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February 18, 2001

Behavior, Meal Planning, Food and Diet

Question from New York, USA:

My nine year old son has diabetes and is out of control with his eating habits. He knows what he can have, but he is always sneaking sweets, especially at school. His blood sugars have been high practically every day for the last three months. He gets up in the middle of the night to sneak food. The school nurse and I have tried to explain what could happen to him, but he just doesn't listen. I've even sent him to diabetes camp last summer to see that he is not the only kid with this illness. Now he is not allowed to eat with is peers at school. He has to eat with the administrators because he cannot be trusted. I really need advice on how to deal with him. Can you send me any listing of groups in my area?


Your son is behaving like any nine year old. He doesn’t want to be different. I assume that his diabetes diet includes allowing him to have a small quantity of sweets before exercise like gym at school or playing outside after school. If not, then it should so that he knows when it is okay for him to have them. You don’t say how long your son has had diabetes, but he’s clearly rebelling against it, and everyone does at some point.

I don’t think he should be separated from his peers when eating. The teachers should be aware that he shouldn’t eat a lot of sweets, but imposition of martial law is unlikely to lead to a change in attitude. What you describe is one of the most common problems facing parents of children with diabetes. Usually, it is a phase, and, with repeated gentle persuasion and emphasis on healthy eating, together with attempts to raise self-esteem, it will pass. You should also consider whether this behaviour is a demand for attention for other reasons (e.g. problems at home).

You will see from the above that there are no easy answers here, but hang in there. There’s plenty of time, and you don’t want to go to war over this one.


[Editor’s comment: I agree with Dr. Robertson. However, cheating is a word we rarely use any more. Perhaps a different issue is that he may be hungry. I would be curious to know when his meal plan was last changed. Nowadays, using the carbohydrate counting method of meal planning, no foods are forbidden! Growing children who have diabetes need to have their meal plan reviewed in consultation with a dietitian experienced in the their care a least every six months.

You should make an appointment with your son to visit a dietitian who is familiar with kids with diabetes, who can make sure that he is on the right amount of food for his age and wants and to help both of you learn how to incorporate those so-called forbidden foods. Also, there are a few books that might be of great help:

Sweet Kids: How to Balance Diabetes Control & Good Nutrition with Family Peace by Betty Brackenridge & Richard Rubin
How to Get Your Kid to Eat but Not Too Much by Ellyn Satter
Child of Mine by Ellyn Satter

To find support groups, I would ask your son’s diabetes team for ideas. You might also local chapters of the American Diabetes Association and Juvenile Diabetes Research Foundation.

I would also suggest that you ask your diabetes team about a referral to a medical social worker or a psychologist experienced in the care of children with diabetes to help sort out some of these issues.