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Nutrition & Type I Diabetes

Nutrition & Type I Diabetes. Goals of therapy Type I diabetes: Promote normal growth & development Encourage good nutrition Prevent (minimize) complications Maintain near-normal blood glucose levels Preprandial BG goals Infants and toddlers: 100-180 mg/ dL Children: 90-180 mg/ dL.

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Nutrition & Type I Diabetes

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  1. Nutrition & Type I Diabetes Goals of therapy Type I diabetes: • Promote normal growth & development • Encourage good nutrition • Prevent (minimize) complications • Maintain near-normal blood glucose levels • Preprandial BG goals • Infants and toddlers: 100-180 mg/dL • Children: 90-180 mg/dL

  2. Delegation of Responsibilities • Functionally able to do things long before cognitive understanding. • Length of teaching sessions based on developmental age • Learning theory

  3. Developmental Issues: Infancy • High caregiver responsibility • Growing brain is greedy: wants glucose!!

  4. Toddler • Inconsistent dietary intake • Give choices when possible • Rituals and routines

  5. Developmental Issues: preschooler • Understands simple explanations • Play therapy • More predictable appetite • Learn to identify CMs hypoglycemia • Avoid calling results “bad” • High energy activities

  6. Developmental Issues: School-age • Dislike being “different” • School personnel – fingersticks • Less parental control • Field trips, parties, athletic events • Eating habits more predictable; more independent • Present oriented

  7. Developmental Issues: Adolescent • Challenge: growth spurt & blood sugar • Body image, peer group acceptance • Risk-taking behaviors • Control shifting to adolescent • Not motivated by future complications

  8. Type 2 Diabetes • Increased incidence in children • Metabolic syndrome (insulin-resistance syndrome)= high risk factor • Sedentary lifestyle • Overeat • Family hx of diabetes • Metformin: only oral agent approved for children

  9. Exercise • Exercise  decreased insulin need r/t insulin more efficient • Avoid active exercise when insulin peaking • Maintain proper hydration • Watch for hypoglycemia after exercise • Avoid exercise if insulin level is too low

  10. Exercise McKinney: • 15-30 Gm carb for each 45-60 min of exercise • Check BG before, during & after • Be prepared w/additional carbs •  BG up to 2 hours after exercise • Coaches & teammates

  11. “Honeymoon Period” • After new dx, 10-20% beta cells function for a time (ucsfhealth.org) • Less insulin required • Potential denial of disease

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