11. Food and diabetes

Introduction and basic food groups

Children and young people with diabetes need to eat the same healthy foods as any other child or young person. Having diabetes doesn't mean you have to be on a 'diet' for the rest of your life, or that you can't enjoy some of your favourite foods from time to time as part of your normal meal plan.

You can read a transcript of this video here.

It is important that we have an understanding of what foods will and what foods will not affect blood glucose levels.

Carbohydrates

Carbohydrate or starchy foods are really important. These are foods that are broken down into glucose when digested and used to provide energy for our body. They are the foods which we need to pay special attention to when you have diabetes, as they will have the biggest effect on your blood glucose levels.

Carbohydrate foods include:

• all breads, crackers and cereals such as weetbix, cornflakes and rice bubbles

• all pastas, rice and noodles

• starchy vegetables like potato, kumara, corn and taro

• foods such as beans, legumes, lentils and baked beans

• foods that contain natural sugar like fruits and milk, and

• foods that have added sugar like biscuits and cakes, jams, ice cream, chocolate and muffins.

Some simple carbohydrates cause the blood glucose levels to rise very quickly. These are foods such as juice drinks, sugar, honey, lollies etc. We often refer to these as quick acting carbohydrates. Other more complex carbohydrates take a longer time to raise the level of glucose in the blood. These are foods that contain carbohydrate but also contain starch and fibre and fat. These are foods such as bread, pasta, rice, fruit, milk, yoghurt etc. We often refer to these as long acting carbohydrates.

Read the attached information sheet on Carbohydrates to give you more detailed information about Carbohydrate foods.

Proteins

Protein foods do not get broken down into glucose so will not have a significant effect on your blood glucose levels.  Protein foods include:

• meat,  fish,  poultry,  eggs and vegetarian equivalents

• dairy products and cheese or dairy alternatives

• legumes, lentils and nuts

Fats

Fat based foods such as avocado, nuts and seeds and oils are also foods that do not get broken down into glucose and therefore do not have a significant effect on your blood glucose levels.

Non-Starchy Vegetables

There is another group of foods that do not get broken down into glucose and these are the non-starchy vegetables, such as salad veges, carrots, broccoli, leeks, peas and other colourful vegetables. 

Foods that do not contain carbohydrate and that do not affect blood glucose levels are often called 'free foods'. Some of these free foods can still be high in energy and need to be included as part of a balanced and healthy diet.

Balancing your food intake

When you are first diagnosed, you might be very hungry. This is normal and is because the lack of insulin in your body has meant that the food you have been eating before starting insulin treatment has not been able to be used to provide your body with energy.

An important part of managing your diabetes is to balance the insulin doses with the right amount of food for your age and activity level.  In order to work out how much carbohydrate you are eating at each meal, and therefore how much insulin you will need, it is important that you eat three regular meals a day, at approximately the same time each day.

Snacks should be limited to no more than three a day and should be eaten at morning tea, afternoon tea and supper before bed. Your snack should contain between 15 and 30g of carbohydrate, and some suitable types of snacks are things like:

• a piece of fruit

• a yoghurt

• 3-4 crackers and cheese

• a muesli bar

• 2-3 plain biscuits

• a small bag of popcorn or chippies.

Your dietitian will help you to understand what a typical day's meals, including snacks, might look like when they discuss your meal plan with you.

Foods and drinks that need to be limited

While all foods can be part of your meal plan, there are some foods that should be saved for special occasions. These types of foods (treat foods) have extra added sugars like cakes, ice creams, chocolates and lollies. They will have a bigger impact on your blood glucose levels due to the extra sugar in them. Things like plain biscuits and some muesli bars may be able to be incorporated into your meal plan more frequently.

Remember it is not just the sugar content of foods that we need to be careful with, but the overall carbohydrate quantity of the food. Being able to read a nutrition information label will help you in being able to decide whether a food is an 'every day choice', or an 'occasional treat food'. Your dietitian will help explain to you the best way of reading a food label and what values of carbohydrate and sugars are okay for different foods.

For all children and young people the best type of fluid to drink is water and plain milk. If you have diabetes, milk has some natural sugar in it and we would need to include it as part of your overall carbohydrate intake.

It is really important that all other drinks with sugar are avoided. This includes all juices, fruit drinks, cordials, Raro type drinks, fizzy drinks, sports drinks, energy drinks, iced teas, flavoured waters and flavoured milk type drinks.  The only time a sugary drink should be used is in the treatment of a 'low', or hypo (see the hypoglycaemia module for more information).

Drinks such as a diet or 'zero' drink that are sugar-free can be consumed occasionally in place of a standard soft drink, but these drinks can be very acidic and cause your teeth to decay. Water is the best choice of drink to keep your body working well and it has no effect on your blood glucose levels.

Let's go over the main points. Read our one page summary about nutrition and diabetes. Ready?

Think you've got it sorted now?

If you and your parent/carer have read through the information above and watched the video, and you feel confident that you understand this topic, print off and fill in the evaluation form below (you might need to ask someone to print this off for you) and return to the nurse on your ward. If you have any questions, note them down on this form and your diabetes nurse specialist will discuss them with you.

Food and Diabetes: Evaluation

After reading this module and watching the video I:

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