The goal of type 1 diabetes treatment is to control glucose levels and prevent your child’s blood sugar from being too high. The ideal diabetes management regimen includes insulin therapy, glucose and ketones monitoring, regular exercise, and healthy eating.
Insulin therapy replaces insulin the body cannot make on its own. Usually, this is done with both long-acting (basal) and short-acting (bolus) insulin injections. Many people with type 1 diabetes use insulin pumps instead of injections. Your diabetes team can teach you more about insulin pumps.
Glucose monitoring: It is very important to monitor glucose levels throughout the day. You can do this with finger-stick blood glucose checks and/or with a continuous glucose monitor (CGM). CGM devices measure blood sugar with a subcutaneous glucose sensor and report a value every five minutes. Some devices can report values directly to a parent or patient’s mobile phone. The FDA has approved some CGM devices for use as a replacement for finger-stick tests.
Ketone monitoring: When the body doesn’t have enough insulin, the liver compensates by producing extra ketones, a chemical that converts fat into energy. High levels of ketones in the blood can become a medical emergency. Therefore, in addition to monitoring glucose levels, it is very important to monitor ketones when your child’s glucose level is very high or when your child is sick.
The role of food in diabetes management
It is important to understand how food impacts blood glucose for children with diabetes.
Food causes blood glucose to go up. Insulin causes blood glucose to go down. Too much food with not enough insulin can cause blood glucose to go too high. Not enough food with too much insulin can cause blood glucose to go too low. Further, the type and amount of food will affect how much and how quickly the blood glucose goes up. Balancing food and insulin together can help keep blood glucose in a normal range.
Carbohydrates, also known as carbs, are an important source of energy. They are also the main nutrient the body turns into blood glucose, also known as blood sugar. Everyone needs to eat some carbohydrates to stay healthy. Common carbohydrate foods include: bread, crackers, cereal, pasta, rice, fruit, and milk.
- Carbohydrates that are high in fiber such as whole grains, fruits, and vegetables slow digestion and contribute to a feeling of fullness. High-fiber food can also reduce spikes in blood glucose after eating.
- Processed carbohydrates that are low in fiber can raise blood sugars too high. Eating fewer processed carbohydrates helps manage blood glucose levels.
A dietitian can help determine the right amount of carbohydrates and types for your child.
Proteins and fats help kids feel full and have less impact on blood glucose levels than carbohydrates. Because of this, children with diabetes are encouraged to include protein and healthy fats at meals and snacks. Examples of healthy proteins include poultry, fish, beef, pork, peanut butter, cheese, and eggs. Healthy fats include avocados, olive oil, eggs, nuts, and cheese.
While these foods can be a part of a healthy diet, appropriate portion sizes are important. Too much protein can cause blood glucose to rise. Too much fat can slow down how food digests, making it difficult to balance food and insulin. Too much fat can also contribute to the risk for heart disease.
A healthy diet can mean different things to different people. A dietitian is very important to help with meal planning and understanding the right balance of foods for your child.
