My 11 year old daughter was diagnosed last week. We are “Carb Counting” but are concerned with total calorie intake. She has gained 4 pounds in less than a week (she lost 11 total but was a little overweight). Should we also monitor total fat and calories? We are concerned because of future problems that may be aggravated by the combination of diabetes and extra weight.

One of the unfortunate things about carbohydrate counting is that even though we as dietitians stress that a balanced diet — moderate in fat intake and protein — is important, sometimes it just boils down to grams of carbohydrate. It is very important that children, regardless of whether they have diabetes, eat a balanced diet with about 50-60% of calories from carbohydrates, about 15% from protein and 30% from fat. If there is heart disease in the family, fat intake may need to be reduced further. The Food Guide Pyramid gives good guidelines on how to achieve this.

It is not uncommon for children to have a rapid weight gain after diagnosis. You need to discuss this issue with your diabetes team, especially the dietitian so that adjustments can be made in your daughter’s management plan to help address your concerns. Remember this is all pretty new and her metabolism has been affected and will take a little time to regain it’s balance.

JM