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October 6, 2000

Meal Planning, Food and Diet

Question from Mustang, Oklahoma, USA:

My three year old son was diagnosed with type 1 diabetes about three months ago. Some days, it is so hard for us to get our son to eat. What do I do about a picky eater?

Answer:

I can only answer your question about the picky eating part. Two books may be very helpful to you. The first is called Sweet Kids. The second is called The Ten Keys to Helping Your Child Grow Up With Diabetes. They’re both published through the American Diabetes Association. Keep in mind that food should never be a battle, as the child will always win by refusing to eat. Also, picky eating is part of being a preschooler. If your child is getting the carbs per meal that are needed, even if its not with the foods you’d prefer, then your child is actually doing fine. Talk your concerns over with your diabetes team, as many parents of preschoolers give their child their Humalog after the meal so that they give the dose based on the carbs actually consumed.

JWB
Additional comments from Dr. Stuart Brink:

Best plan for picky toddlers with diabetes is to work closely with your diabetes health care team and make sure that they have experience working with preschoolers. We utilize Humalog insulin, often immediately after eating, so that the dose of insulin can be adjusted and balanced with what is actually ingested rather than what is “supposed” to be eaten. Being so flexible stops the battles and still allows excellent overall control coupled with frequent blood glucose monitoring and a multidose insulin regimen. Jean Betschart and her colleagues have an excellent book about preschoolers with diabetes (Diabetes Care for Babies, Toddlers, and Preschoolers: A Reassuring Guide).

SB