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February 16, 2007

Meal Planning, Food and Diet, Other

Question from New Jersey, USA:

My son has achieved excellent control of his type 1 diabetes since his diagnosis 13 months ago. He is 18 years old, uses an insulin pump, and has had A1cs under 6%. The doctor prescribed a regular diet, which I still cannot get used to, since I was a registered nurse and remember the "diabetic diet." He can eat cake, ice cream,chips, etc. Isn't this bad for him? He simply eats the cake and covers the carbohydrates with insulin by counting carbohydrates. Is this okay to do? Or, is this a bad habit which will eventually come back to haunt him? His LDL and cholesterol are well within normal limits. His LDL is well under 100. Also, he starts college in September and will live in a dormitory. The thought that a stomach virus can send him to the hospital, if he develops ketones and can't keep down fluids, is scary. Living in a dormitory situation, will stomach viruses be unavoidable? Should I expect that he'll ultimately get sick and require hospitalization? Other than hand washing, is there anything he can do to prevent a stomach virus? Under the ADA, can he request a private room and bathroom?


While I, too, don’t “restrict” the diet. I do talk about sense with it, including no sweetened drinks. There are real practical limits on the “bolus” of carbohydrates, especially sugar. I would counsel on moderation, a good notion for college with all the temptations.

As for a virus, I would advise that the real enemy is a bad site and not knowing. Changing a site and going to bed and not knowing it is good can get you in trouble. Not testing enough can likewise leave you with an unknown.

Teach about sick days. Teach about fluids, Pedialyte, other drinks, frequent checks and small amounts of insulin to cover carbohydrates. The duo in the dormitory isn’t the risk, every one he contacts is the risk. It is a risk he runs daily now, too. Don’t fret too much as long as he is willing to take good care of himself.


[Editor’s comment: As the parent of a college student, I understand your concern with illnesses and such, but I don’t necessarily think that a private room is a good option. A roommate might actually be helpful if and when your son is ill, injured or having blood sugar issues that might require another’s assistance. If there were an emergency, the roommate could go to a pharmacy or grocery store, or inject glucagon. Clearly, these are not things that a parent would ever want to experience, but a second set of hands or pair of eyes could come in handy.

With respect to his diet, see a recent previous question.