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July 2, 2002

Daily Care

Question from Daly City, California, USA:

My 22 month old grandson has type 1 diabetes. I don't believe my son is paying enough attention to what my grandson eats and depends too much on the insulin injections. I thought both were important. What advice can you give?


Diet is an important part of good care of diabetes. I would recommend avoiding simple sugars (except for rare treats) when possible and focusing on a healthy well-balanced diet.

Additional comments from Dr. Jim Lane:
I think we strongly encourage children with diabetes to think about issues of nutrition and health before their peers have similar concerns. I hope that lifestyles are healthier, but I am not convinced of that. There are alot of people that do not get access to the care they need to treat the diabetes, for alot of reasons. I think there is room for encouragement. We have shown that our therapies to work to prevent complications. We are continuing to do research directed at prevention and a cure for diabetes. Until then, we need to continue to support diabetes research.


[Editor’s comment: I’m not quite why you are posing this question. If you think that paying closer attention to what your grandson eats will eliminate the need for insulin, you are mistaken. Your grandson most assuredly has type 1 diabetes which means that his insulin producing cells have been destroyed so that insulin now needs to be replaced by injection until another delivery method or cure can be found.

If you are concerned, I’d suggest that you discuss this directly with your son. I’m sure that he has consulted with a dietitian, well-versed in the management of toddlers who have diabetes. The goal of meal planning in a child this age is to provide adequate calories for growth and development, reasonable blood glucose control, and devised according to the usual eating habits of any toddler (diabetes or not). Insulin is typically given based on the child’s individual eating pattern. Trying to change normal toddler behaviors can be deleterious to psychosocial development and will not alter the need for insulin.

Sweet Kids: How to Balance Diabetes Control & Good Nutrition with Family Peace by Betty Brackenridge and Richard Rubin is a great reference for managing a toddler with diabetes. You might find it quite useful for yourself and your son (and grandson!).