Overcoming the dietary challenges of toddlers with type 1

Type 1 diabetes

By Kate Marsh

8 Oct 2015

Having a toddler with type 1 diabetes adds additional pressure to mealtimes and is particularly stressful for parents, but there are ways to overcome these challenges, the conference has heard.

Speaking at ISPADAPEG 2015 in a clinical practice symposium session on the Challenges of Toddlers with Diabetes Sharon Youde an Accredited Practising Dietitian at the Royal North Shore Hospital in Sydney said much of the stress reported by parents centered around uncertainty about whether their child would eat enough to match the insulin they had been given.

While there was some research to suggest that pumps may help they don’t seem to completely remove mealtime stress, she told delegates.

Diabetes health professionals could help parents by providing basic mealtime behaviour strategies including discussing the division of responsibilities at mealtimes– the parents deciding what to offer and the child deciding what and how much to eat.

It helped to explain to parents that the goal was to match the insulin regime to appetite rather than other way around.

Families should also be encouraged to move away from the grazing pattern of younger toddlers towards regular meals and snacks through the day, she advised.

Evidence showed that using strategies to address general levels of stress in parents of children with T1 diabetes can help with stress around mealtimes, she said.  Working closely with a psychologist can help, she added.

But it was important that dietitians and other health professionals working with this group of patients were respectful of the families’ usual food selections.

“You don’t want to go in and change this initially but just start with working towards regular meal patterns” she said.

“You need to build a respectful relationship with the family first. Once you have built up their trust, then you can work with the family to see what other changes they will make”.

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