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February 27, 2000

Daily Care, Insulin Pumps

Question from Connecticut, USA:

My daughter was diagnosed at 13 months; she is now 3 years old. About 2 months ago she started using an insulin pump. It has helped to level out her blood glucose levels, however, her appetite has increased. She always seems to be hungry. Besides her blood glucose levels spiking, she was also put on the pump because of her weight gain. She weighs 46 lbs and is 42 inches tall. Since she gets insulin 24 hours a day now in a basal rate, does the insulin itself trigger hunger?


From: DTeam Staff

Yes, insulin will drive hunger! Since she’s on a pump, discuss with your daughter’s diabetes team the possibility of giving the bolus after she eats, so that you can more closely match insulin with food intake. Everyone (including those of us without diabetes) are getting some insulin all the time, but perhaps her basal rates are too high. If you are “chasing” the highs with extra boluses, this creates a vicious cycle of more insulin provoking more hunger and hence more high blood sugar levels, then more insulin, etc.

It is essential that you have her meal plan reevaluated by a dietitian if you have not done so recently. She may just need more food. Please read the chapter on toddlers in Sweet Kids: How to Balance Diabetes Control & Good Nutrition with Family Peace. There’s a lot of good information there on this very topic.

The last reason she may be complaining of hunger is behavioral. Kids at this age will often use “I’m hungry” as a means of getting parents’ attention.