Fact sheetDiet specifications

Published on 1 Nov 2012 ; Partial revision Apr 2021


Diabetes paediatric diet - CHO in grams - pump

This document is part of the ACI Diet Specifications for Paediatric Inpatients. It is not to be used for patient education.

Aim

To provide a diet that optimises blood glucose and lipid levels in patients with diabetes and specifies carbohydrate (CHO) content of items to allow precise insulin dosage. Intake can be individualised meal by meal according to age, weight, appetite, activity and growth needs.

Characteristics

Specified CHO intake.

Reduced simple carbohydrate, low Glycaemic Index, reduced fat diet with lower saturated and higher poly-monounsaturated fats. 50-60% energy from carbohydrate, ≤ 30% energy from total fat and ≤ 10% energy from saturated fat. Inclusion of one low Glycaemic Index food (GI≤55) at each meal and snack. Special sugar-free, diabetic foods and artificial sweeteners as sachets are not required.

Menu item choices include foods with and without carbohydrate.

Indications

  • Children and adolescents with diabetes on insulin pump therapy or being initiated on pump therapy where exact CHO content of foods chosen need to be measured and indicated to allow precise insulin dosing.

Nutritional adequacy

Nutritionally adequate.

Precautions

Intake is chosen on menu selection by the patient, as determined by appetite, along with considerations of age, weight, growth needs and usual intake.

Use of and age-appropriate diet will adjust fat content in dairy to provide full fat dairy for children 3 years of age and under.

Education and support by a clinical dietitian is essential to ensure effectiveness and for monitoring of diet.

The safety of long term use of artificial sweeteners for children is unknown so has been excluded for children under 13 years of age.

Specific menu planning guidelines

Allowed Not allowed
Hot main dishes All others

Dishes in cream sauces

Pies and pastries

High fat meats (e.g. sausages, bacon)

Sauces, gravies

40mL serve gravies and sauces

Cranberry and mint sauces (portion control or single serve only)

White/cream/cheese based sauces, sour cream
Starchy vegetables/pasta/rice

All without fat or using mono- or polyunsaturated oil (e.g. mashed and steamed potato, potato baked in allowed oils)

Use low GI rice (e.g. basmati or doongara) if possible (See GI website for full list)

Cooked in saturated fat

White/cream/cheese based sauces

Vegetables All others

Served with white cheese sauces

Cooked in saturated fat

Soups All -
Sandwiches

Preferably made with mono- or polyunsaturated margarines

Butter
Salads, dressings

All

Low joule dressings or made with mono- or polyunsaturated oils

Cream or full fat dressings or mayonnaise
Breads, cereals

Wholegrain/wholemeal breads (preferably grainy low GI breads) are default. White bread may also be made available

Higher fibre breakfast cereals are default (e.g. rolled oats, muesli, bran cereals, Guardian®, Weet-Bix™)

At least 2 low GI cereal choices per breakfast (See GI website for full list)

Highly sugared breakfast cereals (> 30% sugar, unless primarily from added fruit)

Sweetbreads

Spreads

Jam, Vegemite™, honey, peanut butter

Preferably mono- or polyunsaturated margarines/oils/mayonnaise

Saturated fats (e.g. butter, shortening, lard, cooking margarine, coconut milk, palm oil)
Hot breakfast choices

Boiled, poached or scrambled egg

Mushrooms, baked beans, tomatoes

Fried egg, bacon, sausages

Hash browns

Fruit

Unsweetened fresh/frozen/canned fruit in natural juice or light syrup.

Fruit juices and dried fruit in moderation (≤2 serves per day)

Fruit canned in syrup
Yoghurt

Full fat yoghurt < 3 years of age

Reduced fat yoghurt from 3 years of age

Reduced fat yoghurt < 3 years of age

Full fat yoghurt from 3 years of age

Desserts

Ice-cream maximum 2 serves per week

Low fat custards and creamy rice

Tapioca, sago

High fat and sugar pastries/pies

Sugared jelly

Milk and cheese

Full dairy < 3 years of age

Reduced fat dairy from 3 years of age

Reduced fat dairy < 3 years of age

Full fat dairy from 3 years of age

Beverages

Water, low fat milk, low joule soft drinks/ cordials, plain mineral water

Fruit juice maximum 2 serves per day

Regular soft drinks, cordial, flavoured mineral water, tea, coffee, alcoholic drinks
Biscuits Plain biscuits, Milk Arrowroot™ Cream or chocolate biscuits
Miscellaneous

All herbs and spices, nuts

1 sachet sugar per breakfast tray

1 sachet artificial sugar per breakfast tray (if > 13 years)

Sachets of artificial sweetener (for children < 13 years)
Celebratory Foods/
Special Occasions

20g chocolate easter eggs on Easter Sunday

References

  1. Agency for Clinical Innovation. Nutrition standards for paediatric inpatients in NSW hospitals. Sydney 2011.
  2. Agency for Clinical Innovation. Nutrition standards for adult inpatients in NSW hospitals. Sydney 2011.
  3. Dietitians Association of Australia. 2009. Nutrition manual 8th ed. Canberra: DAA.
  4. American Dietetic Association. Paediatric Nutrition Care Manual. Chicago: ADA.
  5. ISPAD Clinical Practice Consensus Guidelines 2009 Compendium. Nutritional management in children and adolescents with diabetes. Pediatric Diabetes 2009: 10(Suppl.12): 100-117.
  6. Australian Clinical Practice Guidelines on the management of type1 diabetes in children and adolescents APEG. 2005:
  7. Shaw V and Lawson M. Clinical Paediatric Dietetics. 3rd Edition. 2007. Blackwell Publishing.
  8. University of Sydney Glycemic Index.
  9. Diabetes Australia Glycaemic Index.

Change log

Change date Section updatedChange
April 2021 Title of Specification Title changed from Diabetic diet - diabetes in pregnancy to Diabetes diets - diabetes in pregnancy
September 2022 Specific menu planning guidelines Created a new food group row under Miscellaneous, titled Celebratory Foods / Special Occasions
September 2022 Specific menu planning guidelines -
Celebratory Foods / Special Occasions
In Allowed, added 20g chocolate easter eggs on Easter Sunday
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