February 7, 2004
Meal Planning, Food and Diet
Question from Louisville, Kentucky, USA:
My son was diagnosed with type 1 diabetes on Jan 3, 2004. Is there a general guideline for the amount of carbs a two and a half year old needs for each meal and snacks? I think they have him eating too much. They are telling me to make him eat at least 45-50 carbs at breakfast, lunch and dinner, plus 15 for afternoon snack and 30 for bedtime snack. I try to force him, which I know is wrong, and his lunch until morning level are most always at least 250 or higher, usually higher. Any suggestions would be very helpful. He is on 2 units of NPH at breakfast and 1/2 unit of NPH and 1/2 unit of NovoLog insulin at dinner.
I would communicate these concerns with your diabetes doctor or diabetes team about the increased calories and the elevated blood sugars. There is no rule of thumb for calorie needs as much as the RD individualizing meal plans based on current health status. Usually, the diabetes RD will increase calories upon diagnosis to allow for “catch-up” growth because of the usual weight loss that accompanies Type 1 diabetes. Once the blood sugars normalize and the weight normalizes, calories can be decreased. Speak to your RD to see if a change in meal planning is warranted at this time. There is nothing worse for a newly diagnosed child with diabetes than to begin setting “food battles” between them and the parent. Hopefully, there is a compromise with which everyone involved can live.