My 12 year old grandson, diagnosed about one and a half years ago with type�1 diabetes, has continued substantial and frequent fluctuations in glucose levels, and there is considerable controversy in the family about the effects of carbs, proteins, and fats on this pre-teen (in the early stages of puberty). He often complains of hunger, but he’s a picky eater. We try to adhere to the eating plan prescribed by his team dietitian. If he needs more food, wouldn’t it be better to allow him a few extra proteins (low-fat turkey, ham or beef, all of which he likes) rather than carbs which, of course, he often craves?

Puberty is a wonderful thing, isn’t it? For a teenage boy, in one moment you have a refrigerator full of food, and a bit later, just a pile of dirty dishes. I think that a proper approach/answer to your question hinges a lot on his insulin regimen. Nevertheless, I have a couple of ideas.

First of all, your approach would generally be perfectly fine! He’s hungry? Then let him eat “free foods” (veggies, sugar-free, etc.) or less concerning foods (protein, low carb/low fat). I generally do not advocate withholding food when the child is hungry despite higher readings. That is a set up for a possible eating disorder. However, you might specifically relay your observations to his diabetes team or dietitian. They may not recognize that he is in a growth spurt (if he is) or appreciate fully his extra activities or his increased calorie needs while in puberty. Remember that pubertal hormones also inhibit to some degree the effects of insulin so his insulin dosages may need to be adjusted also.

DS