Our 12 year old daughter has had type 1 diabetes for three years. She loves food. We have been to a dietitian, therapist and talked to the doctor. She is gaining about a pound per week. We don’t know what to do. The doctor thinks maybe the pump would help, but I feel the pump is a reward. We have bought all the foods the dietitian told us to. She is allowed to have “junk” food a few times a week. So, she is not really missing out on anything. She just wants food all the time. She does eat fruits and veggies. Any suggestions would really help.

First of all, the insulin pump shouldn’t be considered a “reward”. It is a tool that can give more flexibility, but requires more effort to get that flexibility. Many teenagers with the pump overdo the flexibility and frequently give extra insulin to cover extra food resulting in excessive weight gain.

The pump or multiple injections, might still be helpful in your daughter’s situation if you use these intensive forms of therapy to better fine tune the insulin to her food, but still trying to keep her food intake constant from day to day as much as possible. With intensive therapy, you are less apt to have times during the day when you have to eat to avoid low blood sugars even when you are not hungry.

If your daughter is gaining a pound a week, something is wrong. Possibilities to consider and discuss with her and her doctor, dietitian, and therapist:.

She is developing an underactive thyroid — ask her doctor if her thyroid tests have been checked recently.
She is taking more insulin than she needs which is increasing her appetite and she is eating extra to “feed her insulin” and avoid lows.
She is eating more than she is telling you and possibly even giving extra insulin without telling you to prevent high blood sugars (the pump makes this even easier to do as you always have extra insulin easily available).

TGL