Q: I keep hearing about popular high-protein/high-fat eating plans — could opting for more meats and cheeses over starchy snacks and sides in our son’s diet make blood sugar management easier?

A: When parents encounter challenges with their child’s type 1 diabetes management, it can be tempting to look for quick fixes such as trendy high-protein/high-fat/low-carb or “paleolithic” diets that seem to promise so much. There are certainly times when a lower-carb snack can be helpful for keeping blood sugar within range, but if you’re considering steering your child toward a low-carb eating plan, you’re taking a risk that could lead to low blood sugar. One very important question to ask yourself is: Why do I think my child’s diet needs to be changed?

If it’s because your child’s blood sugars are frequently out of range, get in touch with your child’s diabetes care team. Are numbers after meals and snacks problematic? Your registered dietitian and certified diabetes educator can review with you steps such as how to count carbohydrates in foods and how to properly calculate carb-to-insulin ratios. Carbohydrates are not the enemy! In your child’s diabetes management program, carbohydrates are important for many body functions, and insulin is what allows the carbohydrate to be properly utilized. The most important thing is to know how many carbohydrates should be consumed at meals and snacks and to adjust insulin when needed, and your diabetes care team can help you do that.

The goal when choosing foods to include in a child’s diet is to meet his or her overall nutritional needs and instill healthy habits. Kids with type 1 can eat all the same foods as other children as long as carbohydrates in the foods are covered with insulin. We want all kids to make healthy choices. Because research tells us that children with diabetes are at higher risk for developing complications like cardiovascular disease later in life, it’s especially important for kids with type 1 to eat meals and snacks filled with fruits, vegetables, whole grains, lean proteins, and other heart-healthy foods to help reduce this risk.

Diets that heavily restrict carbs can leave out very healthy foods and include some that are not so healthy. Some low-carb diets, for example, advise avoiding fruit but give the okay to eat unlimited pork rinds because they contain few if any carbs. Pork rinds may have negligible carbs, but what is the better choice for your child’s long-term health? Snacking on a bag of pork rinds or on an orange or apple?

It’s all about balance. Talk to your dietitian about how to work in healthy and tasty snacks and side dishes and how all this fits in with good blood sugar management. These days, we are inundated with magazines, talk shows, and the Internet telling us why the latest fad diet is the “right” way to eat. Information about diet and nutrition may be easier to access than ever, but nothing can replace the advice of your child’s own health care providers.

Marlisa Brown, M.S., R.D., C.D.E., C.D.N.—Marlisa Brown, M.S., R.D., C.D.E., C.D.N., is the president of Total Wellness, Inc., past president of the New York State Dietetic Association, and author of numerous cookbooks and nutritional guides.


How Other Parents Deal

“When the topic of low-carb diets came up recently at the parent support group I help run, the diabetes educator who joins us at meetings offered this profound feedback: Putting your child on a low-carb diet is not going to cure your child’s type 1 diabetes. I’ve really taken this to heart. What would be the purpose of restricting my child’s diet so severely when she already has her management routines down and is holding her own with keeping her blood sugar numbers in range? Having type 1 is all about what you can do, not what you can’t do. Yes, we have ups and downs, but eating a wide range of healthy foods — and you can’t tell me that fruit is not healthy! — is the goal in our home for everyone.”

—Liz R., Bryn Mawr, Pa., mom of 18-year-old Erica

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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.