Tools and Techniques for Working With Young People With Diabetes

Diabetes is one of the most common chronic conditions in school-age children, affecting 151,000 children and adolescents in the United States, or approximately one in every 400–500 youth under 20 years of age. Every year, more than 13,000 youth are diagnosed with type 1 diabetes. In addition, more and more children and teens are being diagnosed with type 2 diabetes, a condition usually diagnosed in adults over the age of 40. It is now estimated that type 2 diabetes accounts for 8–45% of pediatric patients with newly diagnosed diabetes in large U.S. pediatric centers.1

Consensus statements and treatment guidelines for the medical management of type 1 and type 2 diabetes in children have been published by the American Diabetes Association (ADA).2,3 These publications outline the current recommendations and treatment goals for this special population with diabetes.

Medical nutrition therapy (MNT) is an integral component of any treatment plan for a child with type 1 or type 2 diabetes, but often is the most difficult part of the treatment plan to successfully implement. The ADA’s position statement “Evidence-Based Nutrition Principles and Recommendations for the Treatment and Prevention of Diabetes and Related Complications”4 includes a section on nutritional recommendations for children and adolescents.

The nutrient requirements for children and adolescents with type 1 or type 2 diabetes appear to be similar to other same-age children and adolescents without diabetes, with an important difference: the food plan must be balanced with optimal glycemic control, exercise, and possibly diabetes medications to promote normal linear growth. Growing children who do not receive adequate calories will not grow to their height potential. Table 1 summarizes the nutrition goals for children with either type 1 or type 2 diabetes.3,5,6

Many children and adolescents with type 1 or …