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July 22, 2004

Behavior, Meal Planning, Food and Diet

Question from St. Johns, Newfoundland, Canada:

I'm 16 years old. I have a question to ask that I couldn't ask my doctor or my parents because they might get upset or something. I'm never really hungry, so I don't eat breakfast or lunch. I do eat supper and sometimes a snack. Is this bad for diabetes? If so, how? I don't understand why you have to eat when you're not hungry. Do you gain weight if you take insulin and don't eat? I've been wanting these questions answered for a while now, but I didn't know where to get them answered until my friend told me to search the Internet and then I found this site, which looks like a good place I could trust with my questions.

Answer:

I believe that many young people feel like you do and often want to skip meals and snacks or have them at different times from when their parents and diabetes teams advise. What matters in managing diabetes well is balancing the insulin with food. This requires quite a lot of knowledge and understanding about the different groups and types of food and how they will affect your blood glucose values. I don’t know what insulin regimen (number of injections and type of insulin) that you are on, but this is a critical element because some regimens allow quite a lot of flexibility (multi-injection regimens) while others (e.g. twice daily insulin) allow very little. I notice that you have had your diabetes since you were six years old, so it is entirely reasonable that your underlying knowledge may not be very good. What you must do is discuss with your team (and preferably also your parents) your desire to have some flexibility. It is also perfectly okay for you to ask for some teaching to bring you up to speed with your parents who got all the initial training. The only thing that you must not do is keep all of these concerns to yourself because you could be risking your health. I know that your diabetes team will not be phased in the least.

KJR