Question:
Our 3 1/2 year old daughter was recently (3 weeks ago) diagnosed with Type 1
Diabetes. Her initial B.G. was at 850. She was stabilized after about 4
days in the hospital. After about 1 week at home her endocrinologist decided
on her insulin dosage to work with as a target (using what he calls a
sliding regular) based on a BG of between 70-150.
The problem that we are experiencing is an insatiable hunger. Within 15
minutes of her being done with her meal or snack, she is complaining about
being hungry (very). The Doctor has put her on a 1200 calorie diet which we
are sticking to. Her hunger is disconcerting and frustrating at best. Is
this just a phase she is going through? Or is there something else that
we don't know about?
Answer:
We feel that growing kids should rarely if ever be put on a strict caloric
intake. It sounds to us like her hunger is indicating that she's trying to
make up for loss of body weight before the diagnosis was made. For kids of
this age, 1200 calories may not be enough.
Talk to a dietitian who knows little kids and diabetes, and ask the
dietitian to assess your daughter's actual caloric need, and to give you
advice about how to add more calories to satisfy hunger, and to allow for
normal growth in her body size.
Also, we wouldn't be using a standard "Sliding Scale" of insulin at this
stage of the game: instead, we'd try to get the insulin doses stabilized
with a combination of NPH and Regular insulin.
Please don't consider this to be "just a phase she is going through;" with a
revised meal plan and medication program, your daughter's hunger should be
satisfied.
Original posting 30 Dec 95