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November 3, 2004

Insulin, Meal Planning, Food and Diet

Question from Manila, Philippines:

For a 13 month old boy, just diagnosed, with poorly controlled type 1 diabetes, what should his ideal dietary prescription be? He drinks milk formula from a bottle. He also currently has pneumonia. His blood sugars fluctuate from 225 mg/dl [12.5 mmol/L] to 573 mg/dl [31.8 mmol/L]. He is now getting an insulin drip of 0.1 units/kilogram/hour.

Answer:

Assuming his DKA is now resolved, which it may not be if he’s still on a drip of 0.1 units per hour, I would recommend looking at the total daily dose of insulin he requires and then calculating a carbohydrate/insulin ratio of 1 unit per — grams (number of grams determined by taking 500 divided by the total daily dose of insulin) and giving him an extra bolus of insulin each time he takes a bottle or other food.

LAD