This past winter, my 10 year old daughter, who has had type 1 diabetes for three years, caught numerous colds, stomach bugs, and fevers whereas she was not this ill during the past two years and has received a flu shot for the past four years. What are your recommendations to help her avoid getting sick? We encourage hand washing, use a children’s vitamin, and a vitamin C. Are there any other vitamins she should take? Is she too young to take echinacea?

I would hesitate to recommend herbal remedies to help her avoid illness. I think the benefits of having a well-balanced diet are obvious but would avoid supplements.

In addition, it’s important to understand that all children have the occasional cold bugs through the winter. When you have diabetes, it is important to be careful during those times of illness and monitor closely for DKA [diabetic ketoacidosis] by routinely checking ketones and checking blood sugars more frequently. I would suggest reviewing sick day management.

MSB

[Editor’s comment: One other important point is to maintain glucose control (hemoglobin A1c less than 1% above the upper limit of normal for the lab doing the test). High blood glucose levels provide a perfect breeding ground for any “bug”.

SS]