Foods and Blood Glucose Levels
All foods are made up of the same three components: carbohydrates, protein, and fat. Of these components, carbohydrates have the most influence on blood glucose levels. Fruits, vegetables, and grains (e.g., cereal, bread, crackers, pasta, rice) are different types of carbohydrates.
When carbohydrates are digested, they are converted to glucose (a type of sugar) and are used immediately or stored for later use. Some carbohydrates are converted to glucose rapidly and some more slowly. How fast a carbohydrate is converted to glucose is important to patients who have diabetes.
When it comes to carbohydrates, fresh fruits, vegetables, and whole grains are healthier. When choosing food for a child who has diabetes, choose these carbohydrates more often:
- 100% whole-wheat bread
- Brown rice
- Whole-wheat pasta
- Fresh fruits and vegetables
Limit these carbohydrates:
- Breads made with refined flour
- Traditional pasta
- White rice
- Snacks with added sugars or sweeteners (including juices)
A dietician or nurse educator can provide more information about managing carbohydrates in the child's diet and how to keep blood glucose levels in balance. They can also provide helpful information about planning for holidays and special occasions, such as birthday parties and Halloween.
Monitoring Blood Glucose Levels
Monitoring the child's blood glucose level and keeping accurate records can help the health care provider and dietician create the best possible diabetes care plan. As the child grows, becomes more or less active, and loses or gains weight the care plan should be reviewed and adjusted. If the child is having difficulty following the meal plan or blood glucose levels are not being properly controlled, contact the child's health care provider or dietician.
Parents of school-aged children who have diabetes should communicate regularly with the child's teacher and the school nurse. Talk with a dietician or nurse educator for more advice on how to enlist the help of the other caregivers in the child's life.
Maintaining Blood Glucose Levels
When blood glucose levels are too high over long periods, it can cause damage to the heart, blood vessels, eyes, and kidneys. When blood glucose is too low, the child may feel tired and unable to concentrate. If blood glucose becomes severely low, diabetic coma can occur.
Illness, skipping meals, eating too much or too little, exercising too much or too little, and emotional stress can cause the child's blood sugar to become too high or too low. It is important to learn how to detect the signs of low blood glucose and high blood glucose in the child and to know what to do in each case.
Talk with a qualified health care provider, dietician, or nurse educator about how to handle each of these situations. Also, make sure that other caregivers (e.g., school staff, coaches, babysitters) know how to spot the signs of high and low blood glucose.
Younger children require more help to monitor symptoms of high and low blood glucose. Ask a health care provider or registered dietician for suggestions to help children learn to better manage diabetes care as they mature.
Too little glucose in the bloodstream is called low blood sugar, low blood glucose, or hypoglycemia. Mild to moderate hypoglycemia is fairly common in children with diabetes. Signs of low blood glucose include the following:
- Grouchiness, irritability
If the child has signs of low blood sugar, check blood glucose levels. If the level is under 70 mg/dL, try one of the following:
- Have the child drink ½ cup of grape or orange juice, 1 cup of milk, a juice box, or 1/2 can of a regular (not diet) soft drink.
- Give the child 2 glucose tablets.
- Give the child 1-2 tablespoons of sugar or honey.
- Have the child eat 2-4 pieces of hard candy, 5 gumdrops, or two tablespoons of cake icing.
Check the child's glucose again after about 15 minutes. If the level is still below 70 mg/dL, repeat one of the suggestions above until the level is above 70 mg/dL. If the child develops severe hypoglycemia, the child may become unconscious and slip into a diabetic coma. Talk with a qualified health care provider about dealing with this situation.
Children can also experience nighttime hypoglycemia. Signs of nighttime hypoglycemia (low blood glucose) include the following:
- Pajamas and sheets feel damp in the morning
- Headache in the morning
- Restless sleep
- Excessive tiredness upon waking
- High blood glucose reading (the body can react to the hypoglycemia by raising blood glucose levels)
Talk to a qualified health care provider about the best way to deal with nighttime hypoglycemia.
Too much glucose in the bloodstream is called high blood sugar, high blood glucose, or hyperglycemia. Signs of high blood sugar include the following:
- Excessive thirst
- Blurred vision
- Frequent urination
Hyperglycemia can occur if the child is ill or not following the care plan closely enough. A brief period of exercise may help; however, exercise can be dangerous if the blood sugar level is too high. Ask a qualified health care provider in advance about what to do if the child experiences high blood sugar.
To help prevent the child's blood glucose from going out of balance, check the blood glucose levels as directed by a health care provider and follow the diabetes care plan as closely as possible.