In saying this, it is easy to forget that the answer is likely to have been "No" even if the child did not have diabetes: "No, you will damage your teeth", "No, we can't afford it", or "No, in our family we have sweets only on Saturdays". The practical effect will be the same (no sweets) but, for the child, the difference is important. If you always refer to the child having diabetes when saying "No!", the child will soon start hating the illness which appears to lie behind the limitations. He or she will start to believe that it is the diabetes alone that makes this and everything else impossible.

We don't want to ban sweets from children with diabetes, but neither do we in any way want to say that they are unrestricted either. The message is that of course you can have some sweets or ice cream - but you need to think about how and when to eat them so your blood glucose will not be affected too much. Most adults allow themselves a treat every now and again. So children, too, should be given opportunities to manage their insulin and food in a way that enables them to enjoy something sweet on occasion, without their blood glucose rising too high. Going to parties is far more fun if you can eat the same food as everyone else. However, just as adults won't feel well if they go out partying all the time, we emphasize to children that this is something they can do only on special occasions, not every day. Too many sweets are not good for people without diabetes either. They provide empty calories, which increase the risk of weight gain and cause damage to your teeth.

It is all about freedom with responsibility and to master this you need to practise and experiment. It is important to monitor your blood glucose before and after you have tried something new. It will often not be perfect at your first attempt but after a few times you will learn better how your body works. The logbook is important so that, later, you will remember what you did and how it turned out.

Chocolate

Chocolate contains fat, which will slow down the absorption of glucose by emptying the stomach more slowly. For example, you may eat a small chocolate bar (24g, 1 ounce=14g carbohydrate) for a snack instead of an open sandwich. This may be fine occasionally, but (in common with anyone who does not have diabetes) you should not snack like this every day. However, when you are physically active you will probably be able to take a small chocolate bar in addition to your usual snack without problems.

Sweets

A good idea is to exchange the apple of the afternoon snack for a box of sweets that contain jelly, making them tougher to chew, and causing the sugar to be absorbed more slowly. Other sweets, which taste sweet and easily break into small pieces during chewing, contain mostly pure sugar. Sugar-free sweets usually contain sorbitol, which is better for your teeth and raises the blood glucose level more slowly. Tell children these facts at the same time as they taste sweets of various types, in order to help them recognize the difference.

One box of jelly-type sweets sweetened with sorbitol (about 15g) has the same blood glucose-raising effect as an apple or a pear. Keeping sweet intake low is a good rule for all children whether or not they have diabetes. This situation should be the same for families without diabetes, in that it is the parents who decide which rules apply. The important thing is that children with diabetes feel that, as far as possible, they receive equal treatment as their friends without diabetes and siblings when it comes to sweets.

These principles for managing eating both ice cream and sweets combine freedom and responsibility. In order to learn how to manage different situations well, you will need to practise and experiment. It is important to measure your blood glucose level both before and after trying something new. It is likely that your blood glucose level will not be quite as it should be the first time around, but after a couple of times you will get to know your body better.

Taking a break from eating sweets

It is not easy to manage diabetes if you are eating large amounts of sweet things as everyone who has tried can testify. Even so, many individuals with diabetes do this. This is a bit like smoking for some people - just cutting down doesn't work. Try then to avoid eating sweets completely, at least for a while. If it is difficult to say "no" to yourself, do not keep them in the house. Unfortunately, excessive sweet eating must remain exceptional behaviour for any person with diabetes. And if you do something every day, it ceases to be exceptional.

Many families practise a system of taking a break from eating sweets, whether or not they have diabetes in the family. Children may then receive money instead or some other kind of bonus if they can manage without sweets for 6 months or a whole year. This system works well for children who benefit from not having sweets for other reasons as well, such as those who are overweight. If you have weight problems you will find it difficult balancing sweet eating with diabetes. If you eat sweets containing fat, this will have less of an effect on your blood glucose, but it will cause you to put on weight. If you eat sweets containing less fat, they will have a greater effect on your blood glucose level. A total break from eating sweets may be your only chance in this situation if you want to manage both your weight and your HbA1c.

Chewing gum

Chewing gum contains such small amounts of sugar (about 2 g per stick) that chewing one piece at a time over a couple of hours will not cause you a problem. If you chew in this way, you will find little disadvantage, from the point of view of your diabetes, in using ordinary chewing gum, as opposed to the "sugar-free" variety. Your dentist will almost certainly recommend the latter of course. If you prefer chewing half a packet at a time, it is better to choose a brand with an artificial sweetener.