When you have a child with type 1 diabetes, meal planning is important. Everything your child eats can affect his blood sugar. Your doctor or a registered dietitian can help you come up with the best plan for your child, but there’s information all parents of kids with this condition should know.
Like all children, kids with type 1 diabetes need nutrient-rich foods that help them grow and keep them at a healthy weight. Over the course of a day, your child should get about 10%-20% of his calories from protein, 25%-30% calories from healthy fats, and about 50%-60% from carbohydrates.
Carbs are found in most foods -- not just bread and potatoes. They supply the energy that the body and brain need to work their best. Steer your child toward complex carbs such as vegetables and whole grains. They have vitamins and minerals that will keep him healthy, and fiber, which helps control blood sugar levels.
Try to stay away from simple carbs, like white bread and pasta and other processed grains, candy and frosting. They can raise blood sugar quickly.
The amount of carbs your child needs depends on his weight, age, size, exercise level, and any medicines he’s taking. Your doctor or dietitian can help you figure out the number of grams or serving sizes your child should have each day.
Many families keep their child’s blood sugar levels steady by counting the number of carbohydrates eaten at every meal or snack, then adjusting insulin doses for it.
On packaged foods, the number of total carbs per serving is listed on the label. You can subtract the grams of dietary fiber since this isn’t digested. Then multiply the total by how many servings of that food your child eats. If you’re cooking at home or eating out, you can look up carb counts and portion sizes of foods online.
Constant Carbohydrate Plan
Another option is to have your child eat a set amount of carbohydrates at every meal and snack. He’ll need to eat at the same times every day, and also take insulin at set times. You don't have to eat the same foods everyday. You just need to stick to the total carbs set for each meal and snack. Keeping to a schedule works well for many kids.
Exchange Meal Plan
With an “exchange plan,” your child’s menu will include the amount he can eat from six different food groups: starch, fruit, milk, fat, vegetable, and meat. One food can be exchanged for another with the same amount of calories, protein, carbs, and fats. In children with type 1, dietitians often will focus on carb exchanges since this affects blood sugars the most. You can find exchange lists online.
Foods To Avoid
There are no specific foods that are off-limits to your child, but there are things to consider when meal planning and grocery shopping.
People with diabetes have a higher risk of developing heart disease. Because of that, it’s good to steer your child away from fatty foods that contain cholesterol, saturated fat, and trans fat.
Avoid foods high in salt. Eating too much sodium can lead to high blood pressure.
Limit sugary foods like candy, cookies, frosting, or soda that raise blood sugar quickly. They’re best given at a meal and with insulin. You'll adjust insulin based on carb counting. Your child doesn’t have to miss out on treats for special occasions like birthdays or Halloween. You'll just have to account for those carbs over the course of the day.
Snacks to Keep on Hand
“Free” snacks like cucumbers and celery or sugar-free gelatin contain very few carbs, so they won’t have much effect on your child’s blood sugar. You can also have “controlled-carb snacks” handy to for between meals. Some good kid-friendly choices: low-fat string cheese, a hard-boiled egg, or a small serving of nuts with a sugar-free drink.
Highs and Lows
If your child eats more than expected or at a different time than you’ve planned, he may get high blood sugar, or hyperglycemia. If this happens, you may need to make some adjustments. Talk to your diabetes team about adjusting his meal plan or his doses of insulin or other medication.
Hypoglycemia, or low blood sugar, can cause serious problems that need treatment right away. Your child’s glucose levels can drop if he skips a meal or snack or doesn’t eat as many carbs as expected. It can also happen if he takes his insulin at the wrong time or exercises more than usual without eating extra snacks or adjusting his insulin. If your child’s levels are low, give him a sugary food. Regular soda, orange juice, or even cake frosting raise glucose levels quickly.
You can also keep glucose tablets on hand or talk to your doctor about a glucagon kit. Glucagon is a hormone that treats a severe low blood sugar reaction.
Keep a record of your child’s carb intake, insulin doses, and blood sugar readings. These numbers can help you and your doctor see if his meal plan is working.