My three year old was diagnosed with type 1 diabetes eight months ago. Her team has told me to “get the carbs in” even if it means giving her candy or pop. This doesn’t seem to be right. Why can’t I just give her a diet higher in protein and lower in carbs, which seems to be what she wants (she picks the meat and cheese out of her sandwich and leaves the bread)? If she has a high number, instead of increasing her insulin the next day why can’t I reduce her carbs?

Most three year olds don’t eat exactly what we’d like to see them eat. Sometimes they eat very little, and sometimes they eat a great deal. If you try to force them to eat, frequently you’ll find that a toddler can be quite stubborn and both of you will end up frustrated (and the toddler will likely win that fight). For my young children with diabetes, I usually suggest giving Humalog insulin with the meal based on the carbohydrates the child actually eats. You’ll need to talk with your diabetes team to come up with a good strategy for calculating an insulin dose based on carbohydrate intake. In addition, there is usually not a set required amount of carbohydrates a child must take in during the day. Caring for diabetes in a toddler requires a great deal of creative flexibility in diet and insulin dosing.

MSB

[Editor’s comment: Sweet Kids: How to Balance Diabetes Control & Good Nutrition with Family Peace by Betty Brackenridge & Richard Rubin is an excellent book that should help you sort out some of these issues.

SS]