The old way was based, for the most part, on having to help the body react to the different peaks of insulin varieties that children were given. The standard meal plan was precise and hard to stick to, and yet, that was what was done.

Traditional Meal Plan and Why It Was Done

Traditional meal plans were broken down in pretty much the same way across the board: three meals and three snacks with each meal featuring a serving of each food group, and each snack containing about 15g of carb (a double snack if extra activity was expected). Children had to be fed at exactly the same times every day, and rarely, if ever, at other times. Needless to say, it was hard to get a child of any age to adapt to such a life.

If, for example, Thanksgiving dinner was coming up and the family was expecting to eat at 2 P.M., parents would have to begin planning days in advance to make that work. Something as simple as a school lunchtime being changed would send shivers of fear down the spine of a parent.

And yet, even to this day, parts of the meal plan make sense. With everything around diabetes being so hard to put your finger on (since the weather, stress, changes in activity, even a test that day can affect a child's blood sugar), the discipline of serving planned and expected meals and being aware of carb totals and ingredients take some of the guesswork out of figuring out the daily treatment of a child with diabetes.

Rapid-Acting Insulin and the Advent of a New Plan

Or, should we say the plan-less revolution? For families who had been dealing with the regimented meal plan for years, the introduction of rapid-acting insulin, be it by needle, pen, or pump, meant a whole new way of living.

As many medical teams told families to watch what their child eats but to let him eat like any other child, the glee of being free from the anchor of a meal plan led many families to go, as some would say, hog wild. After all, if you've forced a child to eat at exact times every day for years (and exact amounts, no more and no less) and suddenly you can just go with the flow, you're going to go with a heck of a lot of flow.

So the motto came to be embraced and embraced quickly: A carb is a carb is a carb. Families rejoiced as they let kids eat breakfast late (after having to drag them out of bed and feed them at exactly 7:30 every morning for years). So, too, did they smile when they heard the once-horrifying bells of an ice cream truck, because no longer did they have to hope that truck would only show up at exactly 8 P.M. or at the exact moment a child experienced a low. Those first years of rapid-acting insulin were giddy times. But like anything, a balance had to come.

Finding a Balance Between the Two

While it is true that rapid-acting insulin leads to more freedom and choices and less stress, most diabetes experts now agree that it's best to have some kind of plan, even if it is just there to ignore from time to time. Most nutritionists agree that the ideal way to treat blood sugars in a child with diabetes is with the combination of a set meal plan and rapid-acting insulin.

That said, almost no parents today are doing exactly that. After all, although the rigidity of the set meal plan may lead to a better assessment of where blood sugars are going, it also can lead to eating disorders at the worst and an obsession with food (and the control of it) at the least. It's not easy being a child on such a meal plan, and since raising a child with diabetes is about treating the whole child — physically, psychologically, and socially — parents, with the help of their medical team, need to look at the entire picture and come to a compromise.

So how to find a balance? The best bet is to think the way you would for any healthy child. For the most part, children need regular meals and regular snacks. Set a goal of three healthy meals a day and allow for snacks as the mood hits, but not too many every day. Think variety, health, and not too, too many carbs.

By setting that as your base and allowing yourself to hop off it from time to time (just as any parent of any child would), you'll set a standard that your child should be able to not only live with, but learn by.

Still, while it's true that you expect to serve three square meals a day, what if you are invited to a brunch? There is no reason you cannot skip breakfast with your child, head to brunch, and even let him overindulge a bit, making sure you count the carbs and cover them with insulin. Would you do that every day? No, but neither would you do so for any child. Point out to your child that you are treating him almost the same as you would a child without diabetes.