Paediatric Diabetes – Dietary management of snacks

Paediatric Diabetes – Dietary management of snacks

What about snacks?

Children who are very young or very active tend to need more snacks than those who
are older and less active.

Snacks may be an important way of getting enough energy into your diet to support your
growth and development.

Most children and young people are often hungry when they get home from school and
before the evening meal they may eat a ‘mini meal’ rather than a small snack. Others
may find that if they have an early evening meal, they are hungry at suppertime.

When you have a snack or a ‘mini meal’ it is important to know the carbohydrate content
of the food that you are having and the effect of that food on your blood glucose level.

If you want to have a snack and your evening meal will be within about 2 hours of that
snack take a blood test before your snack and than before your meal.

Some children and young people are able to maintain good blood glucose control when
they have snacks that contain a small amount of carbohydrate, while other children will
need insulin with all carbohydrate containing foods.

Your diabetes specialist nurse and your dietitian will guide you with the appropriate
snacks and the amount of insulin may need.

Children and young people when newly diagnosed may find that they are more hungry
than usually for the first few weeks after diagnosis. This excessive hunger normally
passes a few weeks after diagnosis. Try to fill up at meals and ensure that you are
having plenty of sugar free fluids. Limit snacks to no more than 10-15g carbohydrate (5-
10g carbohydrate for younger children) and have some low carb snacks if you still
hungry.

The snack rules:

• Snacks between meals should not contain only small amount of carbohydrate
• It is good to have a variety in your snacks and choose healthy snacks
• Try to avoid grazing on different carbohydrate snacks
• If you are still hungry consider having some low carbohydrate snacks from the list
  of Low Carbohydrate Snacks
• Snacks containing more than 15g of carbohydrate will need to be covered with
  rapid acting insulin
• You may need more carbohydrate snacks if you are physically active.

How to choose healthier snacks

Snacks that are low fat, low sugar and high fibre are better for you as they contain more
vitamins and minerals to keep you healthy and are better for your heart.

☺ All types of fruit are really healthy snacks, as they provide vitamins and fibre.
Have one portion at a time, which is a medium fruit or a handful of smaller fruit.
☺ Choose low fat milk, yoghurts and fromage frais as they provide calcium.
Have one portion at a time, such as a glass of milk or a small pot of yoghurt.
Check the total carbohydrate content of the yoghurts and milkshakes, as some are
very high in added sugars.
☺ Try not to have more than two biscuits or chocolates per day. Choose plain biscuits
and try the wholemeal or oat varieties.
☺ Choose cereal bars that contain plenty of wholegrain fibre and are low in sugar.
Check the total carbohydrate content, as some are very high in added sugar.
☺ If you choose crisps try to have no more than one packet per day. Low fat, low salt
and baked style crisps are healthier.
☺ You could choose some plain popcorn, rice cakes or oat cakes.
☺ Celery, cucumber and carrot sticks, cherry tomatoes and other salad vegetables,
which are great to help fill you up and are very low in carbohydrates.

Try a healthy dip for the vegetable sticks, crisps, rice cakes or oat cakes, such as low
fat soft white cheese, salsa, guacamole or low fat hummus.

Will I need insulin for my snack before exercise?

It is a bit of trial and error to work out how much carbohydrate you need for exercise.
The amount of carbohydrate need for exercise will depend on how often you exercise,
the type, length and intensity of your exercise.

On average for every 30-45 minutes of moderate intensity exercise you will need
between15-30 g of carbohydrate.

You do not need insulin with your exercise snack!

If your exercise is within 1.5 hours of your last meal you may choose to have slightly
more carbohydrate at that meal or a snack just before exercise.
You may also need additional carbohydrate after exercise, such as an additional snack
or additional carbohydrate at the meal following exercise.

In time you will learn that if your meal is within 1.5 hours of your exercise, rather than
having more carbohydrate to support your exercise you can reduce your insulin dose.
Your Diabetes Team will help you how to appropriately adjust your insulin for exercise.

If you do a lot of exercise your dietitian will discuss with you how to manage your
exercise effectively and give you in information sheet called ‘Exercise and Diabetes.

Snacks of 10 to 15g of carbohydrate:

The portion size of the foods listed below is between 10 to 15 g of carbohydrate.
On average each snack will raise your blood glucose by 2 to 3 mmol/l.

Children younger than 7 years to have smaller snacks 5-10g carbohydrate.

The values provided here are only an approximation and it is important that you check
the total carbohydrate content of the products you have using nutrition labels on the
products.

1 cup = about 250ml = about 8 ounces

Foods that contain none or very small amounts of carbohydrates

*Have these in moderation as part of a healthy diet as they are high in fat and salt

Read the label to help you choose healthier snacks:

Healthy snacks contain less than:

Make a list of snacks you usually have:

Diabetes Nurse and your Dietitian will discuss your snacks with you further and will
advise you if you will need insulin with your snacks.

If your symptoms or condition worsens, or if you are concerned about anything,
please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you
and your loved ones. If you have any questions or concerns, please do speak with a
member of staff on the ward or in the relevant department who will do their best to
answer your questions and reassure you.

Feedback
Feedback is really important and useful to us – it can tell us where we are working well
and where improvements can be made. There are lots of ways you can share your
experience with us including completing our Friends and Family Test – cards are
available and can be posted on all wards, departments and clinics at our hospitals. We
value your comments and feedback and thank you for taking the time to share this with
us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the
nurse in charge or the department manager in the first instance as they are best placed
to answer any questions or resolve concerns quickly. If the relevant member of staff is
unable to help resolve your concern, you can contact the PALS Team. We offer informal
help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf,
if you feel unable to do so, to resolve your problems and where appropriate refer to
outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate
your concerns. You can make a complaint orally, electronically or in writing and we can
advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: wah-tr.PET@nhs.net

Opening times:
The PALS telephone lines are open Monday to Thursday from 8.30am to 4.30pm and
Friday: 8.30am to 4.00pm. Please be aware that a voicemail service is in use at busy
times, but messages will be returned as quickly as possible

If you are unable to understand this leaflet, please communicate with a member of staff.

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