Patient Information
Department of Nutrition and Dietetics
Paediatric Diabetes: Carbohydrate
counting
Everyone with diabetes need to be careful about the foods they eat to ensure that their
blood glucose levels stay as close to normal as possible.
Glucose in the blood comes from carbohydrates eaten in the diet. There are five
groups of carbohydrate foods that affect blood glucose:-
Starchy foods
Potato, yam, sweet potato, plantain
Bread, chapattis,
Pasta, rice, noodles, cous cous, oats, corn, breakfast cereals,
Flour and foods prepared with flour e.g. pizzas, pastries, pies, crackers, biscuits and
thickened sauces and soups.
Starchy foods should be eaten regularly to provide the body with energy. They also
provide vitamins, minerals and often fibre. Starches need to be broken down into
glucose before they can be digested. They usually raise blood sugar levels more slowly
than sugary foods but this does depend on how much is eaten, how the food is cooked
and how much starch is in the food
Sugary foods
Glucose (dextrose), sugar (sucrose), honey, jam, syrups
Sweet drinks, sweet cakes, sweet biscuits, sweets and chocolate.
Sugars are digested very quickly so will have a quicker effect on your blood sugar
levels. Often these foods are low in other nutrients. You should not eat these too
frequently and they are best taken for an occasional treat as part of a meal or if
You are not overweight before exercising.
Patient Information
Milk & Dairy foods
Milk, yoghurt, fromage frais, custards, ice cream
Milk contains a sugar called lactose which will raise blood sugar. However milk also
contains protein and fat which slows down the breakdown of lactose to glucose.
Milk and dairy foods are fine to have with diabetes and are an excellent source of
calcium.
Cheese does not contain carbohydrate.
Fruits & fruit juices
Fresh, tinned in juice, dried or fruit juices
Fruit contains a sugar called fructose which will affect your blood sugar levels. Fruit
also contains fibre which slows down the absorption of this sugar into the blood stream.
Fruit is rich in important vitamins and minerals so you should aim to eat some fruit
everyday.
Other carbohydrate foods
Beans, pulses, lentils and vegetables
The carbohydrate content of these foods is variable. There are only small amounts of
carbohydrate in most vegetables so unless you are eating a very large portion you will
not need to count them. Certain vegetables-parsnip, beetroot, sweetcorn, peas, mushy
and processed peas and, have higher carbohydrate contents. If portions are large, or
the vegetables are highly cooked/ processed e.g. creamed sweetcorn, you may then
need to include some carbohydrate value for them.
Beans, pulses and lentils (including baked beans) are absorbed into the blood stream
very slowly due to their high fibre content. If eaten as the main protein source of a meal
(i.e. in place of meat and in a large quantity) they should be counted. If added to a
meal, so the portion is small i.e. kidney beans in chilli con carne you can usually avoid
counting them. Everyone reacts differently to these. Watch your blood sugars after
having beans or pulses to help you calculate how much carbohydrate you will need to
count for them.
These foods are very nutritious and should be eaten regularly. Vegetables should
ideally be eaten everyday.
If you are on twice daily injections, the amount of carbohydrate eaten during meals
and snacks should stay reasonably steady. This will prevent large swings in blood
glucose levels.
If you are on basal bolus injections (4 injections daily) you will be able to eat different
amounts of carbohydrate at meals. However, you will need to work out how much
carbohydrate you will eat, to enable you to calculate the amount of insulin you need to
inject.
The Carbohydrate content of most foods can be divided into portions of 10g to help you
learn and remember them easily. The following pages show the Carbohydrate content
of some commonly eaten foods
Paediatric diabetes: Carbohydrate counting – October 2015
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Patient Information
Carbohydrate Counting
The following food portions contain 10g of carbohydrate
1 Weetabix/
Oatibix or
Shredded Wheat
15g (4tbsp)
cereal
4tbsp cooked
porridge/ instant
porridge
1 rounded
serving spoon
cooked pasta
1level serving
spoon cooked
rice
1 boiled baked or
roast potato
(egg-sized)
1small scoop of
mashed potato
5-6 medium
or 3 large
chipped
potatoes
1potato waffle
=20g
Carbohydrate
2 smiley face
potatoes
3 small
chipolata or
2 thick
sausages
2 Fish fingers
5 chicken
nuggets
1 level serving
spoon tinned
spaghetti
1
/3 rd small, thin
base individual
pizza (5”)
2 beef/
hamburgers
(not 100%
meat)
1 small sausage
roll
Paediatric diabetes: Carbohydrate counting – October 2015
1½ small
Yorkshire
puddings
1 fish cake
1
/4 individual
meat/vegetable
pie
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3
Patient Information
1 Hobnob/Garibaldi
Digestive/oatcake/
fig roll
2 semi-sweet
biscuits
2 crackers
2 tablespoons
fruit fresh or
tinned in juice
1 small piece of
fruit
1 diet yoghurt
(125g pot)
1
/3 rd pint
(200mls) milk
1 small scoop
plain ice-cream
4 tablespoons low 1 small 25g
sugar milk pudding bag of crisps
Please note
1 medium slice
bread= 15g CHO
1 thick slice bread
=20g CHO
1 scone=
20-30g CHO
1 wrap/ tortilla
=20-30g CHO
1 oat based
cereal bar
=15-20g CHO
1 small bread
roll
= 20g CHO
1 croissant
=20g CHO
Paediatric diabetes: Carbohydrate counting – October 2015
1 pitta bread
Large =30-50g
CHO
Small =15-20g
Count 2 serving
spoons of baked
beans as 10g
CHO
(actual content is
30g CHO but low
GI)
www.uhcw.nhs.uk
1 teacake /hot
cross bun
=30-35g CHO
} if counting
} these as 10g
} CHO make
} your blood
} sugars high
} then count as
} 20g or 30g as
} necessary
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Patient Information
To get the best idea of carbohydrate content of commonly eaten foods
1. Weigh food portions initially (on scales that weigh in grams). This is especially
useful for breakfast cereals, rice and pasta. Once you know your normal portion
size you can then work out the carbohydrate content of the meal more easily.
Alternatively use a handy measure for example a plastic cup or pot. Weigh out
the portion of food contained in this once. Then you will always know the
carbohydrate content of your portion based on the number of measures you eat.
2. Look at nutritional labels these will tell you all you need to know about the
carbohydrate content of purchased foods
Nutrition Information
Per serving
1462
351
9.1
Per 100g
975
234
6.0
Carbohydrate (g)
Of which sugars (g)
Of which starch (g)
28.2
3.0
25.2
18.8
2.0
16.8
Fat (g)
Of which saturates
Of which mono-unsaturates
Of which poly-unsaturates
23.3
7.6
10.9
2.7
14.9
5.1
7.3
1.8
Fibre (g)
Salt
1.6
0.6
1.1
0.4
Energy (Kj)
(Kcals)
Protein (g)
When carbohydrate counting, you are looking for the total carbohydrate figure which
includes all the starch and sugars in that food.
The ‘of which sugars’ figure is also important as it shows the amount of added sugars
and naturally occurring sugars e.g. fruit sugar (fructose) and milk sugar (lactose) in a
food. When choosing between similar foods, always go for the one with the lowest ‘of
which sugars’ content as this will have the lowest amount of added sugar.
Points to remember when looking at labels
•
How has the carbohydrate content been recorded? per 100g/ per item/ per
serving
This will make a large difference when calculating your intake if you read the
figure as per 100g and the actual product weighs 420g
•
Is the portion cooked or uncooked weight?
Rice and pasta double their weight when cooked
•
If it is per serving, is this your serving size? Or is it a great deal smaller? - weigh
it out and see if you are unsure!
Paediatric diabetes: Carbohydrate counting – October 2015
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Patient Information
Calculating the carbohydrate content of foods from labels
If using information from nutrition labels you can work out the carbohydrate content of a
food by:1. Weighing your portion of food
2. Finding out the carbohydrate content per 100g from a food label on the
packet
3. Divide the weight of your portion by 100 then multiply this number by
amount of carbohydrate per 100g (as on packet)
4. The answer will tell you how much carbohydrate your food contains
Follow the steps above for this example:
1. Your portion of Wake up cereal weighs 60g
Wake up Flakes
Per 100g
kcal
294
Protein (g)
8
Carbohydrates (g)
64
(of which sugars)
23
(of which starch)
41
Fat (g)
2.5
2. The carbohydrate content per 100g is 64g
3. 60 x 64 = 38.4g of carbohydrate
100
4. = 40g (rounded up to the nearest 10g)
Using Visual Carbohydrate Counting Guides
When using visual guides for Carbohydrate Counting in the form of a book or a phone
app, remember they include all foods containing carbohydrate, irrespective of whether
they are a healthy option or not.
Please contact your diabetes nurse on 024 7696 7230 or your dietitian on
024 7696 6161 if you feel that you need help.
The Trust has access to interpreting and translation services. If you need this
information in another language or format, we will do our best to meet your needs.
Please contact the Department on 024 7696 6161
The Trust operates a smoke free policy
Author:
Department:
Published
Reviewed
Review
Version
Reference No
Susan Cooper, Sarah Jarvis
Paediatric Diabetes/Nutrition & Dietetics
June 2011
July 2013, October 2015
October 2017
4
HIC/LFT/566/07
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