My five year old daughter was diagnosed with type�1 diabetes about three weeks ago, we are checking her blood sugar more than 10 times daily, and there seems to be no cause and effect with her glucose levels. One day we give her a peanut butter and jelly sandwich and her glucose count goes down, but the next day the sandwich can bring the glucose up 150 mg/dl [8.3 mmol/L]!

I’ve done some research into the glycemic index and want to give her food that will burn off slowly, not leaving her lingering under 100 mg/dl [5.6 mmol/L] during school. Cheerios seems to burn off very fast while the PBJ sandwich brings her up too fast. Any suggestions?

You are certainly learning with your daughter the varying impact that even the same foods can have on her blood sugars. I would stress that there are other factors than food that can impact blood sugars that can explain some of the variances. Looking at the food side of it, I would stress a good combination of carbohydrate and protein with a moderate amount of healthier fats (monounsaturated and polyunsaturated vs. saturated fats) at meals and snacks. This should give your daughter a slower rise and drop in blood sugars and prevent some of the more erratic blood sugar patterns (especially associated with sole carbohydrate or higher fat meals).

I also suggest scheduling an appointment with a registered dietitian who specializes in diabetes meal planning to review appropriate food options to achieve this goal.

JMS