**1. Introduction**

[164] Berlin KS, Davies WH, Jastrowski KE, Hains AA, Parton EA, Alemzadeh R. Contex‐ tual Assessment of Problematic Situations Identified by Insulin Pump Using Adoles‐

[165] Di Battista AM, Hart TA, Greco L, Gloizer J. Type 1 diabetes among adolescents: re‐ duced diabetes self-care caused by social fear and fear of hypoglycemia. Diabetes Ed‐

[166] Sparapani VC, Borges AV, Dantas IO, Pan R, Nascimento LC. A criança com Diabe‐ tes Mellitus Tipo 1 e seus amigos: a influência dessa interação no manejo da doença.

cents and Their Parents. Families, Systems, & Health 2006;24(1) 33-44.

Revista Latino-Americana de Enfermagem 2012;20(1) 117-125.

ucator 2009;35(3) 465-475.

468 Type 1 Diabetes

An optimal nutrition along with insulin therapy in pations with type 1 diabetes, is the pre‐ requisite for normal growth and development, adequate pubertal development, and regular performance in school and extracurricular activities, including sports in diabetic patients. Moreover, a balanced and healthy diet prevents hyper- or hypoglycemia and delays devel‐ opment of microvascular diabetic complications, including diabetic nephropathy. (Kliegman M Robert et al., 2007)

Dietary recommendations for children with diabetes are based on healthy eating recommen‐ dations suitable for all children and adults and therefore the whole family. Nutritional ad‐ vice must be adapted to cultural, ethnic and family traditions and the psychosocial needs of the individual child. Likewise the choice of insulin regimen should take into account the di‐ etary habits and lifestyle of the child.(NICE, 2004., American Diabetes Association, 2003)

A meal plan based on the individual's usual food intake should be determined and insulin therapy integrated into the usual eating and exercise patterns. Individuals on insulin thera‐ py need to eat at consistent times synchronized with the time-actions of insulin, monitor blood glucose levels, and adjust insulindoses for the amount o food usually eaten or re‐ quired ( Frany J. Marion et al., 1994).
