I do a lot of home cooking and baking. My daughter is seven and uses an insulin pump. I figure out the carbohydrate counts per ingredient in a recipe and then total it for the carbohydrate count for the entire recipe. I then either weigh the entire item and then figure out how much each serving is per gram or divide it in equal portions and figure it out that way. It seems, though, that every time, my daughter has a low blood sugar or is on the lower end. What am I doing wrong? Should I not be including the carbohydrates for bananas or carrots if they are in a home baked item? Do cakes get metabolized very slowly if there is a high fat content? Please help me. I would like to continue to bake, but the lows are upsetting.

You ask a good question about the fat content of baked goods. In some kids with diabetes, higher fat foods tend to slow down the absorption of carbohydrates, so, in theory, foods that have a higher fat content might cause lows after eating since their fast acting insulin is beginning to work but the food is not fully meeting the insulin’s action. A higher blood glucose hours later after eating may be due to the delayed absorption of the fat. You are correct in how you are incorporating the carbohydrate counts from ingredients in calculating your carbohydrates for the portion size served. The good way to counteract this glucose rise is to use the combination bolus or extended bolus (each insulin pump has this feature) to match fast acting insulin with slower acting fat. Consult with your health care team if you need help with using this useful feature.

JMS