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November 5, 2000


Question from Rochester, New York, USA:

My three year old daughter was diagnosed with type 1 diabetes at 20 months of age. Overall, we seem to be managing her diabetes fairly well. Our biggest problem is getting her to eat what we serve at meal time. When I can't get her to eat what I'm serving, I end up giving her something she likes more in order to get her carbs in her. She seems to be figuring out that she can get her way by carrying on, and then I'll give her what she wants. This doesn't seem to be fair to her brother since we make him eat whatever is served. Can you offer any advice as to how I can get my daughter to eat what is served?


Eating is a definite challenge, especially if you let it get the best of you and your family. Try involving her in mealtime preparations so she feels like she is a part of all of this. She can help set the table, or take part in menu planning. Also, please only add one new food at each meal and don’t expect her to eat more than small amount. The dietitian on her diabetes team should have other ideas. If you let the mealtime be a time of her control, she will take that to the max.

You can take part of the struggle away by talking with your diabetes team about how to give doses of Humalog after she eats, since if she does not eat, she may not need any insulin.

There are several excellent books out dealing with diabetes in young children. Check out Child of Mine by Ellyn Satter, Diabetes Care for Babies, Toddlers, and Preschoolers: A Reassuring Guide by Jean Betschart, C.R.N.P., C.D.E., Raising A Child With Diabetes by Linda Siminerio, RN, MS, CDE, and Jean Betschart, RN, MN, CDE., and Sweet Kids: How to Balance Diabetes Control & Good Nutrition with Family Peace by Betty Brackenridge & Richard Rubin.


[Editor’s comment: Even though it is difficult, you need to very careful not to let your daughter manipulate you (and your family) just because she has diabetes. The rules for her should be no different than for your son, and the consequences at least similar to those you impose on him, if he doesn’t follow the rules. If you allow your daughter to manipulate and get away with it now, it will only get worse as she gets older.

Lois’s suggestions are excellent ones, and you should try them first. However, if they don’t work, I would strongly suggest that you meet with the social worker or psychologist on your diabetes team. If your team doesn’t have such an individual, ask for a referral.