There are 2 primary types of diabetes. The nutritional goals for each are different. With type 1 diabetes, studies show that total carbohydrate has the most effect on the amount of insulin needed and the maintenance of blood sugar control. There is a delicate balance of carbohydrate intake, insulin, and physical activity that is necessary for the best blood levels of a sugar called glucose. If these components are not in balance, there can be wide fluctuations -- from too-high to too-low -- in blood glucose levels. For those with type 1 diabetes on a fixed dose of insulin, the carbohydrate content of meals and snacks should be consistent from day to day. For children with type 1 diabetes, weight and growth patterns are a useful way to determine if the child's intake is adequate. Try not to withhold food or give food when a child is not hungry. Insulin dosing and scheduling should be based on a child's usual eating and exercise habits. With type 2 diabetes, the main focus is on weight control, because 80% - 90% of people with this disease are overweight. A meal plan, with reduced calories, even distribution of carbohydrates, and replacement of some carbohydrate with healthier monounsaturated fats helps improve blood glucose levels. Examples of foods high in monounsaturated fat include peanut or almond butter, almonds, walnuts, and other nuts. These can be substituted for carbohydrates, but portions should be small because these foods are high in calories. In many cases, moderate weight loss and increased physical activity can control type 2 diabetes. Some people will need to take oral medications or insulin in addition to lifestyle changes. Children with type 2 diabetes present special challenges. Meal plans should be recalculated often to account for the child's change in calorie requirements due to growth. Three smaller meals and 3 snacks are often required to meet calorie needs. Changes in eating habits and increased physical activity help reduce insulin resistance and improve blood sugar control. When at parties or during holidays, your child may still eat sugar-containing foods, but have fewer carbohydrates on that day. For example, if birthday cake, Halloween candy, or other sweets are eaten, the usual daily amount of potatoes, pasta, or rice should be eliminated. This substitution helps keep calories and carbohydrates in better balance. For children with either type of diabetes, special occasions (like birthdays or Halloween) require additional planning because of the extra sweets.
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