Type 1 Diabetes : What is Carb Counting and does it Help ?

Q1 ) What is Carb counting ?

A1) Carbohydrate counting or Carb counting is the balance between the carbohydrates you eat and insulin you take that determines how much your blood glucose levels will rise after your meal. So to put it simply more Carbs you eat, the higher will be the
spike in blood glucose levels and the more insulin you will need to cover that meal.

Q2) What all is counted as Carb in our diet that needs insulin ?

A1) Carb includes every food item with starch, which include cereals such as wheat, rice, jowar, bajra, ragi, breakfast cereals, bread, biscuits, oats, noodles, pasta, maida, starchy vegetables, beans, peas and lentils.

Q3) Who can use Carb counting ?

A3) Any child or adult with Type 1 diabetes taking insulin either on multiple daily injections or on insulin pump can use carb counting to calculate meal values and give bolus insulin.

Q4) How does carb counting help?

A4) Carb counting helps in managing insulin dose and getting HBA1C in range:

  • One of best and easiest methods to plan your meals and estimate the rise of glucose
  • Counting carbs can also offer more variety to your meal plan as it make calculating the dose of insulin easy
  • The right balance of carbohydrates and insulin will help your blood glucose level will usually stay in normal target range

Q5) How much Insulin is needed to cover the Carbs in our diet?

A5) The amount of insulin needed for a meal is calculated based on 3 parameters:

  • Insulin to Carbohydrate Ratio,
  • Target blood glucose
  • Insulin Sensitivity Factor

This is calculated for each child

Insulin to Carbohydrate Ratio is the number of carbohydrate grams that is covered by one unit of insulin.

Target blood glucose- is the blood glucose value that is targeted when we need to give a correction dose. The target may change for pre-meal, post-meal or bedtime.
For children premeal blood glucose target is generally taken as 80-120mg/dl (<5yrs can be taken as 90-130mg/dl); 2 hours post prandial is 140-180mg/dl.

Insulin Sensitivity Factor - is the amount or dose of insulin that needs to be given to bring down a high blood glucose level to the desired target range.

If the blood sugar value 2 hours after a meal is within the target range then it means that the car counting and insulin carb ratio is correct.

Q6) What is correction dose of Insulin ?

A6) Correction Dose of insulin is the EXTRA amount of insulin that is given to correct blood glucose that maybe above normal target or the amount of dose reduced from a bolus dose to correct blood glucose blood sugar level if it is low.