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February 20, 2002

Meal Planning, Food and Diet

Question from Balmertown, Ontario, Canada:

My seven year old son was diagnosed with type 1 diabetes about four months ago, and a nurse educator or a dietitian ( I'm not sure which one) said that if he ever wanted an extra treat or something to just let him have it and correct later, meaning to give him extra insulin to bring him down. Do you think this is okay to do once in a while or never? My son takes Humalog and NPH.

Answer:

I think that, for the most part, you should treat your son as if he were seven year old who happens to have diabetes rather than he is “a diabetic” who happens to be seven. This means, that I generally agree with your diabetes educator.

Meal plans should be followed, but how can you realistically expect no “special treats” for holidays, birthdays, Valentine’s day, etc.? It is best to limit the sweets or find alternatives, but the occasional treat is fine. I don’t usually advocate for “fixing later” by chasing the glucose, unless there are ketones in the urine. (You should check urine for ketones if the glucose reading is more than 250 mg/dl [mmol/L].) There are times and different insulin regimens in which chasing sugars is really needed but on your son’s regimen, just having a higher reading on the rare occasion after the special treat, can probably be handled by drinking extra water, or having a bit more exercise.

DS