I am researching information about eight year old twins, who have had type 1 diabetes from an early age. These are foster children who have had traumatic early experiences compounded by diabetes that was not identified properly by their biological mother. Both boys are quite thin and do not gain much weight.

They need to eat all the time and tend to steal snack food, treats, milk, etc. from the lunchroom and teacher’s rooms in school. They are monitored frequently, but have become adept at sneaking foods of all kinds, hiding them in their pockets or bookbags. Although they are repeatedly counseled by the school nurse about the importance of eating nutritious food and staying away from snack foods, they continue to show defiance.

Do children with diabetes need to be eating constantly? Is there some other message they are giving to those who care for them? There are undoubtedly emotional issues present in this situation, but to what degree is their behavior a manifestation of a medical condition?

You do not state how you are involved with these boys. Are you a teacher? A foster care parent?

Children with diabetes should not need to eat constantly. Their sneaking foods likely has very little to do with their diabetes, and more to do with their traumatic past. Please help to get them to a diabetes team that has counseling available to help them learn more effective and healthier ways to meet their needs other than sneaking foods.

JWB

[Editor’s comment: If these boys are stealing food and not gaining weight, it also might be they are indeed hungry. I would be curious to know their level of blood glucose. If it’s consistently high, their bodies are starving! Whether the problem has a physiologic or psychologic basis, is really a matter of semantics at this point.

It seems to me that these boys need a thorough evaluation by a diabetes team (including an endocrinologist, a nurse educator, a dietitian, and a mental health specialist) which is experienced in dealing with children. Such a team will be able to properly sort out what is going and develop an appropriate treatment plan, which is beyond the scope of what we here can do for them.

SS]