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Question:

From Niantic, Connecticut, USA:

My daughter was diagnosed with Type 1 diabetes at 13 months of age. She is now 18 months and we are doing our best to control her blood sugars. Her counts do tend to be all over the place -- sometimes high, sometimes low and not very predictable.

I have spoken with a few people whose children were diagnosed around the same age. Some treat high blood sugars strictly with diet by withholding carbs, some strictly by giving additional shots of Humalog. My husband and I tend to do a little of both. It all depends on when her "high" is and when the latest dose of insulin is do to peak. Currently she takes Humalog, Lente and Ultralente and all, obviously, peak at different times during the day.

My questions are:

  1. Is it preferable to treat high blood sugars with diet instead of additional insulin?
  2. Are there long term problems related to withholding carbohydrates or using additional insulin?

Answer:

  1. Never withhold food: children are growing and need the nutrition. It also creates psychologic problems, and potential eating disorders later.

  2. You may get into trouble with bouncing blood sugars by giving extra Humalog for highs; I wouldn't advise giving it unless its been extremely high for several measurements.

  3. Talk with your diabetes team: kids this age have varying appetites and often giving insulin after a meal based on what's eaten works better.

  4. It might help you to read Betty Brackenridge's book, Sweet Kids: How to Balance Diabetes Control & Good Nutrition with Family Peace.

  5. Kids this age do fluctuate a lot. That's a fact of life.

SS

Original posting 21 Jun 1998
Posted to Hyperglycemia and DKA

  
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Last Updated: Tuesday April 06, 2010 15:08:58
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