Newer Concepts of Dietary Therapy in IDDM in Children

The most important aspects of the diet for diabetic children are: 1. The timing of the meals. For the main meals, the time of the school meal and of the family dinner should be followed. Smaller meals will be necessary in between, with a total of about 6 meals daily. 2. The size of the meals and total amount of energy must be adjusted to the need of the children, and to the insulin type, dose and time of injection. A reasonable variation in energy intake is supported. Extra intake related to exercise will not only be taken on the days of exercise but also on the day after. This is supported by our own investigation. The appetite of the children should also be used in this regulation. Newer studies are summarized about the change in absorbability of starch by heating and cooking, and the effect on blood glucose of potatoes, rice and bread, different fruits and sorbitol. A long-term study of different fibres in bread is presented. A decrease both in mean bloodglucose and HbAl was found to be induced both by bran and by guar. The practical accomplishment of the diet is a larger problem than the theoretical ones.