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August 27, 2006

Behavior

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Question from California, USA:

I am at a loss. My husband and I are feeling like it is impossible to maintain a healthy blood sugar for our 11 year old daughter. She sneaks food and hides wrappers, eats foods blatantly in front of us that we have stated repeatedly she cannot have. She has a major attitude and acts as though she doesn’t need to listen regarding her diabetes control. As a result, I believe she has poor maintenance of her blood sugar and horrendous body odor that we have heard can be a result of low magnesium (a result of poor blood sugar control). I have other children and her grandparents living in the house. I cannot lock the food away or keep it away from her, it seems. I don’t know what else to do. Please give me advice or some suggestions on how to get this under control. Talking to her doesn’t help. Grounding and spankings don’t work either. Boot Camp?

Answer:

From: DTeam Staff

Living with diabetes can be so overwhelming and you have shared a very important story about your daughter’s struggles. The good news is that with current insulins and with carbohydrate counting, there really are no forbidden foods. The key is knowing how to balance carbohydrates with insulin, and making healthy food choices. It sounds, however, like you are under the impression that there are foods she is not allowed to have. Therefore, it is extremely important that you meet with a nutritionist who specializes in children with type 1 diabetes. I would imagine that your diabetes team has such a specialist on their team. This will help you and your daughter work together on food issues. In addition, it may be helpful to talk with the rest of your family about the foods you have in your home. Are there items in your home that are really not healthy for anyone? If so, maybe they don’t need to come into your home any longer and those foods can be consumed outside of the home during special occasions.

As far as sneaking foods, it is important that you and your daughter have an honest and open relationship. If she feels the need to eat foods you’d rather she not eat, she needs to tell you so you understand the blood sugar numbers you may be getting. However, this is a more complicated issue and you should discuss it at length with your diabetes team. It may be that your daughter is really very hungry (either because she’s going through a growth spurt, or because her blood sugars have been running higher, or some other issue). If she sees food as something she must sneak in order not to upset you, then a vicious cycle may have begun and it’s very important to get to the bottom of it.

Finally, I’d encourage you to take over her daily diabetes regimen. That means you should check her blood sugars and record them. You should give her the insulin. In that way, you will be able to make appropriate changes to her insulin doses so her blood sugars are not running too high (and that can happen no matter how much food she eats).

Please make the necessary appointments with your diabetes team members as soon as possible.

JWB

[Editor’s comment: You might also want to ensure that your daughter participates in some type of exercise program or other physical activity. This could help lower her blood sugars and ensure that she does not gain unnecessary weight.

BH]