It is very difficult to control my daughter’s blood sugar levels as she is a toddler. She is now aware that there are some foods that she cannot have and those we give her in limited amounts. All she seems to focus on is food. She is always hungry and is always asking for food and more food. Sometimes, I have to give her extra insulin to adjust to the amount of food that was eaten. Often, when I check her blood sugar, she is over 300 mg/dl [16.7 mmol/L]. Is it okay to give extra insulin so often? Should her meals be tightly controlled even if she is screaming for more? How much weight should she gain?

My typical advice is to concentrate on a healthy diet in all patients. Avoid simple sugars when possible and replace them with good tasting sugar substitutes. If your child is hungry, my advice would be to feed her and cover any carbohydrates with insulin based on the insulin to carbohydrate ratio that your diabetes team has suggested (i.e., one unit for each 15 grams of carbohydrates).

Dietary advice that strictly regulates the amount of food offered to a child and giving no flexibility for a hungry child, is not likely to be the best advice or most current advice in treating kids and teens with diabetes. A knowledgeable diabetes educator or dietitian that is familiar with current therapies in type 1 diabetes may be your best resource for additional information.

MSB