Q: My grandson was recently diagnosed with type 1 diabetes, and his family will be coming to my house for Thanksgiving dinner. What do I need to know?

A: Celebrating a holiday meal together as a family could be just what your grandchild needs to feel like life is finally getting back to normal following his diagnosis. As far as what to serve at Thanksgiving, general diet recommendations for children with type 1 diabetes are actually the same heart-healthy nutritional standards that all children are recommended to follow. These include eating lean meats, whole grains, and fruits and vegetables; avoiding sugar-sweetened beverages (opting for water or milk instead), and limiting sweets and desserts to small portions.

It’s a common misconception that people with type 1 diabetes need to eat sugar-free foods. This is simply not the case. Children and adults with diabetes count the carbohydrate grams in their foods and then cover those carbohydrates with the correct amount of insulin. By taking insulin, the body is then able to use the carbohydrates in food as energy.

At Thanksgiving and other food-focused special occasions, it’s expected that a child may eat more food than normal and that the food may be very different from what the child typically eats. One big help you could provide is to let your son or daughter know the menu in advance. This will help them count the carbohydrates in the dishes and calculate proper insulin amounts for what your grandson eats. An easy way to give them the info is to take photos with your phone of the various food package labels (or photos of the foods themselves) and send those to your grandson’s parents to help them start planning.

Because holiday meals tend to be lengthy and spread out over appetizers, main courses, and desserts, be prepared to see your son or daughter check your grandson’s blood sugar levels and administer insulin as needed. Stopping to take care of these routine management tasks is not a sign that anything is wrong. Checking blood sugars and taking insulin are two ways children with diabetes stay healthy.

Sometimes guests stay long after the holiday meal has been eaten. If your grandson is hungry later on and asks for a snack, a good response might be something along the lines of, “Let’s count the carbs in the snack and then make sure you’re covered.” His parents can then check his blood sugar and decide whether additional insulin is needed.

As a way to learn more about diabetes, pay attention as your son or daughter checks blood sugars and calculates insulin doses, and ask questions. Spending time together as a family may be more important than ever for your grandchild—and for your own child in his or her new role as caregiver to a child with diabetes. Showing interest in learning about your grandchild’s type 1 can be the first step toward participating in his care. And this is something he and his parents can be truly thankful for.

Megan T. Robinson—Megan T. Robinson, M.S., R.D., C.D.E., L.D.N., is a registered dietitian and certified diabetes educator at The Children’s Hospital of Philadelphia.

How Other Parents Deal
“When our son was diagnosed with type 1 diabetes at age 8, it was August. Once we felt back on our feet, I invited my parents over for dinner a few times so they could begin to understand the different steps we now had to take at meals, including counting carbs and administering insulin. Later, when we all gathered for Thanksgiving at their house, we really didn’t get any ‘Are you sure he can eat that?’ questions, because—thankfully—they pretty much already knew the drill!”
—Suzanne C., Manalapan, N.J., mom of 14-year-old Andrew

Related topics:
Thanksgiving Do’s and Dont’s
Holiday Travel with Type 1 Diabetes
People in the Know: Can Grandma Look After Her Alone?

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Disclaimer: The information in these articles is not intended as medical advice. Families should check with their healthcare professionals regarding individual care.