Although individuals with
insulin-dependent diabetes mellitus (
IDDM) represent only a small proportion of the total number of persons with diabetes,
IDDM is one of the most prevalent chronic childhood diseases. The goals of management in
IDDM include normal growth and development, control of
blood glucose, maintenance of optimal nutritional status, and prevention of complications.
Insulin replacement is the mainstay of treatment in
IDDM; however, optimal
therapy requires a careful balance of food,
insulin, and physical activity. To our knowledge, this is the first comprehensive nutrition review of
IDDM that emphasizes research specifically in the area of
IDDM (vs
non-insulin-dependent diabetes mellitus), including data on children and adolescents when available. the process of nutrition education utilizes a staged approach beginning with "survival" information and progressing to in-depth or continuing education and counseling. Important considerations should be to guide the child/adolescent to a meal plan that fits individual life-style, promotes optimal compliance, and advances the goals of management. Throughout the diabetes nutrition education process, the dietitian can positively affect the lives of children/adolescents and their families. More research is needed to better define ways of meeting the nutrition needs of children and adolescents with
IDDM in the areas of fiber and
glycemic control,
fish oil and
lipids,
sodium and
hypertension, and weight control.