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October 18, 2009

Daily Care, Meal Planning, Food and Diet

Question from Aguadilla, Puerto Rico:

My two-year-old daughter was diagnosed five days ago with type 1 diabetes. The nutritionist gave her a diet of 1200 calories which includes having one egg daily. Would this cause an increase in her cholesterol? She is still at the intensive care unit of the hospital as they have not been able to get her ideal insulin dose to control her blood sugar. She has been between 200 and 300 mg/dl [11.1 to 16.7 mmol/L] since her diagnosis. What do you advise?

Answer:

A daily egg should not be harmful for your daughter. In general, you should also focus on a healthy selection of foods for your daughter limiting simple sugars when possible. A nutritionist familiar with the treatment of very young children with type 1 diabetes will be very helpful to you. Counting calories can be a less than successful strategy in children with diabetes. The strategy I usually employ is to focus on a healthy diet — and use rapid insulin (e.g. trade names are Humalog, NovoLog, or Apidra in the U.S.) to treat high blood sugars and for any carbohydrate intake at meals or snacks. The amount of rapid insulin to take is typically based on the amount of carbohydrates eaten as well as the blood sugar at the time of the meal or snack.

MSB

[Editor’s comment: With respect to your daughter’s elevated blood sugars, your doctor should continue to adjust her insulin until her blood sugars are lowered to a range with which he/she is comfortable for a child so young. Once your daughter is released from the hospital, you should keep in close contact with your diabetes team as you adjust her insulin dosing. Your daughter may go through a honeymoon period in which she needs little or no insulin. Many endocrinologists recommend that you try to continue giving background insulin, such as Lantus, in very small doses, to try to extend the honeymoon. This time varies from person to person. Be sure to have your doctor teach you how to deal with low blood sugars, high blood sugars and sick days.

BH]