Friday, May 20, 2022

Food for a diabetic child

Food balance or diet?
A child with diabetes should have a normal diet, identical to that of children without diabetes: no food is prohibited. It is important for everyone that the diet is balanced to grow properly and maintain a good state of health.

This balanced diet is recommended for everyone, so there is no need to make separate menus.

Food is made up of “main nutrients”: carbohydrates, proteins, and lipids. (1)

Sugars, called carbohydrates, are the body’s main source of energy. They are simple or complex, that is, composed of long molecules of glucose. They represent half of our daily caloric intake. It is insulin that allows glucose to enter cells, especially those of the liver and muscles, and to transform glucose into energy. When a child with diabetes consumes carbohydrates, he must provide insulin to be able to use them as energy. It is therefore important to identify foods containing carbohydrates and quantify them to adapt insulin treatment.

The dietician will teach you and your child, depending on their age, to identify carbohydrate-containing foods and quantify them. (1)

Insulin does not make you fat and children with diabetes are no more at risk of gaining weight than other children.

Weight loss is almost always observed at the onset of the disease. This will be quickly resumed with an increase in appetite observed in the first weeks. Indeed, the body replenishes its reserves of muscle and fat that have been used due to the lack of insulin. After this phase, appetite and weight stabilize.

It is advisable to provide a food from each food group at the main meals: (2)

Dairy product ;
Meat, fish or egg;
Starch or cereal product;
Vegetable;
fruit;
fat;
Water.

At the onset of diabetes, the health care team most often offers your child, depending on his age, weight and height, a diet with a fixed carbohydrate intake at each meal: that is say that the amount of carbohydrates remains the same for the same meal from day to day.

This method simplifies the choice of the insulin dose for the meal; the food being fixed, only the value of the glycemia (or the forecast of sporting activity) modulates the dose of insulin predefined by your protocol.

Over time, it is important to add flexibility, offering to vary the amounts of carbohydrates and the doses of insulin according to the circumstances (for example at parties).

For example, if your child is small, it is sometimes difficult to force him to finish his plate when he is no longer hungry or, on the contrary, to restrict him if he is still hungry. For a teenager, the rhythm of life can change between weekdays, weekends, and school holidays and the amount of carbohydrates can also vary between meals eaten at home or outside. It is then possible to modify the carbohydrate intake of a meal by adding or reducing the dose of rapid-acting insulin compared to the usual meal: this adjustment is to be discussed and calculated with your healthcare team.

Subsequently, the healthcare team may suggest that you calculate the precise meal insulin dose based on the “insulin ratio” in the context of functional insulin therapy (FI).

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