Initial dietary advice for children and young people with diabetes

Initial dietary advice for children and young people with diabetes

The Paediatric Diabetes Dietitian contact number: Dorota Amador Bueno: Tel: 0783417222

What should children and young persons with diabetes eat?

This leaflet provides basic information on diet for diabetes to answer some of your initial
questions when you are newly diagnosed with diabetes. You will see your dietitian as
soon as possible and you will be provided a detailed advice on diet for diabetes adapted
to your individual circumstances, such as likes and dislikes, sports and hobbies.

There is no ‘special’ diabetes diet required. You will be encouraged to follow a healthy
eating plan, which is same as other children and young people of your age and suitable
for your whole family. Continue to eat your familiar meals and try to follow the principles
of the Healthy Eating Plan below. Special ‘diabetic’ foods are not needed and can be
expensive.

In the next few days your dietitian will show you how to count carbohydrates in your
meals and snacks and how to adjust your mealtime insulin doses according to what you
eating.

Healthy eating plan:

• It is important to have regular meals and to eat the right
  proportions of different foods, as shown on the picture.

• About 1/3 of each meal should come from starchy
  carbohydrates to give you sufficient energy, e.g. bread,
  potatoes, rice, pasta or plain breakfast cereal. You will
  soon learn how to count the carbohydrates is in these
  foods.

• About 1/3 of each meal should be from vegetables and fruit, aiming to have at
  least 5 portions per day to provide your body with vitamins and minerals. You will
  also learn how to count carbohydrates in fruit and only some vegetables.

• Include milk or dairy foods daily to provide calcium. You will also count the
  carbohydrates in milk and other dairy foods (but not cheese).

• Add protein rich foods to your meals, as these are needed for growth and repair
  e.g. meat, fish, chicken, cheese, eggs and beans. These foods do not usually
  contain carbohydrates, unless they are breaded, battered or in pastry.

• You may have small amounts of sugary foods with your meals and your dietitian will
  explain how to include different sweet foods in your diet and maintain good blood
  sugar levels. For now it is best to choose only small amounts of low sugar puddings,
  such as a small pot of yoghurt, low sugar custard, a scoop of plain ice cream or
  portion of fruit. You could also try some sugar free foods, like sugar free jelly / sugar
  free ice lollies.

• Drink water or squash labelled ‘no added sugar’ or sugar free / diet fizzy drinks.
  If you like to drink of fruit juice, only have a small glass with a meal. If you like milk,
  you can have more of it at meals and only have a small glass between meals or a
  bedtime.

• If you used to add sugar to your drinks and cereals, try an artificial sweetener
  instead.

• For long term health it is important to limit foods high in sugar, fat and salt.

• It is important to reduce snacking to only small amounts of foods that contain
  carbohydrates or low carbohydrate snacks. You will be given a leaflet on suitable
  snacks.

What if you feel exceptionally hungry?

You may find that just after diagnosis of diabetes your appetite changes. Increased
hunger is common and it is fine to initially eat more than you normally do. Your appetite
will go back to normal in a few days or weeks. You need to eat enough to satisfy you
and to help get your blood glucose within a good range, try to fill up at meals, as this is
the time you will take insulin. If you hungry between meals, then only have small
amounts of carbohydrate rich foods and maybe add some low carbohydrate snacks. For
further information see the leaflet about ‘Snacks’, which will be given to you by your
dietitian or diabetes nurse.

Where does blood glucose come from?

Blood glucose rises after eating carbohydrate rich foods, such as bread, pasta, rice,
potatoes, cereals, biscuits, cakes, chocolates, sweets, sugary cold drinks, fruits and milk
products. The body breaks down carbohydrates found in food into a sugar called
glucose.

After a meal glucose is absorbed from the gut into the bloodstream and the blood
glucose level rises. In people who do not have diabetes the pancreas releases a
hormone called insulin, which helps to open up the body cells and move glucose from
the blood into the cells in muscles and other parts of the body, to be used as a source
of energy.

What happens when you have diabetes?

People develop diabetes when the pancreas stops producing insulin. Without insulin,
the blood glucose levels become high, as there is no insulin to move the glucose from
the blood into the body cells to provide energy.

Children and young people with diabetes have to learn to manage their blood glucose
level by injecting insulin when having foods that contain carbohydrates.

What types of carbohydrates are there?

• Starchy carbohydrates: found in grains, rice, breads, cereals and starchy
  vegetables
• Natural sugars: found in fruit, milk and other dairy foods
• Simple sugars: found in sugar, and foods sweetened with different sugars, such
  as sugary fizzy drinks, cakes, biscuits, sweets, chocolates and puddings

Starchy carbohydrates and foods with natural sugars are a better choice for
maintaining a stable blood glucose level throughout the day.

Foods with simple sugars raise your blood glucose quickly. You can have small
amounts of foods that contain simple sugars as part of your healthy eating plan and your
dietitian will explain how to include these to maintain a healthy blood glucose level

Is there anything that you cannot eat when you have diabetes?

No, all foods are allowed, but it is important that you know the effect of different foods
on your blood glucose levels and learn to adjust insulin doses according to what you are
eating.
Your diabetes team will teach you carbohydrate counting and support you to be able to
adjust your insulin doses according to the foods you are eating and your blood glucose
levels.

Summary

• The diet for diabetes is a healthy eating plan
• Have regular meals that contain starchy carbohydrate at each meal
• Try to eat a good amount of fruit and vegetables
• Only small amounts of sugary and fatty foods
• Drinks need to be sugar free
• Snacks with only small amount of carbohydrates or low carbohydrate snacks

What next?

As soon as possible your dietitian will meet with you and your parents or guardians to
show you how to work out the amount of carbohydrate in your meals and snacks and
how to adjust your insulin doses to keep your blood glucose level within a normal range.
This is called Carbohydrate Counting.

In the next couple of days you will be learning to estimate the amount of carbohydrates
in your meals. Your dietitian will show you different methods how to do this and you will
be given further patient information leaflets on Estimating Carbohydrate Portions and
Insulin Dose adjustment.

In the meantime it would be useful if you could get the Carbs and Cals app or book,
which is a pictorial food atlas showing carbohydrate content of different foods.

You can find more about it on:https://www.carbsandcals.com/

You will be given a Food Diary to keep for the next few days. Please could you write
down all your meals and snacks, your blood glucose levels, insulin doses and the
amounts carbohydrate if you know them. Your dietitian will use this diary to help you
further with learning to estimate the carbohydrates in your meals and will work out your
insulin to carbohydrate ratios, which you will need to be able to adjust your insulin doses
according to your carbohydrate intake and blood glucose levels.

If your symptoms or condition worsens, or if you are concerned about anything,
please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you
and your loved ones. If you have any questions or concerns, please do speak with a
member of staff on the ward or in the relevant department who will do their best to
answer your questions and reassure you.

Feedback
Feedback is really important and useful to us – it can tell us where we are working well
and where improvements can be made. There are lots of ways you can share your
experience with us including completing our Friends and Family Test – cards are
available and can be posted on all wards, departments and clinics at our hospitals. We
value your comments and feedback and thank you for taking the time to share this with
us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the
nurse in charge or the department manager in the first instance as they are best placed
to answer any questions or resolve concerns quickly. If the relevant member of staff is
unable to help resolve your concern, you can contact the PALS Team. We offer informal
help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf,
if you feel unable to do so, to resolve your problems and where appropriate refer to
outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate
your concerns. You can make a complaint orally, electronically or in writing and we can
advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: [email protected]

Opening times:
The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please
be aware that you may need to leave a voicemail message, but we aim to return your
call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.

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