My almost five year old stepson, who has type�1 diabetes and takes three shots of insulin a day, has very irregular blood sugar levels when we have him, and we are having a hard time with his diet. The doctor has suggested several different methods, but nothing to me seems to be working. He is typical kid who burns a lot of energy. We need help finding a good diet for him, so that his eating habits will be strong and balanced when he is an adult.

I would recommend that you and your stepson schedule a visit with a registered dietitian who specializes in working with children who have diabetes. Meal planning for diabetes nowadays is more individualized and personalized to the person’s food preferences and usual eating times. This individualization assures adherence without compromising optimal blood sugar control. Ask your stepson’s physician or diabetes team for a referral to a registered dietitian.

JMS

[Editor’s comment: Irregular blood glucose levels are not at all unusual for a five year old, especially one who goes between two households. The stress of this situation and increased activity is quite frequently expressed as high blood sugar, and when that stress wears off, the blood sugar often goes low.

If your stepson’s overall control (as reflected by a hemoglobin A1c) is acceptable, I wouldn’t worry about it too much. However, Mike’s suggestion is an excellent one, if for no other reason, than to give you peace of mind.

SS]