My three-year-old daughter was diagnosed with type 1 three months ago. I picked up her symptoms quickly since my husband has had it since he was five. She is now stabilized. Her last A1c was 6.8 and I feel I’ve gotten control of her blood sugar with the help of our diabetes team and dietitians. My worry now is that since being diagnosed, she has gone from 32 pounds to 37 pounds. She eats a very healthy diet, so I know it’s not so much what she is eating. After being ill for so long, she has developed an extreme anxiety of walking and insists on being put in her pushchair. For a three-year-old, she is very sedentary, even though I take her to the park every day and have enrolled her in swimming. Is this weight gain common and the physical exercise aversion as well? It’s been three months since she was diagnosed and she has not shed any of the weight. I want to do everything I can to make sure she is healthy.

Weight gain is common among children as you improve metabolic control, especially in girls and if on an intensified insulin scheme or on pumps, and quite often with a family history of type 2 diabetes. Weight gain following insulin therapy occurs for a number or reasons including caloric retention because of improved metabolic control, excess caloric intake, decreased caloric expenditure, sedentary lifestyles and nonphysiologic insulin formulations.This suggests that most of the weight gain observed after the insulin initiation is a “catch-up” weight re-gain. There is no evidence that weight gain after insulin therapy initiation is associated with a deterioration in the lipid profile or arterial hypertension or an excess risk for cardiovascular events, contrary to common beliefs. However, weight gain with insulin therapy is not inevitable and can be avoided trough a careful dietitian involvement. Physical activity aversion is not linked to diabetes.

MS