Q: Our 12-year-old with type 1 diabetes just informed us that she intends to be a vegan. We want to respect her choices, but I've looked up some vegan recipes, and they all seem to have an overload of carbs. Is being a vegetarian or vegan realistic for someone with type 1 diabetes?
A: A vegan or vegetarian diet can work for someone with type 1 diabetes and should not be a problem for blood sugar control. If the carbohydrate content of your daughter's diet increases on a vegan diet, you may find that the insulin she needs to cover her meals may need to be increased accordingly. Your child's diabetes care team can help you calculate this adjustment or answer questions you may have about changes in insulin requirements. Most families are taught to adjust insulin for changing carbohydrate intake, and you may already be quite skilled at making these adjustments yourself.
The main issue you may have is making sure your daughter is still getting all the nutrients she requires as a growing girl, especially as she navigates the physical changes of puberty. This isn't to say that a vegan or vegetarian diet can't be healthy and meet all nutrient needs adequately. However, by eliminating animal products, vegans and vegetarians may miss out on good dietary sources of protein, iron, calcium, vitamin D, vitamin B12, zinc and riboflavin. Vegetarians and vegans must make a conscious effort to include the right foods from plant sources to provide these nutrients. In other words, replacing a turkey sandwich with a vegan cupcake at lunch isn't going to cut it!
If she doesn't take one already, you might want to talk to your daughter's dietitian about whether your daughter needs a daily multivitamin to help ensure adequate intake of all vitamins and minerals. As for food sources, iron can be found in dried beans, whole grains, and dried fruits, while zinc and riboflavin are found in nuts and legumes. All three nutrients are also provided by leafy green vegetables and iron-fortified cereals and breads. Calcium and vitamin D are usually found in vegetarian-friendly dairy products like milk, yogurt and cheeses; since vegans do not eat these, they need to get them from foods like broccoli, almonds, or fortified soy milk and tofu. Vitamin B12, on the other hand, is found primarily in animal products. On a vegan diet, a B12 supplement or B12-fortified foods (such as cereal) are needed.
Having a difficult time planning healthy family meals that adhere to your daughter's new preferences? Check in with the registered dietitian on your diabetes care team (or get a referral to one) for meal and snack ideas that will satisfy everyone.
-- Gail Spiegel, MS, RD, CDE, is a dietitian at the Barbara Davis Center for Childhood Diabetes, University of Colorado Denver.
Disclaimer: The information in these articles is not intended as medical advice. Families should check with their healthcare professionals regarding individual care.