ALTERNATIVE SNACK SYSTEM FOR CHILDREN AND TEENAGERS WITH DIABETES-MELLITUS

An alternative snack system facilitates diabetes management and provid es a teaching tool for age-appropriate nutrition education of children and teenagers with diabetes mellitus. The system consists of four sna ck sizes: Mini - 7 to 10 g available glucose, Little - 15 to 20 g, Big - 30 to 35 g, and Super-Big - 50 to 55 g. Within each category, sever al snack patterns are equivalent to each other in terms of available g lucose and energy. By using this system, a child or teenager can eat s nacks that contain different food groups and still adhere to the overa ll meal plan. When additional carbohydrate is needed for exercise or t he prevention of nighttime hypoglycemia, a snack from the next largest category will increase available glucose by approximately 15 g and en ergy intake by approximately 100 kcal. Generally, for every hour of ex tra physical activity, a Little snack is added. When blood glucose con centrations before a nighttime snack are 4.4 to 6.7 mmol/L, a Little S nack is added to the usual bedtime snack, and when levels are less tha n 4.4 mmol/L, a Big snack is added. Further adjustments are made for c hildren younger than 5 years old. The alternative snack system is a va luable nutrition education tool for the management of diabetes in chil dren and teenagers.