Children with diabetes “cheating” or “sneaking” food is a touchy subject. I cringe when I hear that term. I’ve had several patient’s whose parents or grandparents complain about it and I’ve seen posts in Facebook groups about it. It saddens me that children feel they need to sneak food, and are made to feel guilty for being hungry or wanting some food that everyone else gets to eat.
I’ll admit, we don’t want our children eating junk all the time, though some of the “cheating” is not junk food. No one’s children should eat junk all the time, with or without diabetes. Moderation and balance is the key to eating healthy. Research shows that restricting foods causes food cravings to increase. It also shows that when negative terms like cheating, sneaking, bad food, or other negative terms are used for food, food cravings and sneaking increases.
The American Diabetes Association revises its Standards of Care each year. The Standards of Care are a guideline for physicians and providers on the current recommended treatments for diabetes. The guidelines state that the current recommended treatment for people with type 1 is to count carbs and adjust the insulin based on a carb ratio. Food is not restricted though a healthy diet is encouraged. This means that a child can eat based on appetite and prefereces and the insulin dose is adjusted based on how much the child eats. If a snack is needed, which in children is normal due to their appetites and small stomachs, an insulin dose can be given if the snack is large or over 15 grams. If a child eats something sweet, the carbs can be estimated and an insulin dose given.
If the child is on an insulin pump, all snacks and all carbs can be easily entered for a dose of insulin. This what some people refer to as “freedom” with a pump. This is scary for some parents because they are afraid of what their child will eat. Trust me, they may go overboard at first, but once they realize that is ok to eat what they want, their eating improves.
In the beginning when children are diagnosed, some providers set a goal for the carbs to be eaten at a meal and give a set amount of insulin to be given. If you are doing this but your child is still hungry, speak with your doctor about moving to a carb ratio and adjusting the insulin. Most providers quickly move their patients to this method once they are over the initial shock and feeling more comfortable with diabetes and are in an emotional place where they are ready to learn and move into more complicated education.
The main problem with sneaking food is not getting insulin for it. The goal for eating less healthy alternatives is they are eaten in moderation, enjoyed and mindfully eaten so they are satisfiable, and then dosed with insulin to prevent a blood sugar spike.
I know allowing foods may feel scary and you may think your child will go nuts eating large amounts of junk. The first day, even week or so they may and will need more insulin, but as they become confident that it is ok to eat these things sometimes, they will not feel like they should eat large amounts because they may not get this chance again. This will result in them learning to recognize that eating too much junk makes them feel sluggish or worse and they naturally learn to listen to their body and stop when they are full. They will sometimes even recognize that they don’t even like the junk and choose other foods.
When children feel restricted, they sneak food in order to not feel shamed. This results in them not getting insulin. The key is having your child know deep inside that all foods are ok in moderation and they key is figuring the carbs in what is eaten and getting an insulin dose.