Living with Diabetes

Let's eat! 
Nutrition for Children with Diabetes and Their Families

Healthy eating habits are a key component for healthy children -- with or without diabetes.  The DRI's Education Team offers up some tips and guidelines for all families living with diabetes...

Provide adequate nutrition to ensure normal growth and development; integrate insulin regimens into usual eating and physcial activity habits.

Have a family approach to healthy eating with consistency between siblings.

Adopt healthy eating habits that ensure an adequate amount of essential vitamins and minerals.

Consult with a registered dietician with experience in pediatric nutrition and diabetes. Meal plans must be individualized to accommodate food preferences, appetites, cultural influences, physical activity patterns, and family eating patterns and schedules.

Make healthy food choices.  While this might seem obvious, it's helpful to know that fresh produce often is located around the outside perimeter of the supermarket. Avoid going up and down the aisles as much as possible. Choose less packaged foods.  Food choices should include fresh fruit, vegetables, lean meat, dairy products (milk, yogurt, cheese), and high fiber bread and cereals.

Know if carbohydrate foods have a high impact or a low impact on glycemic index (the numerical index based on the average increase in blood glucose levels occuring after the food is eaten).  Research suggests the carbohydrate amount is more important, rather than the carbohydrate type.

The pre-meal insulin doses should be adjusted for the carbohydrate content of the meal.  For individuals receving fixed doses of insulin, day-to-day consistency in the amount of carbohydrate is important.

Insulin timing -- optimize opportunity for success.  Best BG response if insulin is administered pre-meal -- safety with young children a key consideration.  For pumpers, utilize pump features, both in terms of splitting the bolus and in terms of available bolus types.

BG numbers provide information about responses to food eaten and ideas for optimal insulin delivery to reduce BG swings.  However, don't let the numbers become the focus.  Rather, use them more like a story teller providing information for a future strategy.

A healthy relationship with food is essential in achieving good nutrition. Flexibility, not restriction, is the key ingredient.

Don't avoid challenging foods; get even with them! Involve children in carb counting as early as possible. Don’t do all of the work for them if they have the ability to participate. Problem solve with children…they may be more open to incorporating the solution.

Be mindful of “disordered” eating…elevated A1c in a knowledgeable patient; DKA frequency; anxiety about being weighed. The key is to negotiate realistic glucose levels, weight and behavioral goals, and encourage positive communication (verbal and non-verbal).

Avoid perfectionism!

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SOURCE: Diabetes Research Institute Education Team
(2014)


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