Dietary advice for individuals with diabetes has gone through periods of change over the decades in conjunction with changes in medical management. National (APEG) and international (ISPAD) evidence based clinical practice guidelines are available. These are essential documents that should be used to inform local clinical practice guidelines in any paediatric diabetes health service. It is apparent that not all dietary recommendations have a strong evidence base. The skill of the clinician is being able to translate current evidence, keep abreast of emerging evidence and ideally contribute further knowledge to the evidence base, while at the same time provide their patients with simple, clear and effective management advice.  

The overall dietary management for children with diabetes must be evidence-based where evidence is available. Insulin regimens are individualised based on the child’s usual routine and developmental stage. Dietary advice must consider the individual’s medical management alongside numerous other considerations. Research does support that quality and quantity of carbohydrate intake are a key priority in dietary management and that consistency of dietary carbohydrate intake remains important for all children with diabetes. However, no one method of quantifying carbohydrate intake is more beneficial than another. Dietary advice and education must be individually tailored to meet the learning needs of the family and the highly variable and constantly changing nutritional needs of the growing child. Consideration of specific developmental behaviours and lifestyle issues at each life stage are necessary to allow for the normal physical, emotional and psychological development of the child, while at the same time supporting best evidence-based practice to optimise long-term glycaemic control and quality of life.