General Guidelines On Dietary Management For Children With Diabetes

General guidelines on diabetes and dietary management for children

The principles of the dietary management of type 1 and type 2 diabetes are similar.

Your dietitian can give you more details and advice that's right for your child or young person.

Some general guidelines

• have regular meal times every day
• do not skip meals
• try to stick to meal plan and times as much as possible
• include carbohydrate at each meal
• spread carbohydrate food evenly over the day
• a carbohydrate snack in between meals is important for children and young people who are on insulin injections, to avoid hypoglycaemia
• try to include low GI foods in meals and snacks
• choose a variety of food from the different food groups for growth and development
• limit intake of high sugar food such as sweets, cordial, powdered drinks, soft drinks and fruit juice

Remember 'treats' are not the same as 'snacks'

Foods that are high in fat, sugar and salt are for occasional treats only - don't give these as regular snacks. 'Treat' foods are potato chips, corn snacks, muesli bars, chocolate, sweets, cakes, sweet biscuits, pies and pastries.

Limit intake of high fat (especially saturated fat) food

• choose low or reduced fat dairy products and cheeses
• choose lean cuts of meat (removing visible fat from meat and skin from chicken and poultry)
• limit high fat snacks and takeaways, and processed meat

A low fat diet is not recommended for children under the age of 2 years.

What's important about carbohydrates for my child with type 1 diabetes? 

Learning how to work out the amount of carbohydrate from foods is important for the management of type 1 diabetes. Amongst the 3 main nutrients (carbohydrate, protein and fat) in food, carbohydrate has the most direct effect on blood glucose levels.

Understanding how to count carbohydrate will help your child to increase food choices and flexibility while maintaining blood glucose levels within the target range. There are 2 common ways to count carbohydrate:

• carbohydrate portions
• carbohydrate counting

Carbohydrate portions

A carbohydrate portion is a given serving of food which contains approximately the same amount of carbohydrate.

One portion of carbohydrate contains 15 grams of carbohydrate.

The dietitian will advise you on the appropriate amount of carbohydrate portion your child needs for each meal and snack. The choices of carbohydrate foods can be changed on different days as long as the total carbohydrate portions for each meal and snack is relatively consistent every day.

Carbohydrate counting

This is a method to count the total grams of carbohydrate in meals and snacks. A gram (g) is a unit used in measuring foods.

You will count the grams of carbohydrate in each of the foods your child eats, and then add them all up to work out the total carbohydrate (g) for the meal or snack. Your child's meal plan will specify the amount of carbohydrate needed for each meal or snack.

This method provides a more precise method of calculating carbohydrate in foods. Children or young people who are on insulin pumps need to count carbohydrates.  Those who are on more intensive insulin regimes such as multiple daily injections benefit from this method.

What's the treatment for my child with type 2 diabetes?

The treatment goal for type 2 diabetes is to normalise blood glucose as much as possible. Once your child or young person achieves optimal blood glucose control, you also need to target:

• lowering blood pressure
• reducing high blood lipids

First line therapy is weight reduction by making the following changes:

• healthy eating
• becoming more active and engaging in regular physical activities
• continuing to live a healthy lifestyle throughout adulthood

It is very important to involve the whole family/whānau in supporting your young person making healthy lifestyle changes.

See more KidsHealth content on diabetes

Check out KidsHealth's section on diabetes