November 5, 1999
Meal Planning, Food and Diet
Question from Wellesley, Massachusetts, USA:
My 9 year old daughter has had Type 1 for almost a year, and we are starting to feel more confident about counting and estimating the carbohydrate content of foods. One problem though: it seems to me that the carbohydrates in milk and yogurt have much less of an effect on blood glucose than the carbs in fruit and starches, even when you take into account that the presence of protein and fat slows down the rate at which they are digested. Any suggestions about how to count them?
I have heard this from some other folks, although I have not seen anything actually written about this effect. If a normal amount of insulin is 1 unit per 15 grams of carbohydrate, I would go down 1/2 or one unit if one or more of the carbs is milk or yogurt. For example, if her usual dose would be 4 units to cover lunch, but 8 oz of milk is part of the lunch, use 3 or 3 1/2, not 4 units.
We had thought the delayed effect of the carbohydrate could be due to the extra protein and fat content of the milk or yogurt, but this may not be so. I guess research is needed, but until that time, go light on the insulin.