams of carbohydrates. Examples include:

• 1 slice of bread
• ½ cup of cooked oatmeal
• 1 small apple

Medium Carb Portion: Around 30 grams of carbohydrates, equivalent to two standard servings. Examples include:

• 1 cup of cooked pasta
• 1 medium baked potato
• 1 cup of cooked rice

Large Carb Portion: Approximately 45 grams of carbohydrates, or three standard servings. Examples include:

• 1½ cups of cooked pasta
• 1 large bagel
• 1½ cups of cooked rice

These methods give flexibility while still supporting good blood sugar management.

Making It Part of Your Routine

Carb counting can feel overwhelming at first — but it gets easier with practice. Kids can join in by helping plan meals, read labels, and measure foods. Getting them involved builds confidence and independence.

With the right tools and support, your child can enjoy a full, flexible diet while staying healthy. A registered dietitian or certified diabetes educator can help you create a plan that fits your child’s needs — and your family’s lifestyle.