As much as you don't want your nutritionist to be the diabetes police, neither do you want to come across to your child that way. However, a good assessment of what she is eating and how it is affecting her is a necessary part of life with diabetes.
Food Journals: Use Them but Don't Abuse Them
Making insulin work with food is all about patterns. In fact, the only way you can truly know how certain carbs react with insulin in your child's body is to watch what happens, not once, not even twice, but three times. Of course, there is no way you can record all this in your memory, so you will need to keep a food journal.
Begin tracking snacks and meals (including meals in this cookbook). Write down the blood sugar before the meal, what the insulin dose was (and the carb ratio) and then what the postprandial blood sugar is (this is a blood sugar check done two hours after a meal is complete).
Look for trends that will tell you if you are over or underbolusing for that food, and if your child tends to spike from it.
The information you will glean does not mean you'll have to remove the food from a plan; it simply shows you what special steps you'll have to take for your child when he enjoys that food.
So when can a parent go too far? Once you are well into your diabetes life, there will be no need to write down everything a child eats. In fact, in time, a food journal will only need to be reviewed and updated a couple of times a year at most. Don't get bogged down in watching and planning. Be conscientious, but not overreactive.
Do I need an official food journal?
No, a simple notebook that you keep on hand will do. However, there are a wealth of food journals available at no cost online that would allow you to keep it all in your computer. Simple ones can be found at Calorie Count and Dia-Log.com.
Recording Your Child's Reaction to Foods
So you get the information suggested above. How do you keep it and what do you do with it? Let's say you've discovered a great new healthy pizza recipe. Pizza has always been a food that messes with your daughter's blood sugars, and you are hoping this will help. Prepare the meal and record her reactions as suggested in the previous section. Be sure to take into account any special circumstances each day.
For example, if she played hockey for an hour before the meal, her reaction could partially be due to the activity, and that needs to be considered. Once you've served the meal a few times with few variables, look for patterns. If she seems to be ending up a few hours later within her target blood sugar range, you've hit on the perfect insulin dose for this meal.
But don't pat yourself on the back for too long. Doses tend to change annually or even more often during growth spurts. Check again if you see something questionable happen. These recordings will help you help your child enjoy all foods and, more important, understand what all foods mean to her.