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I would like some advice on meal planning for my 11 year old daughter. She was diagnosed 2 1/2 years ago and last month went into diabetic ketoacidosis.


If it is at all possible, it would be worth the time to see a dietitian who specializes in the care of children with diabetes. Food habits are so individual, it is important to have a plan tailored to you the way your child prefers to eat. We are not usually successful if we "tell people how to eat."

In addition to what you have found here, there are many resources available to read once you get started (through the American Diabetes Association, and books such as Understanding Insulin Dependent Diabetes. Ask your dietitian to recommend some resources.

Concerning the recent episode of diabetic ketoacidosis:

Diabetic ketoacidosis happens from lack of insulin. You can't "eat your way" into ketoacidosis. Either insulin was missed or your child had an illness which made her need extra inulin.

Speak to your diabetes educator or specialist about sick day management to prevent diabetic ketoacidosis. When kids are sick, they may need extra insulin and fluids. Start by checking the urine for ketones when your child is sick or her blood sugar is over 300 mg/dl [16.7 mmol/l] (or the number your diabetes specialist recommends). If ketones are present and the blood sugar is high, then extra Regular or lispro insulin [Humalog® brand] insulin should be given every few hours to prevent diabetic ketoacidosis. Many centers use a 10 to 20% booster dose of Regular or Humalog. (That is, they add up the units of insulin needed in 24 hours and take 10 to 20% of that number, and give it in addition to to the usual insulin dose every four hours or so.) Keep checking and giving extra insulin, while treating the illness. Give extra fluids when the blood sugar is high, too. Always work with your doctor or diabetes team when your child is sick.


Original posting 17 Aug 97


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