Fixed Carbohydrate Meal Plans for Diabetes

This resource from Children's Hospital of Philadelphia is for patients with diabetes who need to follow a fixed carbohydrate meal plan. It includes nutrition information and sample menus.

Your diabetes team has recommended that your child follow a meal plan with a fixed amount of carbohydrates for each meal and snack. Click on the menu that matches your child's plan below for sample breakfast, lunch, dinner and snack ideas.

• 30 grams carb per meal, 15 grams carb per snack

• 45 grams carb per meal, 15 grams carb per snack

• 60 grams carb per meal, 15 grams carb per snack

• 60 grams carb per meal, 30 grams carb per snack

• 75 grams carb per meal, 30 grams carb per snack

How does food affect blood sugar?

There are three main nutrients found in food: carbohydrate, protein and fat. Learn more about diabetes and food.

Carbohydrates (carbs)

• A carbohydrate (carb) is a nutrient that provides energy.

• Types of carbs include:

  • natural sugar in fruit, and milk

  • added sugar in cakes, candy, and sweetened beverages

  • starch and fiber in bread and crackers

• When we eat carbs, the body breaks them down into sugar. The sugar goes into the blood and the blood sugar level goes up. Insulin then carries the sugar from the blood to the rest of the body so it can be used for energy.

Healthy carb choices include whole grain breads, pasta and cereals, fruit, low fat or skim milk, brown rice, vegetables, and other starches including potatoes, corn, beans and peas.

Protein

• Protein is a nutrient that helps your child build and repair muscle.

• Foods that are made up of protein include meat, poultry, eggs and cheese.

• Nuts, beans and vegetable proteins (tofu, veggie burgers, and other soy products) have protein and carbs. The carbs in these foods will turn into sugar.

Healthy protein choices include cheese, grilled, roasted, or baked chicken, turkey or fish, lean ground meats and beef, nuts and beans.

Fat

• Fat is a nutrient that is important for the brain and nervous system.

• Fat does not turn into sugar but digests more slowly and may cause a delayed high blood sugar.

• Foods that are 100% fat are butter, oils and mayonnaise.

Healthy fat choices include olive oil, avocado oil, low-fat or light tub spreads and reduced fat cream cheese.

How do we match insulin and food?

• Keep a meal schedule, follow the meal plan and count carbohydrates.

• Your child may eat less than the carb amount set by your dietitian at a meal but should not skip eating a meal.

• Your child should finish each meal or snack within 30 minutes.

How can we count carbs?

This list of foods gives you and your child an idea of which foods are made up of carbs.

• Fruit - fresh fruit, fruit cups, dried fruit and raisins, applesauce, 100% fruit juice

• Milk - white milk, chocolate milk, yogurt, and other non-dairy milk products (rice, soy, almond, pea, and oat milk)

• Grains - bread, hot and cold cereals, waffles, pancakes, tortillas, rice, pasta, couscous, quinoa

• Vegetables - all vegetables, including green beans, broccoli, salad, cooked greens, carrots

• Starchy vegetables - potatoes, sweet potatoes, corn, green peas

• Nuts, seeds and beans - nuts, seeds and nut and seed butters (like peanut butter), kidney beans, chickpeas, baked beans, edamame

• Breaded meats and cheeses - contain carbs and protein- chicken nuggets, chicken patties, fish sticks, mozzarella sticks

• Condiments - ketchup, tomato sauce, prepared salad dressing, sweet and sour sauces, honey mustard sauce, barbeque sauce, syrup

• Snack foods and treats - pretzels, crackers, cookies, cereal bars, potato chips, corn chips, pudding, ice cream

Learn more about how to count carbs. These tools can help:

• Carb counting book

• Carb counting web site

• Phone apps

• Food labels

To read a food label:

1. 

   Check the serving size. The nutrition information listed below is based on one serving size.

2. Check the Total Carbohydrate grams per serving.

3. Figure out many servings your child is eating.

4. Add up the total amount of carb grams based on the number of servings your child will eat.

For example:

• 1 serving = 2/3 cup. Each serving = 37 g carb.

• If your child eats 2 servings, the total carb gram amount will = 74 g carb.

• Bolus insulin dosing is based on the amount of total carbohydrate grams your child plans to eat.

Carb counting resources will tell you and your child the amount of carb grams found in a set serving size of a food. To figure out how many carbs are in the amount of food that your child is eating, you will need to accurately measure the food using a food scale or measuring cups and spoons.

What if the carbs do not add up?

If your child does not eat or drink all of the foods that have carbs at a meal or snack, they need to make up those carbs with other options at that time to prevent a low blood sugar.

Use fruit, milk or fruit juice to replace uneaten carbs.

What about foods that do not have many carbs, like meats and fats?

Although these foods do not have many carbs, the body still uses insulin to process them. Eating meats and fat in excess to avoid insulin is not heart healthy and may lead to unwanted weight gain. Your child should eat them as part of a meal or snack, with foods that have carbs.

I'm still hungry!!

You may hear this from your child when you first return home, especially if your child lost weight before diagnosis. Once your child regains weight, their hunger should decrease.

If your child wants more food at a meal, add more non-starchy vegetables like cucumbers, tomatoes, peppers, cauliflower, carrots, or celery.

If you feel that the meal plan is not meeting your child's hunger needs, please send your diabetes provider or dietitian an MyCHOP message to discuss if the meal plan should be changed.

Snacks

Your child can have up to 3 snacks every day. If your child is not hungry for a snack, they do not need one.

Snacking is ok if your child is hungry, but if your child is eating snacks to keep blood sugars from running low regularly, consult your diabetes team for a possible insulin dose adjustment.

What about drinks?

• Your child can drink carb-containing drinks at meals and snack times

• Remember to add the carbs into the carb count for the meal

• The healthiest carb-containing drink for your child is milk.

• Other drinks that have carbs use up the allowed carb amount at a meal or snack without providing healthy nutrition.

• Between meals and snacks your child should drink liquids that do not have carbohydrates. This includes:

  • Water

  • Crystal Light or similar drinks

  • Sugar-free fruit flavored seltzer

  • Sugar-free juice

  • The healthiest no-carb drink is water. Many other sugar-free drinks contain sugar substitutes. They can be used in small amounts but should not be your child's main beverage.

What about other sugar-free, diabetic, low carb, or low glycemic index foods?

Many of these foods have sugar substitutes that will be listed on the Nutrition Facts label. There are two groups of sugar substitutes.

• Artificial sweeteners (aspartame, sucralose, saccharin)

• Alternative natural sweeteners (stevia, lo han go, sugar alcohols)

Sugar alcohols may cause stomach cramps or diarrhea and should be eaten in small amounts. Even though sugar alcohols are not sugar, they do make blood sugar levels go up.

You may choose to use reduced-sugar or lite versions of foods like jelly or syrup. These foods have less sugar than the regular version but still have carbohydrates.

Reviewed on March 22, 2023, by Megan Robinson, MS, RD, CDCES, CSSD, LDN