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Food and Meal Planning

When food is eaten, it is broken down into sugar particles, which are then absorbed into the blood stream. Insulin then transfers the sugar into cells to be used as energy. Treatment of type 1 diabetes involves matching injected insulin and food intake. Just after diagnosis, following a meal plan helps to ensure a consistent intake of food (same carb content and similar foods for a given meal across days – for example, breakfast every day has 30g of carbs; lunch every day has 40 g of carbs, and supper every day has 50 g of carbs). After the “just diagnosed” period, some individuals continue to follow a meal plean, while some do not; over the long term, how consistent your child’s intake of food needs to be depends in part on what insulin program your child is on. However, for the short term (just after diagnosis) it is important to be as consistent as possible – this takes out a few of the many variables that affect blood glucose, and allows your child’s doctor to figure out, as quickly as possible, the correct type, timing and dose of insulin for your child. In these first few weeks following diagnosis, trusting the expertise of your child’s diabetes health care team will help them sort things out.

*If your child is using a peaking intermediate-acting insulin (N/NPH), he will likely have carb goals for each meal, which strive to match the insulin action. If your child is using a “peakless” insulin (Lantus®/Levemir®) or insulin pump, he will not likely have a set meal plan. Rather, the amount of carbs for each meal will be flexible (depending on family eating habits, your child’s appetite for that meal, particular foods chosen). In this case, carbs will be counted and the matching insulin dose calculated for each meal or snack.

To ensure a consistent intake of food, meal planning is very important. For meal planning, we look at the foods that contain carbohydrate. Carbohydrate is the part of food that has the most effect on blood glucose levels. If your child is a patient at the Alberta Children’s Hospital, his dietician will review this with you (and your child, depending on their age).

Meal Planning and Type 1 Diabetes

(The following is particularly applicable for those recently diagnosed, or those using an intermediate-acting insulin such as N/NPH.)

With your help, the dietician will set up a meal plan with carbohydrate goals, based as much as possible on your child’s usual way of eating. The amount of food may change at first, depending upon increases or decreases in your child’s hunger.

  • The meal plan will provide 3 meals and usually 2-3 snacks per day
  • Times will be set for each meal and snack, based on your family’s eating times. These times may become more flexible later, as your child’s blood glucose stabilizes and if you adopt certain insulin programs.
  • At the Alberta Children’s Hospital Diabetes Clinic, the meal plan will be set up using the Canadian Diabetes Association’s Beyond the Basics food choice system

 

Beyond the Basics divides food into eight groups:

  • Grains and starches
  • Fruits
  • Milk and Alternatives
  • Other Carbohydrate-Containing Choices
  • Vegetables
  • Meat and Alternatives
  • Fats
  • Extras

The meal plan will tell how many grams of carbohydrates to have from each food group at each meal and snack.

  • Some foods can be taken freely as they do not affect the blood glucose. These include water, diet drinks/pop/Jell-O, and many vegetables.
  • Your dietician will also help you include as many foods as possible that are family favourites. Assuming your family’s eating habits are fairly healthy and consistent, you should not have say “goodbye” to your family’s traditions and eating habits just to accommodate this dragon that has come to live with you; you can learn how to fit your regular family life into this new context.
Ideas on “free” or low carb foods and snacks:
Low Carb Snack Ideas

When a meal plan is part of your diabetes management strategy, remember:

  • Eat meals and snacks at set times
  • Measure and weigh foods for correct portion size/carb content

Tips from the Trenches

For me, when we left the hospital with my son after diagnosis, the meal plan that our dietician sat down and developed with us was a sanity-saver! There was so much to learn in the beginning, and my anxiety was so high,that all we did was take that 3-day meal plan and repeat it again and again (for 2 or 3 weeks) until I had the mental energy to construct a “new” meal. There were times in the months to follow when I just pulled out one of these ready-made meal plans so that I didn’t have to think so much. Even within a basal-bolus insulin program, meal-planning was a very useful tool for us, both in the beginning and later on.
~Michelle

The following information was adapted with permission from The Alberta Children’s Hospital Diabetes Clinic information handouts.

The above information was reviewed for content accuracy by clinical staff of the Alberta Children’s Hospital Diabetes Clinic.

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