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August 19, 2002

Insulin

Question from Michigan, USA:

My friend's six year old daughter was recently diagnosed with type 1 diabetes, and she says her daughter can eat anything she wants (ice cream, or Cocoa Puffs, anything she wants) as long as her insulin injection is adjusted properly. However, my understanding of diabetes has always been the less insulin you need the better. Is there something new I have not heard about? Won't all of this extra insulin hurt her? Where can I find this information out, so I can show it to her or ease my mind?

Answer:

The question is never that less insulin is better. The questions should be phrased about taking the appropriate amount of insulin to cover the glucose surges after eating and also to provide basal insulin effect between food.

It is often easiest to do this with fewer simple carbs — so staying away from simple sucrose like substances often works best. More recently liberalizing diet choices by allowing insulin to cover carbs seems to be a good solution for many people since they don’t get so frustrated at having to completely avoid all sugars of all kinds. However, learning with blood glucose readings before and after meals answers such questions for each child, teen or adult with diabetes. If weight is okay, if hemoglobin A1c is okay and if day to day glucose control is okay, who cares how you get this solution? If these are not okay, then alternatives should be considered.

SB