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Feeding a Child with Diabetes. Special diet or not?

Nutrition is one of the great fears and controversial issues in children and families with diabetes. Unfortunately in our Latino culture, there are many myths and misconceptions about what a person with diabetes should eat.

No wonder nutrition is such a controversial topic. Diabetes is the only condition where we have to make extremely important decisions at every meal of every day. This represents at least 3-5 decisions a day to count carbohydrates, measure glucose, calculate insulin dose and much more. But like everything in this life, we keep learning and moving forward.

How should the diet be for a child with diabetes? Do children with diabetes need a special diet?

The nutrition of a child with diabetes is exactly the same as that of a child who does NOT have diabetes. That is, children with diabetes need the same nutrients as a child who does not have diabetes. The fact that they have diabetes does not require different nutrients than a child who does not have a chronic condition: the growth and feeding needs are the same. Your child is still a child and we have to ensure a healthy diet to guarantee her development.

The only difference in children with diabetes is that their bodies do not produce the insulin needed to keep their glucose levels stable. Therefore, they need exogenous insulin to keep their glucose levels under control. The goal is to balance the amount of insulin with the amount of carbohydrates.

What are Carbohydrates and should I limit the amount my child consumes?

Carbohydrates are our gasoline! Did you know that our brain runs almost exclusively on glucose? Carbohydrates turn into glucose in the blood. That is why they are one of the most important foods for people with diabetes since they raise blood glucose. If we deprive our little ones of the necessary carbohydrates, they will not have the necessary energy. Some studies have even found that children who consume low-carbohydrate diets have lower cognitive function. If carbohydrates are limited, it could be that we are also harming the learning, memory and reasoning of our little ones.

Children need carbohydrates for their development and growth. They should not be limited but we must pay attention to the TYPE OF CARBOHYDRATE, since not all are the same. Carbohydrates are in:

  1. Cereals and starches
  2. Fruits
  3. Milk and yogurt
  4. Sweets and sugar

Let's opt for whole grain carbohydrates such as breads and legumes that contain a lot of fiber. Fiber helps carbohydrates to be absorbed more slowly and prevents spikes in blood glucose.

Children need a balanced and varied diet. Each meal should include:

  1. Carbohydrates- such as whole grains, grains, vegetables and natural fruits.
  2. Protein such as chicken, eggs, fish and lean meats.
  3. Healthy fats like nuts, olive oils, avocado
  4. Non-starchy vegetables like lettuce, cucumber, tomato, bell pepper, carrots, broccoli- Try to include at least one non-starchy vegetable in every meal.

The amount of carbohydrate that your child should consume per day should be individualized since it depends on their age, weight, physical activity and caloric needs. The chart below represents a good estimate of the typical amount children and teens need.

Recommendations for average carbohydrate intake in children at each meal *
Gender/Age <5 Years 5-13 years Teenagers
Girls 30-45g 45-60g 45-75g
Boys 30-45g 45-60g 45-75g+
*Source: Evert 2007

The amount of carbohydrate should be individualized based on each child's caloric needs, age, weight, and physical activity

Can my child with diabetes eat candy or cake?

Yes! First of all, your son is a boy. Which means that he will participate in birthdays and parties and will be exposed to sweets or cakes. The most important thing is to estimate the amount of carbohydrate and calculate the appropriate dose of insulin to cover the cake. The key is in the planning. If you know there is cake, you can count it in the insulin dose of the meal. Remember to monitor your glucose before and after your meal to make sure your insulin dose was correct. It is important that you do not abuse this type of food since they do not provide much nutritionally. However, it is necessary that your son feels "normal" and that he can participate in these celebrations with his friends.

Your child does not need a special diet. He needs a healthy and nutritious diet just like all children with or without a chronic condition. Choose to offer a variety of foods at each meal and do not get overwhelmed at parties or birthdays.

Above all, remember that diabetes is not a limitation for your little ones and they can live a full and totally healthy life!

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