
May 26, 2006
Insulin Analogs, Meal Planning, Food and Diet
Question from United States:
My teenage daughter hates taking insulin and has been consistently skipping her supper time NovoLog by consuming only vegetables and meats. She also jumps up and down one hour after eating. Her blood sugar is usually within range four hours afterward, although sometimes a little higher at 144 to 162 mg/dl [8.0 to 9.0 mmol/]. Are there any dangers in doing that? With no fast acting insulin to counteract food consumed, would her blood sugar run very high right after eating? She doesn’t want to check her blood sugar two hours after meals.
Answer:
One of the problems with teaching flexible insulin therapy is the patient learns. I mean that in a slightly jesting way, but do mean it.
The advantage of the fixed diet was the “prescribed” carbohydrates, protein and fat. We prescribed and patients didn’t usually follow. So, it really wasn’t better. Now, we want a varied and healthy diet.
I guess the most disturbing thing about the note is the “hates to take insulin.” That worries me as you likely face issues with other meals, the long acting insulin, etc. and eventually poor control. Try to help her and seek help through your diabetes team to address that issue. The blood sugars you quote aren’t the issue.
LD