April 29, 2009
Meal Planning, Food and Diet, Research: Cure
Question from Roswell, Georgia, USA:
My 12-year-old daughter was diagnosed with type 1 on January 10, 2009. Her A1c was 11.9; now it is 6.7. For the last six weeks, she has not taken any insulin, as instructed by the endocrinologist. We have been pursuing other alternative sources for health and nutrition as well as following the endocrinologist’s plan to a tee. She has been very cooperative and desires to reduce her insulin completely or significantly. All of the information we see tells us to NOT stop taking insulin. Her numbers are 70 mg/dl [3.9 mmol/L] to 110 mg/dl [6.1 mmol/L] with monitoring several times a day and minimizing carbohydrates. She is on 1:100 and 1:60 ratios so this is not a problem, but we try to limit her to less than 20 gram of carbohydrates at meals. We have never heard in our research of a case of a child being removed from all insulin during the honeymoon.
We believe her body can be healed and we want to give her pancreas a fighting chance to heal by not making it dependent on insulin. If she were to go high (over 250 mg/dl [13.9 mmol/L]) then we would give her Humalog. We have had to give her three units in the past six weeks.
Our endocrinologist knows her situation but they have never asked us what she is eating (healthy or not healthy) and we are concerned about this industry not providing healthy alternatives to children with newly diagnosed diabetes.
Please provide some insight as to your opinion of her condition and the true possibility of healthy eating, nutritional supplements, and alternative therapies healing the pancreas.
We were told emphatically at the Emergency Room, when we admitted her, that she would be insulin dependent for the rest of her life and that she would take shots every day. Well, that has not happened. What next?
Answer:
There are some children who can stop insulin, but you are correct that this is rather uncommon. We believe that resting the damaged pancreas under such circumstances allows it to keep working for weeks or months. Overeating, obesity, and inactivity all require more insulin to be needed to process food and these are also things that you can do. All other “natural cures” have not much scientific basis so you are likely raising false hopes and wasting money. But, of course, this is also your right to choose. There are some experimental studies looking at ways to turn off or turn down the autoimmune process that look promising in animals and in very early human research but these remain experimental at present. In our practice and those of most other diabetologists, the best way to rest the pancreas in this very early phase is to continue a small dose of insulin and to do profiles of blood glucose levels before and one to two hours after eating as a guide to how much insulin to provide. Make sure you stay in close contact with your diabetes team for specific guidance.
SB
[Editor’s comment: For guidance on meal planning, your endocrine team should have a dietitian who can help you. You may benefit by reading some of the previous questions we have answered on Meal Planning, Food and Diet. Some general dietary guidelines are also included in Chapter 12 of Dr. Peter Chase’s book, Understanding Diabetes, 11th Edition , “Food Management and Diabetes.”
BH]
