PLANNING THE DIABETIC DIET IN YOUNG PEOPLE: THE EXCHANGE SYSTEM
A diet for diabetes in young people should achieve these aims quite simply.
Carbohydrates are controlled carefully by a system of exchanges
We control carbohydrates because they are an immediate source of glucose and if not controlled will lead to varying glucose levels in blood. Carbohydrates are controlled by an exchange system. This system allows you to choose the carbohydrates in the meal but keep the total amount the same.
In the diabetic diet, approximately half the energy (calories or joules) should be provided by carbohydrate. The amount of carbohydrate in the diet is referred to as the number of exchanges, where one exchange is equal to a serving of food that contains 15 grams of carbohydrate.
One exchange of carbohydrate foods equals one exchange of another carbohydrate food and so they are interchangeable. It is very important that the amount of carbohydrate (or number of exchanges) stays as constant as possible each day.
You will be advised on the number of exchanges of carbohydrate for each meal, and the best balance between the various carbohydrate groups.
As the child grows or becomes more physically active, the number of exchanges per day will be gradually increased. When growth stops at the end of puberty and if the child becomes less active at that time, the number of exchanges may be reduced.
Protein and fats are taken in moderation and may be controlled
Careful measurement of protein and fats may be important in older persons with diabetes and those who are over-weight. This is because both protein and particularly fats are a major source of energy as calories or joules.
With young people it may not be important to be so precise in allowances of these foods as a rule. It is however sound nutritional advice that excess fats should be avoided as they may be bad for health. Excess protein in the diet may lead to poor diabetic control. The body does have the ability to convert the excess protein and fats into glucose and also store this energy as body fat.
Refined carbohydrates as high sugar foods should be avoided
There are many foods and drinks which have a high content of sugar. Unfortunately these are often favourite foods of children, but they are not normally suitable in the diet for a person with diabetes as they may lead to high levels of glucose in the blood. They hardly satisfy appetite well and they are not necessary from a nutritional point of view.
There are special occasions however when sugar-containing foods are helpful for a person with diabetes. This is particularly when the blood glucose falls too low or when given before extra activity to prevent hypos. They may also be helpful during illness particularly if there is vomiting when your child may not be able to take the ordinary diet.
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