By Seema Khanna
In juvenile diabetes, a patient’s pancreas stops producing insulin or produces insufficient quantities. Mothers of these children come to the physician with usual complaints of excessive hunger (polyphagia), excessive thirst (polydipsia), frequent urination (polyurea) and ‘ants moving on urine’ and weight loss.
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By the action of insulin, glucose gets metabolised and is transported to body tissues so our cells can use it as fuel. When there is lack of insulin, glucose moves in our blood, increasing blood sugar levels. When this condition of high blood sugar level is not taken care of for a long period of time, it results in the use of body fat as fuel. Breakdown of fat in this situation leads to the formation of the acid called Ketones.
When ketones increase in blood, this condition is known as Diabetic Ketoacidosis, which can be a life threatening condition. Symptoms usually include nausea, vomiting, confusion, headache, shortness of breath and at times results in the fainting of the child. High blood sugar levels also lead to dehydration.
To prevent the above conditions, a parent needs to be educated regarding diet plans. There are different diet plans to control this situation.
Nearly half of the energy should be derived from proteins followed by 30 percent from carbohydrates (complex carbo) and 15 percent from fibre and the rest from fats.
The big three macronutrients – carbs, proteins and fats – play an important role in juvenile diabetes.
Stay away from simple carbohydrates and stick to complex carbs such as veggies and wholegrains. The glycaemic index of simple carbs is very high, increasing blood sugar levels rapidly. Complex carbs are also a rich source of fibre, which helps in maintaining body weight, completing the daily requirement of vitamins and minerals. The body will be unable to absorb and break down fibre, in turn maintaining the blood sugars. It also lowers the risk of hypercholesterolemia and hypertriglyceridemia. It also helps to improve gut health and gives you a feeling of fullness.
Proteins are the most important nutrient for body building in children, 1.5 to 1.6 gms per kg body weight is optimum body requirement. It helps slow digestion and prevents post-meal rise in sugar levels in blood. Good quality and quality of protein intakes delays gastric emptying, resulting in less hunger pangs.
Good quality of protein is available in milk (double-toned or skimmed milk), egg, chicken, fish, lean meat, nuts and seeds.
Every day food intake should include a handful of soaked and peeled almonds, two or three walnuts, one serving of egg and one serving of chicken / fish/ paneer.
Another important nutrient to maintain postprandial glucose levels is fibre, which is present in plant-based foods. There are two types of fibres: soluble and Insoluble. Consuming high-fibre diets gives a feeling of fullness with a low glycaemic index, which further controls the appetite. Children-friendly fibre snacks can be wholegrain cereals.
Some diets with high protein content are:
1. Milkshakes with berries, nuts, and seeds
2. Sauteed raw vegetable salads
3. Tomatoes, apples, peaches, plums, pears with their peel.
Whole grain snacks include:
1. Puffed wheat or millets.
2. Maize popcorn.
3. Puffed quinoa.
4. Vegetable oats with different flavours.
Now the most important ingredient is sweet as they are the most important part of a child’s nutrition. They should be given carefully with the understanding of pros and cons. Parents need to be educated that sweets can be consumed with breakfast and up to evening snacks. This is a random time duration, although the accurate time is when insulin levels are at the peak. Peak action absolutely depends on insulin ingestion.
In conclusion, intake of sugar-based foods, avoiding high intake of salt (packed food preservative as additives) should be controlled. Steer away your child from fatty foods, especially saturated fats. Keep a record of blood sugar levels. Visit your doctors and dietician at regular intervals. Keep a check on a child’s exercise and ensure a good amount of activity or exercise throughout the day.
(The writer is a dietician.)
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