That thing under the soup, on the edge of the plate on the bottom left? That would appear to be a piece of cake, with some frosting that looks like spackle. I have to say, giving Lucas a sugary dessert with every meal doesn't really seem to be in line with treating his diabetes, unless these desserts are made with sugar-free frosting or some such, but even then, he doesn't need the calories. Also: putting the dessert on the same plate as the entree just makes him look like a little kid in a school cafeteria. Let's not forget that in addition to this, he drinks two glasses of milk, and one cup of coffee allegedly.
Because his meals are the only thing he documents visually anymore, it's obvious that eating is the only part of his day that gives him any pleasure.
They could probably save money by giving him a bowl of kibble.