I have an eight year old student who, despite his family’s best efforts, has many highs and lows. The snacks he is told to eat are always carbs, like pretzels, crackers, vanilla wafers, etc. Even though he eats an appropriate amount, I am wondering if the addition of a little cheese or peanut butter or eating more complex carbs would help even him out.

You are correct, the introduction of a healthy protein choice along with the carbohydrate snack might blunt the rise in the postprandial blood sugar. This could very well level out the highs and lows of the student’s blood sugars. Some good snacks which include a combination of protein and carbohydrate include: part skim mozzarella cheese sticks with saltines, low fat peanut butter on whole wheat bread, artificially flavored yogurt, pretzels with small amount of melted cheddar cheese or unsweetened cereal with low fat milk.

Of course, you should not change the child’s meal plan without getting approval of the parents and the child’s diabetes team.

JMS