Diabetes: Nutrition for Children with Diabetes

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Guest:  Katherine Nashatker – Dietetic Services

Host:  Dr. Linda Austin – Psychiatry

Dr. Linda Austin:  I’m Dr. Linda Austin.  I’m interviewing Katherine Nashatker who is a pediatric dietician here at the Children’s Hospital, at MUSC, with a specialty in pediatric endocrinology.  Katherine, let’s talk about the child who is newly diagnosed with diabetes.  I know that can be a pretty overwhelming diagnosis for children and parents.  When you sit down and begin to teach a family about how they need to think a little bit differently now, about dietary issues, where do you start?

Katherine Nashatker:  The first thing I do is assure the parents that this isn’t going  to be a huge deal in terms of their child not being able to function normally or eat foods that they like, or fit the lifestyle into a normal growth period.  I’m usually doing a lot to reassure them by telling them that it’s a matter of counting carbohydrates, staying on top of things and checking blood sugar.  That’s really the main core of what I teach.  Beyond that, that’s when I start to show them how to accommodate normal dietary habits as they relate to the diagnosis.

Dr. Linda Austin:  So, let’s imagine I’m a parent with a child who just gets this diagnosis and I say, huh, counting carbohydrates?  How do I go about doing that?

Katherine Nashatker:  Well, first I show them where carbohydrates come from.  I talk about fruits and starchy vegetables, and dairy products.  Once I show the families appropriate portion sizes and how to identify these carbohydrate foods, we determine how many carbohydrates their child needs to eat each day and how much he/she should eat at a sitting.  

Dr. Linda Austin:  Now, we hear, in dieting, about good carbs and bad carbs.  Does that hold true for the child with diabetes?  Are some carbs worse than others?

Katherine Nashatker:  I would argue that too many carbs are bad carbs.  It’s not so much what you’re feeding, but how much, and are you counting them correctly?  Typically, I would love to see children eat whole grain breads and plenty of vegetables.  But, the reality is that, now, in today’s society, we have so many convenience foods.  So, I wouldn’t caution them against using those foods appropriately, for snacks and whatever, but just making sure that they understand that certain snack foods that have starch in them are going to have carbs as well and that they need to be able to count these correctly.

Dr. Linda Austin:  Whether it’s M&M’s or an apple?

Katherine Nashatker:  Absolutely.

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