My 13 year old step-daughter, who only visits with us every other weekend, was diagnosed with type�1 diabetes two years ago and has been on a pump for about six months. Before the pump, her diet and everything she ate was monitored. Since she was trained to use the pump, she eats just like my seven year old daughter (who does not have diabetes) and just “dials up” for whatever she wants to eat. When she visits I feel like a “mean step-monster” because candy and sweets doesn’t seem right to me, and I constantly question her eating habits. Since she doesn’t live with us, she basically tells me I don’t know what I am talking about. Is it true that with the pump you have the freedom to eat like someone without diabetes?

Even though your stepdaughter uses an insulin pump for her diabetes, it does not give her full license to eat unlimited amounts of candy and sweets (just because she can bolus for it). Keep in mind that any kid should strive for a balanced diet. A smart person who uses carbohydrate counting can work in occasional sweets in moderation just like anyone who does not have diabetes.

I stress to patients starting pump therapy that weight gain is likely for two reasons:

better chance of obtaining tighter blood sugar control
more food options becoming “allowed” into a meal plan

The answer to your question — yes and no. A pumper can eat more like a person without diabetes, but need to be wise about working in those higher carb choices. Hopefully your stepdaughter is positive about the pump. This is a perfect age for a kid with diabetes (with the right amount of responsibility and carb counting “savvy”) to manage blood sugars more effectively.

JMS

[Editor’s comment: The Food Guide Pyramid is a good model to follow, whether someone has diabetes or not.

SS]