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September 25, 2001

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Question from Knoxville, Tennessee, USA:

My boyfriend does not know just how concerned I am about his type 1 diabetes. I want to ask him about it, but it's a sensitive subject to him. He went to the doctor about a month ago who said he was in perfect health, but I am still concerned. He takes his insulin twice a day, and I know he checks his blood sugar, but I don't know how often. I am also worried because he does not eat like he is supposed to. (He might eat like once a day sometimes.) I want to know about the average diet for a person with diabetes. I am scared he is not taking good care of himself sometimes because he gets in this state where he just wants to be alone and feels really sad about things such as bills and so forth. How often should he check his blood sugar?

Answer:

As far as a usual diet and activity, I think it would be a good investment for you to consider taking classes on diabetes management and therapy from a local diabetes education center. Most hospitals will have some information about such classes in their service area.

Your question is broad and requires a lot of description. In brief, I would say that most patients with type 1 diabetes should be monitoring blood sugars four times per day or more, eating three meals with intermittent snacks, and aiming for similar carbohydrate intake from one day to the next. It is not enough to take the insulin twice a day. Most intensive diabetes control regimens require three to four injections per day.

I would also suggest you take some time to speak with your boyfriend about where he stands with his diabetes. He needs to be at the front of his care. You can surely support him. However, he is the one who has to make the appropriate management decisions.

JTL