Diabetes In Children

Do Diabetic Children Need Special Foods?

Children with diabetes need to eat the same nutritious food that other family members should be eating.

• They won’t be on a “diet.”
• They can eat everything in moderation – including foods containing sugar.
• Special diabetic and dietetic foods are not necessary.

But people with diabetes need to watch:

• What time they eat (meals and snacks should be about the same time every day).
• How much they eat (meals and snacks should be about the same size every day, provided there is no change in activity).
• The balance of what they eat at each meal (not too much of one type of food).

Planning Meals

Each child’s needs are different. In the beginning, you will probably work closely with a dietitian to plan meals and snacks. Many dietitians recommend a plan called “carbohydrate counting.” This means keeping track of sugars and starchy foods, which have the most effect on blood sugar. You match up the amount of carbohydrate to the amount of insulin your child takes.

With practice, it will become second nature for you and your child to:

• Balance food intake with insulin levels.
• Provide enough calories for normal growth.
• Make meals satisfying, so the child won’t feel deprived.

The Balanced Diet

Meals and snacks will be based on the principles of the diabetes food pyramid.

• About 50 percent of calories should be from complex carbohydrates such as breads, pasta, and rice, and starchy vegetables such as potatoes, corn, peas, and beans.
• The child should eat plenty of vegetables and fruit.
• Protein should come from lean meats, chicken, turkey, fish, beans, eggs, or low-fat cheese.
• Dairy foods should be either nonfat or low-fat.
• Added fats and sugars are acceptable but only in small amounts.

The Diabetes Pyramid

This food pyramid shows what should go into the day’s meals and snacks, with much more from the wide parts than the narrow.

Picky Eaters

If young children don’t eat enough to balance their insulin shots, there’s a risk of low blood sugar. One solution is to give a shot of very fast-acting insulin right after meals. You can calculate the dose according to what the child just ate. Check with your doctor before starting this system.

Weight Gain

Insulin may cause some teenagers to gain weight.

• Work with the dietitian to get a better balance of insulin, calories, and exercise.
• Unless your dietitian recommends one, don’t try any of the popular weight-loss programs!

Sugar: Just Another Food

Until quite recently, people with diabetes were told to think of sugar almost as a poison. Now we realize that it raises blood sugar no higher than the “complex carbohydrates,” such as bread and potatoes, do. But it may raise blood sugar too high if children have sugary foods and drinks in addition to regular food.

• Give sugar as part of a meal (for example, in fruit pies, frozen yogurt, or pudding).
• Avoid too much sugar between meals. For example, the child should drink diet soft drinks, not regular.

Are Fats Bad?

Fats don’t have much effect on blood sugar, and children need some fat. But, there’s another problem with fat. Adults with diabetes have much higher than average rates of heart disease. And, heart disease can start in children who eat a lot of saturated fat, which is found in food such as meat and dairy products.

• Choose lean meats and take the skin off chicken.
• Instead of butter or hard margarine, give fats that aren’t saturated, such as those in liquid oils, nuts, and margarine that lists a liquid oil as the first ingredient.
• Buy skim or low-fat milk, and nonfat or low-fat yogurt. Limit the amount of regular cheese: choose a low-fat type.
• Avoid fried foods. Barbecue, broil, boil, or bake instead.

What About Salt?

High blood pressure can be a serious problem in later life for people with diabetes. Help prevent it by keeping salt intake low.

Why Snacks Are Important

Snacks can be essential in preventing blood sugar from dipping too low between meals. These should not be snack foods high in sugar and fat, like candy or chips, but substantial foods such as:

• Peanut butter and crackers
• Cheese and crackers
• Low-fat sugar-free yogurt
• Fresh fruit
• Bran muffins
• Graham crackers
• Cereal and milk

Children with diabetes should always carry a snack with them in case they can’t get to a meal on time. (Snacks can also be part of the treatment of low blood sugar, or hypoglycemia).