Please remember that I never give medical advice. Ask your endocrinologist or pediatrician for advice about your own child. Make your own informed decisions for your own child.
I’m going to refer to the 2010 Health.gov dietary guidelines. The 2015 guidelines are forthcoming. I’m also going to use my own child’s age and gender when referring to the suggested calories and carbs. The following two tables I’ve taken from “Dietary Guidelines For Americans, 2010” linked to above and will call it “dietary guidelines” here.
According to the dietary guidelines, “Carbohydrates provide 4 calories per gram.” For girls aged 9-13 they recommend 1,600-2,000 calories per day if they are moderately active. Of these calories, carbohydrates should make up 45-65% of those calories.
Using these numbers, and if I did my math correctly, here are the two extremes and the middle:
1,600 calories x 45% carbohydrates (at 4 calories per carb) = 180 carbs per day
1,800 calories x 55% carbohydrates (at 4 calories per carb) = 247.5 carbs per day
2,000 calories x 65% carbohydrates (at 4 calories per carb) = 325 carbs per day
So really, if my child is moderately active and eats between 180 and 325 carbs in a given day, we are within the recommended guidelines.
Sometimes when we carb count a meal I’m amazed at how many carbs it is. For instance at Wendy’s if Q is particularly hungry, she might ask for a junior hamburger (25 CHO), small chili (16 CHO), value sized fries (30 CHO) and a junior frosty (32 CHO). And every time I think, wow, that’s a lot of carbs! A hundred and three, to be exact. But what are kids who don’t have type 1 diabetes having at that same meal? They probably aren’t going for the lower carb kid-size frosty! And they are probably having soda. They are probably having way more carbs.
Or when Q packs her school lunch in the morning and counts the carbs and if it approaches anything over 75 I feel a little embarrassed (because it’s not just us seeing the carb count…the nurse or other staff are seeing it too). And I instantly feel judged that maybe we should be packing a lower carb lunch. But then I think about what most school lunch boxes contain–chips, candy, Lunchables–and I assure myself that her lunch can’t be as high in carbs as the other kids’ lunches. She often packs a sandwich, a salad or carrots, a piece of fresh fruit, and either something crunchy like pretzels or a granola bar.
The thing is that there’s no right answer on how many carbs your d-kid should eat. Your endo may have recommendations. Maybe it’s lower carb. Maybe it’s more complex carbs and less highly refined carbs. Maybe it’s lower glycemic. Maybe it’s “who cares how many carbs it is, let’s just be happy that this d-kid is counting carbs and actually bolusing!”
The reality is that kids without diabetes (and their parents) don’t count carbs. They don’t. But (most) kids with diabetes (and their parents) religiously count carbs because it’s the only way to know how much insulin to give for a meal.
Part of successfully raising kids with diabetes is letting them be kids (Kids First, Diabetes Second after all) and kids eat carbs. Lots of them. Sometimes I want to reign in how many carbs Q is having at a meal, but I also step back sometimes and ask myself if I’m putting the same restriction on my child who doesn’t have diabetes.
(Of course there are other factors involved in decision making. For instance if her blood sugar is already quite high, a high carb meal won’t help the matter.)
(And where do those extra carbs for treating lows fit in? Should we be including those in the daily carb count?!)
And not only do I judge myself and my parenting skills based on the number of carbs in her lunch or on her dinner plate, but what about judging her? (Judging her for her choices based on carb counts when other kids aren’t judged at all.) There are meals that make me say, “Whoa, Q, that’s a crazy amount of carbs!” Or “There’s no way you should have seconds.” Or “You’ll have to save that cookie for later.” Because diabetes management is so tied to food, I want to be careful that I don’t create food issues in her.
I think maybe a “most of the time” philosophy should apply here. Most of the time her meals should be healthy, most of the time total carbs shouldn’t exceed a certain threshold.
But sometimes she just needs to eat like other kids her age and I shouldn’t judge my parenting and diabetes management skills on the number of carbs on her plate or in her lunchbox.
And just a side note: She’s crazy excited about the middle school hot lunch because there is fresh fruit and a salad bar every day.
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