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July 6, 2006

Meal Planning, Food and Diet

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Question from Shelby Township, Michigan, USA:

My daughter was diagnosed at 15 months. At that age, we were told we didn’t have to change her diet because she was a baby. She was eating cereal and milk. Since then, we never really deprived her of anything. Her A1c has always been good. The last one was 7.1. She is on Lantus and NovoLog.

We have a lot of family functions and there are always sweets. Is it bad that we let her eat cookies and cake at these parties? She has ice cream at home every now and then, especially in the summer. At school, when there is a birthday, I don’t want her to feel left out, so I usually arrange for her to have a small portion of the treat. I’ve asked her doctor if this was okay and he said that it was, as long as it wasn’t too often and her blood sugar was controlled. But, how much is too often and will this affect her later in life? She loves sweets. At this point, I can’t completely cut them out. I don’t know if what I am doing is going to lead into trouble later on. I know I have to cut it down somewhat, but I don’t know where to draw the line as far as school goes and family functions.

Answer:

From: DTeam Staff

EVERYTHING in moderation.

Your child is on a basal-bolus insulin plan. Therefore, in theory, she could eat ANYTHING she wants and, as long as she takes appropriate amount of insulin to cover it, then, she should do fine.

The problem is that REALITY is not theory. You may count her carbohydrates, but that does not typically take into account the calories from the protein (later converted into glucose), etc. And, what if you miscalculate the caloric/carbohydrate intake?

So, I think the “occasional” treat is not at all unreasonable, as long as you dose insulin properly. But, perhaps you are subtly (or not) teaching your child that she can eat “whatever/whenever.” I’d suggest some more discipline and educate others to be a bit forgiving and have more sugar-free snacks. It won’t hurt them and probably is better for them. Birthday cake? How about birthday cupcakes? It allows easier portion control and less frosting, etc. What about suggesting sugar-free Kool-Aid, etc.?

I am NOT saying “NO SUGAR” or “NO SWEETS.” But, I think you are really asking permission to be more restrictive (or is it less restrictive?). I’d aim for more appropriate choices.

DS