Nutrition for pediatric type 1 diabetes
To correct for the lack of insulin in type 1 diabetes, families learn how to match insulin doses to the amount of food (carbohydrates) eaten at meals.
Foods contain a mixture of protein, carbohydrate, and fat. One hundred percent of carbohydrates (carbs) are broken down to glucose.
For good nutrition, meals and snacks should include a variety of foods. Include colorful fruits and vegetables each day. Choose whole grains to add fiber to the diet.
Protein and fat
A minimum amount of protein and fat end up as sugar in the blood, so additional insulin is usually not needed to cover these foods. Protein and a moderate amount of fat are important for good nutrition and a balanced diet. They can help maintain a steady level of blood glucose and play a role preventing hypoglycemia (low blood glucose).
- Include protein foods with two or more meals or snacks every day.
- Include low-fat dairy to meet calcium needs.
- Most dairy foods count as carbohydrates; cheese is a low-carb protein substitute. Look for reduced-fat choices to help control saturated fat.
Carb counting
- Carbohydrate is a broad category including sugars, fiber, and starches (bread, cereal and starchy vegetables like potatoes).
- Carbs are found in many food groups, such as grains, fruit, milk, and sweets.
Reading food labels
Reading food labels will help you control your diabetes, and is essential to learning carb counting. Prepared foods are required to have food labels, and reference books will help you find carb contents for ones that do not, like produce, meats, and restaurant foods.
It is important to compare your serving size to the serving listed on the nutrition facts label for accurate carb counting. If the food contains less than 5 grams of fiber, subtract half of the fiber grams from the total carbohydrate, as only part of the fiber is absorbed. Sugar alcohols are only about half-absorbed, so also subtract half of the grams of sugar alcohol from the total carbs.
Measuring foods is recommended to most accurately determine the carb count of high starch or sugar foods, especially just after diagnosis. Over time you will be able to carb-count with confidence and adjust your insulin based on your serving size.
Age-based carbohydrate counting guide
Use this table of suggested carb levels to help meet your needs for growth and good nutrition.
| Age | Breakfast | Lunch | Dinner | Snacks | Approximate Daily Total | |
|---|---|---|---|---|---|---|
| 0-3 | 45 g | 45-60 g | 45-60 g | 15 g x 3 | 210 g | |
| 4-8 | 60 g | 60 g | 75 g | 15 g x 3 | 240 g | |
| 7-12 | 60 g | 75 g | 90 g | 15 g x 3 | 270 g | |
| 13-19 | Girls | 60 g | 75 g | 90 g | 15 g x 2 (no AM snack) |
255 g |
| Boys | 90 g | 90 g | 90 g | 15 g x 2 (no AM snack) |
300 g |
Carb-free foods
These foods contain few carbohydrates or calories and have minimal effect on blood sugar. They include low-calorie vegetables (for example, celery, cucumbers, peppers, etc.) and sugar-free foods (for example, sugar-free popsicles, Jell-O, and drinks).
Low-carb snacks
Low-carb snacks can help control your appetite between meals and insulin doses. Snacks that include high-fiber vegetables and protein, or hot liquids like soup and tea can boost fullness to help control hunger between meals (and insulin doses). We recommend the following low-carb snacks:
- Small serving of nuts with a sugar-free drink
- Reduced-fat string cheese or a hard boiled egg
- Lettuce leaves rolled with meat or cheese
- Marinated cucumber slices
- Vegetable, miso, chicken, or beef broth. Add cooked carrot, celery, or other vegetables
- Scrambled egg with chopped, cooked vegetables
- Small tossed salad with flavored tofu cubes
- Peeled cucumber logs filled with hummus or flavored cream cheese
Concentrated sweets
Concentrated sweets have a large amount of carbs in a small amount of food. They will raise your blood sugar quickly if they are not given with insulin. Use moderation with sweets, and give at a meal with insulin. Examples are cake frosting, candy, cookies, regular soda, and other sweets. Substitute artificially-sweetened foods to help limit carb intake.
Nutrition for pediatric type 2 diabetes
Pediatric type 2 diabetes is associated with obesity and insulin resistance. A cornerstone of treatment is to work on lifestyle changes with diet and exercise to promote weight loss. For the best success rates, the whole family needs to make changes rather than singling out only the child or teen with diabetes. We recommend individual and group nutrition counseling with motivational interviewing and behavioral therapy.