Individualized Meal Plans
The nutritional needs of a student with diabetes do not differ from the needs of a student without diabetes. Both should eat a variety of foods to maintain normal growth and development. The major difference is that the timing, amount, and content of the food that the student with diabetes eats are carefully matched to the action of the insulin.
The student’s meal plan is designed to balance nutritional needs with the insulin regimen and physical activity level. There are usually no forbidden foods for people with diabetes. The family and personal health care team creates an individualized meal plan based upon carbohydrate counting or an exchange system.
Carbohydrate counting involves calculating the number of grams of carbohydrate or choices of carbohydrate the student eats. This information, which can be obtained from nutrition information on food labels, is used to determine the amount of insulin the student needs to control blood glucose for any given meal or snack.
The exchange system groups foods in six different lists, each with a set nutritional value. A meal plan is prepared that recommends several exchanges or servings from each food group for each meal and snack. The exchange list ensures that the meal plan is consistent in portion size and nutrient content while offering a wide variety of foods from each group. Students using this approach consume a prescribed number of exchanges at meal and snack times.
The exchange lists include the following food groups:
- Bread/starch
- Fruit
- Milk
- Vegetables
- Meat/protein foods
- Fats
With some insulin regimens, it is important to maintain consistency in the timing and content of meals and snacks. The student should eat lunch at the same time each day. Snacks are often necessary for a child with diabetes and must be eaten to balance the peak times of insulin action. A missed or delayed snack could result in hypoglycemia. The student also must have immediate access to a quick-acting form of glucose, such as juice, glucose tablets or gel, or regular soda to treat hypoglycemia. The student’s nursing care plan or education plan (504, IEP, or other education plan) should show the timing of meals and snacks and an alternative plan for unusual or unforeseen circumstances.
Produced by the National Diabetes Education Program (NDEP), a federally sponsored partnership of the National Institutes of Health, the Centers for Disease Control and Prevention, and more than 200 public and private organizations.
To obtain copies of the complete publication titled, Helping the Student with Diabetes Succeed: A Guide for School Personnel (NDEP-61), please call the National Diabetes Education Program at 1-800-438-5383 or visit the program's website at www.ndep.nih.gov to download copies.
This reprint is compliments of Abbott Diabetes Care, Inc. Reproduced with permission.
Important Notice: Information provided is for general background purposes and is not intended as a substitute for medical diagnosis or treatment by a trained professional. You should always consult your physician about any health care questions you may have, especially before trying a new medication, diet, fitness program, or approach to health care issues.
DOC11957-Rev-A 04/08
