Diabetes and Nutrition
The nutritional needs of a child with diabetes and a child without diabetes are the same. Both diets should include a variety of foods in order to promote proper growth and development.
Treatment for diabetes consists of finding a balance between carbohydrate, insulin and exercise to keep blood sugars within a safe range.
Carbohydrates
Foods that contain carbohydrates increase blood sugars. This does not mean that the individual with diabetes should avoid carbohydrates. Instead, they need to learn to count carbohydrate grams to match with their insulin. There are many sources to assist with carbohydrate counting such as food labels, the Exchange Book, and Fast Food Guides.
Foods Containing Carbohydrates
Starches: Bread, cereal (sweetened and unsweetened), pasta, rice, potatoes, corn, peas, crackers, popcorn.
Fruits: Fresh, frozen, canned and juices.
Milk: Milk and yogurt.
Others: Cakes, cookies, candy chips, ice cream.
All foods, including sweets, can be worked into a daily meal plan by counting grams of carbohydrates. In the past, it was taught that children with diabetes could not have sugar and/or sugary foods. However, today, this idea is outdated. The American Diabetes Association and The American Dietetic Association recommend that sweets can be included within the context of a healthy diet.
Foods that contain proteins and fats have little or no effect on blood glucose levels. However, if eaten in excess can cause weight gain.
Nutritional differences in Children with Diabetes
The type of insulin therapy the student receives will affect their schedule and plan of care.
I. Conventional Therapy (NPH and Regular Insulin)
- Two insulin injections generally given by parents at home (i.e. usually at breakfast and supper).
- 3 meals and 3 snacks at specific times each day.
- A specific amount of carbohydrate at each meal and snack.
- Checking blood glucose before meals (while at school: before lunch) or if the student exhibits signs of low blood sugar.
Parties / Special Events / Field Trips
- Meal / snack timing should be about the same time each day for optimal blood glucose control. Altering meal / snack times can result in too high or too low blood sugars.
- If possible, notify the student's family ahead of time to include them in the plans.
- Parties are often scheduled 1½ -2 hours after lunch, which usually matches closely with the student's regular snack time.
- Parties generally include carbohydrates (cake, cookies, chips, ice cream, etc.). The treat or a portion of the treat may fit in to the student's snack/meal plan.
- Student's usual snack / meal schedule should be taken into consideration during field trips. Students should be allowed to eat on the bus/van if necessary.
II. Basal Bolus Therapy (i.e. Humalog / NovoLog Insulin) and Pump Therapy
- Blood Glucose must be checked prior to the administration of insulin and to eating foods with carbohydrates.
- Insulin dose is based on the grams of carbohydrate to be eaten and blood glucose reading.
- Insulin must be given before each meal and or snack containing carbohydrate.
Parties / Special Events/ Field Trips
- This insulin regimen allows for flexibility in timing of meals as well as amounts of carbohydrate.
- Treats can be eaten with other students, but insulin must be given to cover the grams of carbohydrate.
- Insulin will need to be taken along for field trips.
- Extra carbohydrate snacks should also be kept with the student in case of hypoglycemia.
Written 9/04
