May 12, 2007
Daily Care, Insulin
Question from West Columbia, South Carolina, USA:
My nephew was recently diagnosed with type 1 diabetes. My sister-in-law is not a believer in conventional medicine, so much so that she feels she’s poisoning her son with each insulin injection she gives him. I’m trying to help her find resources for treatments that might help decrease the amount of insulin he gets. She also needs someone that will help her understand that she has to continue with conventional treatment while she researches and finds a professional to help her find out whether her plan is even possible to implement. As of now, she’s following most of the specialist’s instructions, however, she wants to figure out how to help maintain a better blood sugar level by controlling carbohydrates rather than “covering” them with insulin. So, how does she determine how many carbohydrates he needs per meal that will keep his sugar level down, keep him healthy and not cause him to lose weight? And, why is it not okay for her to check his sugar and if it’s with in the desired range, skip the injection until his sugar levels indicate the need for insulin? I have to admit that I’m wondering why she would have to give him the insulin if it doesn’t appear to be necessary. It does seem contradictory for the hospital to give him pancakes and syrup with four units of insulin instead of grain cereal or eggs and whole grain toast with one unit of insulin.
My sister-in-law has also banned any kind of artificial sweetener or monosodium glutamate, at least that which is in her control. She’s trying awfully hard, but she’s so confused. Truthfully, we’re all confused. My opinion is that she has nothing to lean on right now except for conventional medicine, so she has to rely on that experience. If she wants also to practice more natural treatments, she has to have professional help to coach her in combining the two. She/we cannot do this alone.
The best thing to do is to have the entire family ask questions and work closely with the pediatric diabetes team caring for this boy. It is DANGEROUS to stop insulin, so please carefully think through what option to consider. You are correct, however, that increasing complex carbohydrates and decreasing fast acting simple carbohydrates would be helpful and this could easily be used in any diabetes meal plan already created. The exact choices are up to each family and each patient within carbohydrate counting guidelines. The best teaching sources would be Understanding Insulin-Dependent Diabetes by Dr. H. Peter Chase and Type 1 Diabetes in Children, Adolescents and Young Adults, Second Edition by Ragnar Hanas, M.D.. Both have good advice and guidance. The ADA and JDRF web sites also have excellent material.
All treatment decisions should be based upon frequent blood glucose monitoring and the results that are obtained with insulin, activity and food choices all playing key roles. Stress also has a major effect on glucose control and needs to be considered.
[Editor’s comment: The primary reason you dose insulin BEFORE eating, even if one’s blood sugar is in range, is because food will cause a rise in the blood sugar more quickly than insulin can work to lower it. So, most people give insulin before meals/snacks to allow the insulin to start working to prevent that rise. Higher blood sugars can, over time, lead to diabetes complications. However, a newly diagnosed person may be in a honeymoon phase so they may not see a big rise in their blood sugar. This is something your family should discuss with the child’s diabetes team.