My 11 year old, diagnosed at age five with type 1 diabetes, has always maintained pretty good control of her blood glucose (with my help of course) until now. Lately, she has been sneaking a lot of food and regular soft drinks. Her last HbA1c was 9.2%, and I’m really worried. She knows of all the complications and still does it. I have tried grounding her and that doesn’t work. I am at a complete loss at what to do next.

Your child’s sneaking of foods is not that uncommon. This does not mean, however, that it should be ignored. To help her, you may need to ask yourself some important questions. First, does your family have “forbidden” foods? With the newer insulins and carbohydrate counting, there should not be any forbidden foods for people with diabetes. If she is sneaking because she believes its forbidden, then its vital that you contact your diabetes team and speak with your dietitian about carbohydrate counting and the flexibility in food choices that allows.

Second, how do you react to her eating these foods? Do you get angry or talk immediately with her about the long-term consequences of chronically high blood sugars? If so, then she may be continuing to eat these foods to challenge you.

Third, has she gone through a growth spurt and needs more food? Perhaps her increase in appetite is because of a growth spurt where she then also needs an insulin dose adjustment. Or, her higher blood sugars can be causing her to feel more hungry, so she eats more, has higher blood sugar numbers, and then a vicious cycle begins. Keep in mind that if she does eat more than you expect, the resulting high numbers can be addressed with more insulin. Talk this over with your diabetes team to review these possibilities.

Finally, punishing children around food never works (as you’ve already discovered). In fact, anytime something is “off limits” we want it all the more. With the help of your team’s dietitian, perhaps you can work out a plan where your daughter can fit in some of these foods in a more planned and open way.

JWB