Diabetes

Finding out your child has a condition like diabetes can be overwhelming. And, although it’s a disease that will always be part of your child’s life, getting help sooner rather than later is key to successfully managing the disease so your child can live a childhood unrestricted by the condition.

When children are diagnosed with Type 1 or Type 2 diabetes, it means there’s too much glucose — the body’s main source of energy for cells — in their bloodstream. Although glucose is found naturally in child’s body, it also comes from the food they eat. Too much or too little glucose in the blood can cause serious health problems.

Both types of diabetes can occur at any age, but kids with Type 1 diabetes make no insulin, and kids with Type 2 make insulin, but it doesn't work as well as it should.

Insulin is a hormone found in the pancreas that allows sugar to get into cells of the body so that sugar can be used as energy.

 
Symptoms of Children With Diabetes
Some of the most common signs and symptoms of children with diabetes include:
  • extreme thirst
  • frequent urination
  • drowiness, lethargy
  • sugar in urine
  • sudden vision changes
  • increased appetite
  • sudden weight loss
  • fruity or sweet-like odor on breath
  • heavy or labored breathing
 
Diagnosing Children With Diabetes

Children diagnosed with Type 1 diabetes are typically diagnosed after presenting with symptoms such as unexplained weight loss, excessive urination, or excessive thirst. Children are diagnosed with Type 2 diabetes typically through a urine sample during a routine examination and symptoms are less dramatic.

Some lab tests that may be used to diagnose diabetes include:
  • fasting plasma test (FPG): a blood test that measures blood glucose in someone who has fasted for at least 8 hours
  • oral glucose tolerance test (OGTT): this test is given to someone who has fasted for 8 hours and then is asked to drink a glucose-containing beverage
  • random plasma glucose test: this blood glucose test is done without regard to fasting
 
Nutrition Tips for Children With Diabetes

At Nemours, our registered dietitians are part of your child’s diabetes care team. Nutrition is an important part of proper diabetes management. It’s not only about counting carbohydrates; it’s about healthy eating habits that are enjoyable.

Developing a Healthy Meal Plan

Healthy food choices should be encouraged for all family members. A registered dietitian at Nemours can help plan a healthy meal plan for your child with diabetes. Just as your child grows and develops, so must your child’s meal plan.

A healthy meal plan includes certain types of carbohydrates (carbs), lean protein, and fat and can be used for children with diabetes and without.

Carbohydrates are found in foods such as bread/starch, fruit, milk, and sweets. Eating carbs makes blood sugar levels rise, but that doesn’t mean that people with diabetes should avoid them — the body needs carbs. Since they affect blood sugar levels, it’s recommended children with diabetes track how many carbs they eat.

Follow these tips for healthy nutrition:

Choose healthy carbs that provide fiber, vitamins, and other nutrients,
such as:

  • whole wheat/grains instead of white bread, white pasta, or white rice
  • fresh fruit instead of fruit juices
  • fat-free or 1% milk instead of whole or 2% milk
  • light ice cream instead of full fat ice cream
  • limit desserts like cake, cookies, and candy, to special occasions

Choose protein from lean meats (cuts of beef and pork that end in “loin” or skinless chicken/turkey), egg whites, reduced-fat cheese, nuts, tofu, and beans.

Avoid foods high in saturated fats and trans fats, as these can raise heart-damaging cholesterol in the body. Choose heart-healthy fats, such as olive oil, canola oil, peanuts, and avocado. Remember that all fats are high in calories, so watch your portion sizes if you are trying to lose or maintain weight.

Drink mainly water instead of regular soda, fruit punch, sweet tea, and other sugary drinks. It’s OK to have calorie-free “diet” drinks occasionally.

Watch your portion sizes! Eating too much of even healthy foods can lead to excessive weight gain.

Eating Out When Your Child Has Diabetes

Eating out can be a treat for lots of families. Kids with type 1 or type 2 diabetes don't have to give up that treat — they just have to take some extra precautions and be sure to choose nutritious foods in reasonable portions. Whether they crave Mexican, Asian, or country-style cuisine, their tastes can be accommodated.

Which Restaurants to Visit

Kids with diabetes can eat just about anywhere. Most restaurants offer at least some nutritious foods — even fast-food places have a few healthy options. Many national chains even have standardized food content and portion sizes. Whenever possible, look for the nutrition facts on the menu or ask for them from your server so that you know what's in the food.

Restaurants that serve a greater variety of healthier foods, like salads and vegetarian entrees, generally have more foods that fit the meal plan for people with diabetes. Certain types of restaurants — like buffets — may offer a lot of choices, but they tend to make it difficult to gauge the content of foods. It may also be more difficult to eat reasonable portion sizes at these restaurants.

When choosing a restaurant, consider what your child wants to eat and which places offer the most suitable options. You don't have to find a place that serves "health food" — just the mix of proteins, fats, and carbohydrates that work with your child's meal plan.

Try keeping track of the places that make meal choices easy or that your child enjoys most. For example, you might find more healthy breakfast options at the diner than at the drive-thru.

If certain restaurants don't offer many vegetable choices or only serve fried food covered in cheese, go to others. And don't hesitate to speak up — ask the owner or manager to start offering some healthier foods like salads and lean protein. Chances are, you're not the only one who wants them. A chef may also be willing to make a special meal to accommodate your child's needs. Many restaurants are used to doing this for people with other dietary restrictions, like vegetarians or people with food allergies.

When you're looking for healthy dining ideas, check out menus online.

What to Order

When it's time to order, kids should follow the same rules for food content and portion sizes that they follow at home. Your child's meal plan probably calls for a good balance of proteins, fats, and carbohydrates. Usually, kids can get all the types of food they need at a restaurant. These tips can help:

  • Get answers. Some menus don't clearly state what's in a dish or how it's prepared. If your server doesn't know the answer, ask him or her to find out.
  • Make changes. To help get all the types of food your child needs, ask the restaurant to substitute certain ingredients or side orders (for example, substitute salad for fries).
  • Ponder the prep method. Encourage your child to choose foods that are baked, grilled, broiled, steamed, or poached (instead of fried or breaded). Don't hesitate to ask for a different preparation.
  • Watch the sides. Avoid foods with sauces or gravy, and ask for low-fat salad dressings on the side.
  • Control the portion. If the portion is large, encourage your child to eat only part of the order and take the rest home. This is a good time to set an example by eating a smaller portion yourself. If you know in advance that the portions are large, you might split an entrée with your child.
  • Share the menu. As you help your child choose from the menu, make sure to explain the process. Say what you're looking for and why. Your child will use these skills when dining out with others. Keep a watchful eye while older kids choose foods and portions on their own.

Remind your child that the same tips apply to eating in the school cafeteria or a friend's house. If your child becomes upset or sad because he or she can't eat something truly unhealthy on the menu, explain that all healthy people have to watch what they eat — including you — so kids with diabetes certainly aren't alone.

What to Bring

When you go out to eat, you should bring your child's testing supplies, snacks, and medications. You might also bring a quick-reference guide to food content and portions in your wallet or purse. If your child uses things like artificial sweeteners or fat-free spreads, bring them along, too.

Eating later than usual poses no problem to a child who takes a rapid-acting insulin with meals. In most cases, you can just make a few simple adjustments to your child's medicine schedule. Kids on NPH insulin who delay mealtime may have to eat a small snack at the normal mealtime, and then take insulin while out.

Kids with diabetes can learn how to eat healthy — and they can do it anywhere. By helping your child through the process and setting an example of healthy eating in moderation, you'll teach skills that will last.

Reviewed by: Steven Dowshen, MD
Date reviewed: June 2011