October 12, 2000
Meal Planning, Food and Diet
Question from Ohio, USA:
My 13 year old daughter was diagnosed with diabetes less than a month ago. She is on a carbohydrate counting diet. Yesterday, we went to the diabetes clinic for the first time, and the dietitian was teaching the kids how to count the carbs from a school lunch menu. One of the meals included orange juice. She told them they should always avoid orange juice because it raises the blood sugar quickly, and should only be used when they are treating hypoglycemic episodes. She also was frustrated because my daughter has been eating toast for breakfast, and not just cereal. I have reduced the cereal to cover the toast and keep the carbs within range, but I have been trying to give her more variety than what she gave us in the hospital.
I thought the point of counting carbs was the flexibility it gives, and that as long as I keep the carbs within the specified range, my daughter could have a variety of foods. Should my daughter only be eating the sample meals she gave us, or are we free to rearrange things to get in her favorites, provided she still has the balance of protein, milk, and carbs?
I agree with you. Carbohydrate counting affords people more choices in what they eat from day to day. It has been my experience, over the past 20 years, that orange juice in a meal will not cause high blood sugar excursions and toast and cereal really do count the same as long as you are measuring them correctly. I say, go for the variety with a balanced diet in mind — just like you have been doing.
[Editor’s comment: Well, we now have our writer in a pickle: we agree with what she’s saying, but the dietitian on her daughter’s diabetes team apparently feels otherwise. I’d suggest the writer bring a copy of this question to the dietitian and/or the doctor on the diabetes team, and discuss the reply we have provided.