October 2, 1999
Question from Cheddar, England:
I am an American teaching in England. I have a student who hates being a type 1 diabetic. She is 14 years old, weighs about 107 and is 5’7″ tall. She has started menstrating. She has decided to try a diet that her mother is on because it promises to “cure” diabetes. This diet is all vegetables, no meat, no dairy, no salt, no fruit. 75% of the diet is raw vegetables. A large part of the population here is vegetarian and so this diet does’nt seem to be extreme to most people. My concern is that her blood sugar level for the past 4 months has been extremely irregular, one day registering 9 the next day 14, the next day 18 and then back down to 8. Her doctor told her it is because of her hormones. Do you have any idea about whether or not this diet might be affecting it? She has not completely started the diet yet but has started cutting the dairy out of her diet, and only has meat about once or twice a week.
Currently, there is no cure for diabetes. It can be treated and well managed. My own position is that any meal plan that excludes entire food groups is less than ideal. It sounds as if this child is quite underweight and I am surprised she is having her period.
I must defer to my dietitian friends about the content of your student’s diet, but on the face of it, this sounds like a nutritional nightmare.
Additional Comments from Betty Brackenridge, diabetes dietitian:
I agree that nutritionally this eating plan is questionable, and at your student’s age a nutritionally complete eating plan is very important to assure normal growth and development. In terms of her diabetes, I would guess that her eating habits are contributing greatly to her erratic blood sugars. If she is on an unchanging insulin dose but changing her food intake significantly from day to day and meal to meal, she will have erratic blood sugars over the wide range you describe.
However, I feel the more basic issue that must be resolved is the lack of acceptance of the diagnosis of diabetes that this child and her mother are dealing with. From what you say, neither accepts it. Both are either angry or frightened or both. Taking a logical and effective approach to managing a condition that you don’t even want to believe is here to stay
is all but impossible. If you have any influence with this family, I suggest finding a psychosocial worker who knows families and diabetes and can help these folks work through their issues. With some of the emotional issues out in the open, it should be somewhat easier to examine her food intake and design an insulin plan that will give her a greater degree of control and freedom.
Additional Comments from Joyce Mosiman, diabetes dietitian:
I agree. Depending on the vegetables chosen, the carbohydrate content of the diet could vary drastically which could influence the blood sugars. A consistent intake for each meal from day to day will produce the best results. A vegetarian diet can be very healthy, however, one excluding fruit does not seem nutritionally adequate and I would be concerned about the calcium intake of a young woman who has discontinued dairy products. At the very least she needs to see a
dietitian familiar with vegetarianism and diabetes.