Entry for 22 November 2006

Advice for specific age groups

AS children grow and develop the initial meal plan will require adjustment. The management of diabetes varies greatly at different ages and stages of development.

Infants and toddlers (under five years)

Breastfeeding is encouraged for infants with diabetes. Breast milk or human milk substitute formula remains a major nutrient source until one year of age. Solids may be introduced at four to six months.

Fussy eating food fads and food refusal are common in toddlers and when these occur in a child who has diabetes this can cause great anxiety for parents. It is not unusual for a toddler to eat erratically and be unpredictable with activity and therefore rigid plans of three meals and three snacks are often impractical.

A grazing style diet is promoted with small frequent snacks containing a variety of carbohydrates throughout the day to prevent hypoglycaemia. The food environment is important and parents are encouraged to avoid focusing on food or force feeding as this may further contribute to ‘food strikes’. Toddlers are encouraged to participate in the family’s usual eating pattern with extra snacks whenever they are hungry. As healthy eating habits for life are being established by the whole family a variety of food colours tastes and textures should be promoted. To guard against parents becoming slaves in the kitchen toddlers should be given a simple choice between one food or another rather than asking ‘what would you like to eat?’.

School—age children

Children’s energy needs are constantly increasing with rapid growth and activity. Energy intake nearly doubles from six to 12 years of age. Regular review of meal plans is therefore essential. Eating patterns tend to be more regular at this age and most children adapt well to having three main meals and three snacks during the day. School—age children are encouraged to carry ‘hypo food’and be aware of the need for extra carbohydrate for exercise. School—age children need to be guided about choices from the school canteen. Also be careful about swapping of food at lunchtime which is common.


Adolescence is a natural period of establishing independence and of rebellion and diabetic management is one more thing to rebel about. Growth is rapid lifestyle is more irregular and there is often more snacking eating out and fast foods. The issue of alcohol use may also arise. The desire for independence can cause resentment of any kind of restrictions particularly if food is the focus.

Adolescents on multiple insulin injections or insulin pumps enjoy the flexibility of being able to adjust daily routines to match their lifestyle. Special attention should be given to girls on multiple injections due to the risks of gaining too much weight. Undesirable practices such as skipping insulin or over—restricting food intake to reduce weight or episodes of binge eating are not uncommon in this age group.

Sursa informatie:


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