My daughter is 13 and has been diagnosed for less than two weeks. She wants to consume the bulk of her 2500 calories from 2:30 pm until bedtime. Can she do this as long as her insulin covers the carbohydrates/calories? I’m afraid it will be nearly impossible to change her habits, but I will try if this detrimental to her health.

Your question is a very good one, and, certainly, pertinent to those of us who work with teenagers. My personal opinion is that very quick acting insulin (Humalog) can be used to cover calories when eaten. If that is your daughter’s lifestyle, you may be very wise to work within her eating patterns. Your diabetes team dietitian and nurse should be able to help you with this insulin and food plan. As a health care professional, I would support calories spread throughout the day, especially with something to start her day on, but I would approach that at a later date. Maybe, she’ll actually come to that realization on her own! Learning to deal with diabetes is a big hurdle, so giving her some control over issues that are important to her may help ease her path.

LW

[Editor’s comment: I agree that your daughter needs space right now. If she isn’t on a flexible insulin program with multiple daily injections, ask your diabetes about it. In addition, as soon as you and she feel comfortable with diabetes management, I would strongly urge her to consider using an insulin pump.

SS]