From Mississippi, USA:
We have a 4 year old with Type 1 diabetes. In the Countdown magazine there is a section on transplants. Are pancreatic transplants an option for treatment, are they still considered experimental? Is the life expectancy less for a child with Type 1 compared to a child without diabetes? We cannot get our son to eat when he is supposed to and meals are becoming a battleground. The last snack of the day is sometimes impossible. Any ideas?
- A transplant is not an option at the moment for your four year old son. For the time being the goal must be to concentrate on maintaining good control.
- Life expectancy in Type 1 diabetes is, of course very dependent on the development of complications and these in turn depend to a great extent on the ability to maintain good control. Some figures that I saw the other day that were part of a cost benefit assessment of early screening and successful control gave a surprisingly good life expectation for males that was in the low sixties.
- The meal time problem that you describe is a common one and there are several things you can do. The first is to provide a choice at meals: i.e., whatever was planned or a peanut butter and jelly sandwich - no bribe and no variation and if both are refused, then extra blood sugars one and two hours after the meal. You might like to talk to your doctor about changing to lispro insulin and to give this after the meal, however big that is. In this way you avoid the anxiety of giving an insulin dose to a child who then refuses to eat so that you have to worry about hypoglycemia. Sometimes you are going to have to give in and allow orange juice or a milk shake just to avoid a reaction.
Usually both parties eventually get tired of this problem; but if it persists you may need to get professional counseling just to see if there is some psychosocial issue.
Original posting 3 Oct 96
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