You’re getting a handle on counting the carbohydrate grams in most of the foods your child with type 1 diabetes eats… then up comes a curveball. From vitamins and cough medicine to toothpaste and other semi-edibles that kids have been known to sample — no judgment! — you might still have a few questions. Do these things contain carbohydrates? And if so, do you need to cover them with insulin? Rest assured, you are not the first parent to ask these questions. Here are some answers!

  1. Do Cough Drops Have Carbs?

Carb count: about 4g per serving

With about 4 carbohydrate grams per drop, covering a single cough drop with insulin is generally not something to worry about, say Lory Gonzalez, A.R.N.P., C.D.E., and Mercy Molina, R.D., C.D.E., both from the Diabetes Research Institute (DRI) at the University of Miami’s Miller School of Medicine.

A couple caveats: When reading labels, be aware that cough drops labeled “sweetened with honey” still contain sugar, Molina notes. Sugar-free drops are also available, but since these typically still contain a few carbohydrates, there’s really no significant carb gram savings.

  1. Does Cough Syrup Have Carbs?

Carb count: 5 to 10g, depending on brand and dosage amount for children

Medicines are not required to carry nutritional facts labels like foods are. So it can be frustrating to reach for the bottle of cough syrup tucked away in your medicine cabinet and have no idea how many carbs your child will be taking in by swallowing a serving. Cough syrup usually doesn’t need to be covered with insulin, but once you see how your child’s blood sugar responds to a particular cough syrup, you may need to make adjustments.

To find out the carb count of a particular brand, you can call the toll-free number on the bottle and ask the manufacturer directly. Once you get the answer, take a black sharpie and write the carb grams per serving size directly on the bottle for easy reference next time your child is sick. “Having the bottle labeled can be especially helpful if your child is being watched by a grandparent or babysitter who’ll need to give your child medicine,” says Molina.

  1. Do Chewable Vitamins Have Carbs?

Carb count: about 5 to 10g per two-piece serving of gummy vitamins

Children’s vitamins contain a relatively small number of carbohydrate grams, but monitoring portion size is a must. Gummy vitamins look and taste the same as fruit snack gummies; if kids think of them as candy, that two-piece serving may sneakily increase in size to one that does require bolusing. If portion control is an issue, “try chewable tablets instead of gummies. Tablets have negligible amounts of carbohydrate, and kids may be less likely to go overboard with them,” says Malisa McEachen, R.N., B.S.N., C.P.N., C.D.E., a certified diabetes educator at Children’s Mercy Hospital in Kansas City.

  1. Does School Glue Have Carbs?

Carb count: 0g

School glue is white and creamy and has sort of a pleasant minty scent. No wonder some curious kids like to put a little in their mouth to taste it! The good news: White school glue has no carbs. The not-so-good news: Anytime your child ingests a nonfood item, you need to make sure it’s not poisonous or harmful, says Gonzalez. (School glue is generally nontoxic. Still, check the label for safety precautions.)

  1. Does Paper Have Carbs?

Carb count: 0g

Kids who nibble and swallow paper are getting some fiber in the form of wood pulp cellulose, but no carbs. Phew! Here’s hoping the number of spitballs that end up on the ceiling is also zero.

  1. Do Cat Food and Dog Food Have Carbs?

Carb count: about 1 to 2g per serving

What kid can resist finding out what their pet’s food tastes like? A few pieces of cat or dog kibble have a negligible amount of carbs, so unless your child pours a cereal-sized bowl — and eats it all — there’s not much to count here. Pet food nutritional labels don’t always list things like calories and carbohydrate grams, but you can get a feel for the carb content by reading the ingredients list. Pet foods contain a lot of protein but also have some carb-containing ingredients, like starch or molasses.

  1. Do Sugar-Free Chocolates, Cookies, and Candy Have Carbs?

Carb count: 0 to 25g or more

Check food labels carefully, because “sugar-free” and “no sugar added” do not mean the same thing as carbohydrate-free, especially when the treat has other ingredients such as milk, raisins, and nuts. Check labels for the carbohydrate grams per serving, or use an app like Calorie King or MyFitnessPal to look it up, recommends Gonzalez. Sugar-free treats are often sweetened with sugar alcohols, which can cause GI discomfort or even diarrhea. “We want kids to eat foods that don’t have so many additives, like sugar-free foods tend to have. So if you have a choice between a piece of regular chocolate and a piece of sugar-free chocolate, just enjoy the real thing! Even if you need to cover it with insulin,” Molina and Gonzalez advise.

  1. Does Chewing Gum Have Carbs?

Carb count: about 1 to 2g per stick of sugar-free gum

If you’ve got a tween, then you know how important a few sticks of gum can (apparently) be to getting through the day. Sugar-free gum is considered a “free food” for carb counting purposes, meaning you don’t need to cover it with insulin. If your child wants to chomp on regular sugar-sweetened gum, however — even if he or she doesn’t swallow it — then you’ll need to check the label for the carb count as amounts can vary widely by type and brand.

  1. Do Flavored Lip Balm and Lip Gloss Have Carbs?

Carb count: about 0g

Most lip gloss brands do not contain sugar — their sweet scents and tastes typically come from artificial flavorings and fragrances. If there is honey or sugar or another sweetener in the ingredients, it would likely be a concern only if your child eats a significant portion of the tube in one sitting. Lip gloss ingredients can be an issue for those with celiac disease, since some lip glosses contain gluten, so read labels carefully if this applies to your child.

  1. Does Mouthwash Have Carbs?

Carb count: about 0 to 5g per standard usage

Mouthwash tends to be formulated with sugar alcohols, so in the small amounts that kids use, the amount of carbs mouthwash contains is generally not something you need to factor into your calculations. Swish away! Even if a child accidentally swallows a mouthful, that single child-sized gulp is still not something that needs to be covered by insulin — but it could be problematic for other reasons. Check the label carefully and follow directions for accidental ingestion.

  1. Does Toothpaste Have Carbs?

Carb count: about 0 to 2g per serving

While toothpaste can contain carbohydrates, you don’t need to cover them with insulin, because they’re not absorbed into the body during normal tooth-brushing. If your child were to accidentally eat an entire tube of toothpaste, then you might want to factor the carbs into your insulin calculations (you can find out the amount by calling the manufacturer). However, the more immediate concern may be an upset stomach and other fleeting gastrointestinal symptoms; call Poison Control (1-800-222-1222) for directions on what to do. Since tummy trouble can make your child not want to eat food for a little while, you’ll need to adjust for this in your child’s diabetes management.

Disclaimer: The experiences and suggestions recounted in these articles are not intended as medical advice, and they are not necessarily the “typical” experiences of families with a child who has type 1 diabetes. These situations are unique to the families depicted. Families should check with their healthcare professionals regarding the treatment of type 1 diabetes and the frequency of blood glucose monitoring.

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