Feeding a Child With Diabetes

If your child is diagnosed with diabetes, one of your first concerns may be about his diet. Along with insulin injections, medications, and exercise, following a proper diet and establishing regular mealtimes can be the key to successfully managing diabetes. Although it may take some adjustments to implement, the healthy eating plan you adopt for your child with diabetes can be good for your entire family to follow.

What Is Diabetes?

Diabetes is an umbrella term for a group of diseases involving problems with how the body produces and uses the hormone insulin. Insulin is produced by the pancreas and acts to control blood sugar (glucose) levels by helping glucose move into the cells of the body where it is used to produce energy. Glucose is a simple sugar that's released from the foods we eat when they are digested in the stomach and intestines. If your child has diabetes, his blood glucose levels may be abnormally high at times because his body lacks enough insulin to properly move sugar from his blood into his cells.

Type 1 diabetes (insulin-dependent diabetes mellitus, or IDDM) is the most common form of diabetes seen in children, but it can occur at any age. Type 1 diabetes used to be called juvenile diabetes. It occurs when the pancreas loses the ability to produce enough insulin. People with type 1 diabetes must take daily injections of insulin to control their blood sugar levels.

Type 2 diabetes (non-insulin-dependent diabetes, or NIDDM) is less common than type 1 among children. This form of diabetes is seen more often in obese individuals. The increasing frequency of this type of diabetes among children and teens in recent years may be related, in part, to the rising prevalence of obesity in childhood. Type 2 diabetes used to be called adult-onset diabetes because it's more common in people over age 40. In this condition, the pancreas can still produce insulin but frequently the person's body is "resistant" to the effects of the hormone. Type 2 diabetes often can be controlled with diet, increased physical activity, and oral medications. In some cases, however, people with type 2 diabetes may require insulin injections as well.

For children with either type of diabetes, the goals are to maintain normal growth, development, and lifestyle while keeping blood glucose adequately controlled, usually aiming for a target range of about 80 to 180 milligrams per deciliter (80 to 180mg/dl). Three key variables affect a child's blood glucose levels: diet, physical activity, and insulin. For teens with diabetes, normal hormonal changes associated with puberty can cause further blood glucose swings.

Diabetes of either type is associated with a number of long-term medical complications including vision loss, kidney failure, and the earlier development of atherosclerosis (hardening of the arteries) leading to heart attack and stroke. Research studies have shown that the development of these complications may be delayed or prevented in individuals with diabetes who maintain better control of blood sugar levels over time. Following heart- healthy nutrition guidelines - particularly avoiding excessive saturated fat intake - is also recommended for people with diabetes due to the increased risk of heart disease associated with the condition.

How Foods Affect Blood Glucose Levels

Diet is a key factor in controlling blood glucose levels. Many foods, especially favorite kid foods like pasta and candy, contain carbohydrates that the body turns into glucose. Normally, insulin helps glucose leave the bloodstream and enter the body's cells where the glucose is used to fuel the cells' activities. However, if someone with diabetes doesn't have enough insulin, glucose can't enter the cells and it accumulates to high levels in the bloodstream.

All carbohydrates (including simple sugars, starches, and complex carbohydrates) raise blood glucose levels after they are eaten, but some are better choices for children with diabetes (and also those without diabetes) than others because they are more nutritious. Simple sugars found in sweets, for example, are concentrated in foods that generally have smaller amounts of vitamins, minerals, protein, and other nutrients that are important for growing children.

What does this mean for children with diabetes?
Your child's carbohydrate sources should include mainly whole grains, legumes, vegetables, fruits, and dairy products - all foods that supply nutrients he needs to grow and stay healthy. Try to limit - but don't ban - "empty calorie" snacks and foods like cookies, ice cream, and cake. Anticipate and plan for occasional sugary sweets while focusing on making sure your child's overall nutrition is well balanced.

Diabetes and Weight

Children with type 2 diabetes tend to be overweight or obese; their excess body fat plays a role in the body's resistance to the effects of insulin. Successful weight management in these children and teens can remarkably improve their blood sugar control and in some cases can bring blood sugars back to normal.