The holiday season is a time when many people bond over traditional recipes, sweet treats and comfort meals. However, mealtime can be challenging for kids who have type 1 and type 2 diabetes. Emily Campbell, pediatric clinical dietitian at Ann & Robert H. Lurie Children’s Hospital of Chicago breaks down the dos and don’ts of planning meals for children with diabetes so they can enjoy this special time of year, just like any other child.

For those with type 1 diabetes, the pancreas can no longer make insulin. Insulin must be given via injection for the body to be able to correctly process the carbohydrates eaten and to prevent the blood glucose levels from becoming too high.

When a person has type 2 diabetes, the body’s cells are not as sensitive to insulin, which also leads to high blood glucose levels. Losing weight and being physically active can help the body become more sensitive to insulin. Insulin and oral medications may sometimes also be needed.

Planning Meals

Planning meals for children with both types of diabetes is really not much different than planning meals for children without diabetes. The goal for everyone – even for those who do not have diabetes  – is a balanced plate: Half of the plate filled with non-starchy vegetables, a quarter with starch, a quarter with lean protein, and a serving of low-fat or non-fat dairy (or dairy alternative) on the side. If a patient requires insulin for diabetes management, a few extra steps must be taken. It is important to use measuring cups to help quantify the amount of carbohydrates in the food. This allows for an accurate calculation of how much insulin should be given for a particular meal.

Often, holiday meals have more high carbohydrate-containing foods than typical meals and have high amounts of added sugar, making accurate carbohydrate counting essential to maintaining in-range glucose levels.

Kids with diabetes can eat all holiday foods, including desserts. The only thing Campbell recommends completely avoiding is sugary beverages, including:

• Juice (even 100% fruit juice)
• Regular soda
• Gatorade
• Lemonade
• Sweet tea

These beverages cause the blood sugar to rise rapidly and routine consumption can lead to excessive weight gain. Sugar substitutes such as stevia can be used in place of regular sugar when making sweets or in sweetened beverages.

Other ideas for lower-carbohydrate and lower-sugar alternatives include:

• Mashed cauliflower instead of mashed potatoes
• Fresh vegetables instead of casserole
• Roasted sweet potatoes instead of candied yams

What About Treats?

“It’s fine to enjoy a treat during the holidays. My recommendation for children with diabetes is the same as for children without diabetes: Consume an appropriate portion size, with the caveat to provide insulin if that is part of your diabetes regimen,” says Campbell. “Consuming the treat/dessert with a meal that contains fat and/or protein can help prevent blood sugar levels from rising too rapidly.”

When going to holiday parties, it can be difficult to know the exact ingredients in every recipe. Campbell advises using phone applications, such as Calorie King, Figwee and YAZIO, when estimating the carbohydrate content of unfamiliar foods. “One key thing that patients with type 1 should remember is that carbohydrate counting is not an exact science, and children can use different ways to estimate portion sizes,”says Campbell.

Over the holidays, remember to include regular physical activity. Activity can play an important role in improving overall blood sugar control. Participating in winter-related activities with the family, such as ice skating, having fun in the snow or going on family walks to look at holiday decorations, are healthier alternatives to sitting in front of the TV. Aim for 30-60 minutes of physical activity daily, even over holiday break.

“The holidays are a time to enjoy spending time with friends and family, and there is no reason that a child’s diabetes should get in the way of that,” says Campbell.

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