Diabetes: Your Child’s Meal Plan

________________________________________________________________________

KEY POINTS

• There are several ways to plan meals to help manage diabetes. Your certified diabetes educator will help you find a meal plan that works for your child.
• Most plans are based on counting carbohydrates (carbs) in food because carbs have the biggest effect on your child’s blood glucose level. Carbs are a source of energy for the body. Carbs are found in foods such as pasta, bread, cereals, rice, potatoes, beans, peas, vegetables, fruits, sugary drinks, and candy.
• It is important to meet with a dietitian to develop a meal plan that fits your child’s taste and lifestyle, and your family’s budget.

________________________________________________________________________

Why is it important to manage my child’s meal plan when my child has diabetes?

Having diabetes means that there is too much glucose (sugar) in the blood.

The body breaks down some of the foods your child eats and drinks into glucose. Your child’s blood carries the glucose to the cells of the body. Your child needs the glucose in the cells for energy, but too much glucose in the blood causes symptoms and is not good for your child’s health.

Diabetes is a problem with the way the body makes or uses insulin. Insulin is made by the pancreas, which is an organ in the upper belly. The body uses insulin to help move glucose from the blood into the cells. Type 1 diabetes happens when your child’s pancreas stops making insulin. Type 2 diabetes happens when your child’s pancreas doesn’t make enough insulin or your child’s body has trouble using the insulin the pancreas makes. When your child’s body does not have enough insulin or has trouble using insulin, glucose cannot get into the cells and builds up in the blood.

Type 1 diabetes is treated with insulin, but food choices and physical activity are still very important parts of managing blood glucose and preventing complications. The goal of food choices is to try to keep your child’s blood glucose at a normal level throughout the day. This is done by matching your child’s insulin doses with the amount of carbohydrates (carbs) your child eats or drinks. Meal plans can be designed to fit your child’s lifestyle.

With type 2 diabetes, sometimes your child can control blood glucose levels with just meal planning and physical activity. Or your child may also need to take oral medicine or insulin shots.

Understanding how food and drinks affect blood glucose is an important part of taking good care of your child.

What are the types of meal plans?

There are several ways to plan meals to help manage diabetes. The certified diabetes educator will help you find a meal plan that works for your child. Most plans are based on counting carbs in food because carbs have the biggest effect on your child’s blood glucose level. Carbs are a source of energy for the body. Include carbs in an amount that gives your child energy while managing blood glucose levels. There are three basic types of carbs: starches, sugars, and dietary fiber.

• Sugars such as glucose and fructose raise blood glucose very quickly. Sugar is found in foods such as fruit, milk, sugary drinks, baked goods, and candy.
• Starches are found in plant-based foods such as pasta, bread, cereals, rice, potatoes, beans, and corn. Some starches are converted to energy very quickly, but others, such as whole grains, are converted more slowly.
• Dietary fiber is the part of plants that cannot be digested. Fiber is found in whole-grain bread and pasta, beans, peas, leafy vegetables, raisins, prunes, pears, apples, and berries. Fiber can help control blood glucose by slowing how quickly the body absorbs sugar from foods.

The most common types of meal plans are:

• The Plate Method: Use the MyPlate method to teach your children how to eat a balance of healthy foods in the right amounts. Divide a 9-inch plate into portions for vegetables, grains and starches, and proteins. This helps you to choose foods for breakfast, lunch, and dinner. Fill half of the plate with nonstarchy vegetables. The other half of the plate should be split evenly. In one section, put starches including whole grains and starchy vegetables such as potatoes. The last section is for proteins such as lean meat, beans, lentils, tofu, and eggs. Fruit or a cup of low-fat or skim milk or yogurt on the side is OK. You can also add small amounts of healthy fat. This way of planning your child’s meals is focused on getting more vegetables and less starchy foods. This helps to control blood glucose.
• Carbohydrate (carb) counting meal plan: This plan helps you figure out the amount of carbs in each meal or snack and match your child’s insulin dosage to that carb amount. This plan works best if your child takes insulin with each meal.
• Constant carbohydrate meal plan: With the constant carbohydrate meal plan, your child counts carb choices and has the same number of carb choices at each meal, drink, or snack. Your child takes insulin or other diabetes medicines at the same times and in the same amounts each day.
• Exchange list meal plan: This plan divides foods into starch, fruit, milk, fat, vegetable, and meat groups. The plan gives you serving sizes for foods in each group that have about the same amount of carbs, protein, fat, and calories. This lets your child exchange, or swap, choices from a food list.

It is important to meet with a dietitian to develop a meal plan that fits your child’s taste and lifestyle, and your family’s budget.

What is a healthy way for my child to eat?

Healthy eating habits for your child include:

• Plan for well-balanced meals. Help your child eat a balance of fresh vegetables and fruit, low-fat dairy, lean meats and fish, beans, whole grains, nuts, and seeds.
• Manage carbs carefully. Carbs affect your child’s blood glucose level more than protein or fat. Your child needs to balance how much insulin your child takes with the amount of carbs he or she eat eats and drinks. This helps keep your child’s blood glucose at a healthy level and helps prevent many health problems. Testing your child’s blood glucose 2 hours after a meal will help you find out how different combinations of food and drinks can affect your child’s blood glucose. Learning how your child’s body responds to foods will help improve blood glucose control.
• Eat meals at the same time each day. Insulin and oral diabetes medicines will lower your child’s blood glucose whether your child eats or not. It’s important not to miss meals. Your child should try to eat at about the same time each day to prevent low blood glucose. Make sure that your child carries snacks in case of a change in schedule that affects your child’s mealtime.
• Use snacks to prevent insulin reactions. Snacks help to keep your child’s blood glucose from going too low after taking insulin. Although there are some general times that you can expect each type of insulin to reach its peak activity, actual peaks vary from person to person. You and your child will learn from experience when he or she needs a snack. Different types of snacks have different effects. Sugar from fruit will last 1 or 2 hours, so fruit is good for a morning or afternoon snack. Carbs such as whole grain crackers or bread eaten with proteins such as low-fat cheese or meat, change to sugar more slowly. If your child has low blood glucose during the night, add a lean protein to the evening carb snack. This can help your child’s blood glucose level stay stable through the night. Milk and yogurt are a natural mix of carb and protein and make a good bedtime snack choice.
• Choose healthy fats and limit cholesterol, saturated fat, and trans fat in your child’s diet. Eating too many foods high in cholesterol, saturated fat, or trans fat can lead to high levels of fatty materials in the blood called cholesterol and triglycerides. High cholesterol increases the risk for heart disease. People who have diabetes have a higher risk of getting heart disease. Your child’s blood cholesterol level and triglyceride level should be checked at least once a year. A dietitian can help adjust your child’s meal plan if needed.
  • Saturated fat is found in foods such as red meat, lard, butter, and high-fat dairy products such as cheese and whole milk. Trans fat is found in foods such as doughnuts, cakes, cookies, crackers, and some margarines. Choose low-fat dairy products, lean meats such as fish and skinless poultry, and healthier fats such as olive oil and canola oil. Read food labels and choose foods made with no trans fat and little to no saturated fat.
• Drink plenty of water and sugar-free liquids. Water is the healthiest beverage option. Other sugar-free choices include flavored water, sparkling water, or tea. Be sure to count the carbs in juice, milk, and natural lemonade or punch if your child has these drinks. Choose fewer sugar-sweetened or artificially sweetened drinks.
• Keep a healthy weight. Ask your child’s dietitian how many calories your child needs each day. If your child is overweight, talk to the dietitian about making a plan for gradual weight loss. Losing weight will also make it easier to control your child’s blood glucose.
• Eat more fiber. Fiber is the part of plants that cannot be digested. Adding fiber may help lower blood glucose levels. For example, your child’s blood glucose may not be as high after eating beans than it is after eating white bread because beans have more fiber. Raw fruits, vegetables, beans, nuts, oatmeal, popcorn, and whole-grain breads are good high-fiber foods.
• Avoid foods high in salt (sodium). Eating a lot of salt may raise your child’s blood pressure. High blood pressure increases the risk for stroke, and complications of diabetes such as heart, eye, and kidney problems. Talk to the dietitian about how much salt your child should have each day.
• Avoid too much protein if your child has kidney problems. Eating too much protein can be a problem if your child has kidney disease. Follow the healthcare provider's advice for how much protein your child should have. A dietitian can help you with a lower protein meal plan.

For more information, contact:

• American Diabetes Association
  800-342-2383
  https://www.diabetes.org