Optimal diabetes management requires healthy, balanced eating, combined when necessary with insulin and/or medication, and blood glucose (sugar) control. The best way to manage your child's diet is to create a meal plan. Your child's meal plan provides the basis for healthy eating and safe blood sugar control. The meal plan discussed below features changing carbohydrate intakes.
This method consists in taking the amount of insulin necessary to match the amount of carbohydrates eaten. You can determine how much insulin is needed by using the insulin-to-carbohydrate ratio (I:C) that your diabetes team has set for your child.
The I:C is the amount of carbohydrates (in grams) that one unit of rapid-acting insulin makes available to the body cells to consume. In other words, one unit of rapid-acting insulin "covers" for a specific amount of carbohydrates. The I:C is expressed as 1 unit: X grams of carbohydrates.
Sara's story
Sarah is 13 years of age with type 1 diabetes. She is on a multiple daily injection (MDI) insulin regimen, and has an I:C of 1:10.
She would like to have the following for lunch:
- a grilled cheese sandwich made with two slices of bread (30 grams of carbohydrates)
- 1 medium orange (15 grams of carbohydrates).
Total carbohydrates: 45 grams.
How much insulin will Sara have to take to cover the carbohydrates from this meal?
Because she has an I:C ratio of 1:10, she will need to divide 45 grams of carbohydrates by 10 to get the amount of insulin required to cover the carbohydrates from this meal: 4.5 units of fast acting insulin.
Over time, those on an MDI insulin regimen (using rapid-acting insulin before each meal) as well as those using insulin pumps will have more flexibility in the timing and amount of food they eat. Still, they too need to be consistent in their eating habits when starting on the new regimen, in order for the diabetes team to help them work out their I:C.