 Nutrition and Diabetes
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Your child's meal plan is an extremely important part of being healthy, active and living well with diabetes. When your child eats, his or her blood glucose level will rise. Insulin and exercise both lower the blood glucose level. The key is to balance the amount of food your child eats with exercise and insulin so that most of the time your child's blood glucose levels are in the goal range.
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Your child's meal plan is designed to spread out foods through the day.
The meal plan:
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- Provides guidelines for healthy, well-balanced meals and snacks
- Helps keep your child's blood glucose in a safe range
- Provides the appropriate amount of nutrients to support your child's normal growth and development.
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The dietitian will work with you to create an individual meal plan for your child.
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- You and your child should meet with the dietitian at least once or twice each year to update the meal plan. It may need to be more frequently if problems arise.
- The meal plan will be adjusted depending on changes in your child's growth and development, school routines, seasonal sports or exercise and child care arrangements.
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- Give your child meals and snacks at approximately the same time each day. Try to keep the time of the meals and snacks within 30 minutes of the schedule.
- Do not skip meals or snacks. Skipping or delaying a meal or snack more than 30 minutes could cause your child's blood glucose to drop too low.
- Most children need to eat three meals and two to three snacks each day.
- Your child should eat every two to three hours so that his or her blood glucose does not drop too low. As your child gets older, he or she may not need to eat so often.
- The bedtime snack is very important to prevent your child's blood glucose level from dropping too low during the night.
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- Try to give the same amount of food at each meal or snack.
- If your child eats more food than usual at one time, the blood glucose will rise too high.
- If your child does not eat enough food, blood glucose may drop too low.
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Meal planning helps your child eat healthy meals and snacks that meet your child's nutritional needs. A variety of foods with the ideal balance of carbohydrate, protein, fat, vitamins and minerals will give your child energy and nutrients he or she needs to be healthy and to grow normally.
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The meal plan is based on serving sizes called "exchanges."
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- The exchange lists group specific servings of foods together because they have very similar amounts of carbohydrate, protein, fat and calories.
- You can substitute or exchange one food for another within each exchange list.
- The exchange system was created by the American Diabetes Association and the American Dietetic Association.
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Carbohydrate counting is a method of meal planning that is used together with the food exchange plan. With this method, you will count the grams of carbohydrate or number of carbohydrate servings your child eats at each meal or snack.
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- Carbohydrate is the main nutrient in starches, fruits, milks, starchy vegetables and foods that contain sugar. Using the exchange food lists, count each starch exchange, fruit exchange or milk exchange as 15 grams of carbohydrate or 1 carbohydrate serving.
- Food labels list the grams of carbohydrate for foods that may not be found in exchange lists.
- Carbohydrate-containing foods have the greatest effect on the blood glucose level. When carbohydrate is digested, 90 percent of it turns into blood glucose within one to two hours.
- Carbohydrate counting allows your child to have a wider choice of foods.
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The Nutrition Facts label on food products gives you all the information you need to fit any food into your child's meal plan.
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- Check the serving size of the food product. Using the examples above, the serving size of the nonfat milk is one cup and the serving size of the Cornflakes is one box.
- Use the "Total Carbohydrate" line on the label to determine the carbohydrate grams for each serving size listed. For the nonfat milk, there are 12 grams of carbohydrate per one cup. For the Cornflakes, there are 18 grams of carbohydrate per box.
- Use your child's meal plan to determine how to fit these foods in the appropriate serving sizes. For example, a 60 gram carbohydrate breakfast could include the following menus:
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One cup milk: 12 grams
One box Cornflakes: 18 grams
One slice wheat toast: 15 grams
One small banana: 15 grams
Total carbohydrate = 60 grams
One cup milk: 12 grams
Two boxes of Cornflakes: 36 grams
One small banana: 15 grams
Total carbohydrate = 63 grams
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