From Atlanta, Georgia, USA:
A friend of mine has a 12 year old daughter that is on a very low carb diet. She doesn't have to take insulin as long as she exercises regularly. She needs diet suggestions, and any info that you can give her about children with type 1 diabetes, and excercise to control high blood sugar.
I have a question for you. Does your friend have Type 1 diabetes or impaired glucose tolerance? You should try to find out. The reason why I ask is that in Type 1 diabetes, beta cell function is minimal or absent due to beta cell destruction. Lack of insulin causes inability of glucose to be used as energy in the cell, causing high blood glucoses. Insulin is required to sustain life. The symptoms of diabetes usually occur when 80-90% of the beta call mass of the pancreas is destroyed. There is a period of time where some endogenous insulin is still being produced by the remaining functioning beta cells. This is called the honeymoon period. This period of several months or longer may be a time when a small amount of exogenous insulin is needed to help blood glucose values near normal most of the time. Treatment of Type 1 diabetes includes balancing insulin therapy with a healthy meal plan and exericse. A person with impaired glucose tolerance has a blood glucose level that is higher than normal but lower than the level of someone with diabetes.
But if a person has impaired glucose tolerance, they are more likely to get Type 2 diabetes. Impaired glucose tolerance needs to be treated, even though the person may never get diabetes. The person with impaired glucose tolerance can do a few things: such as lose weight (if they are overweight), eat healthy, and exercise. These three things can help return blood glucose levels to normal.
Here are some books that I think might help your friend out:
- Carbohydrate Counting Getting Started, American Diabetes Association and American Dietetic Association, 1995. (800) 232-3472
- Diabetes In Children: A Guide For The Family, By Arlan L. Rosenbloom, MD. University of Florida, HIN, Inc. The Health Information Network, A Time Inc. Company,1996; ISBN 1-885274-31-9
- The Ultimate Home Diabetes Reference: ADA Complete Guide to Diabetes by Philip E. Cryer, MD and Belinda P. Childs, RN, MN, CDE
Additional comments from Lois Schmidt Finney, diabetes dietitian:I feel that your friend should have her daughter seen by a diabetes team. We do not recommend low carb diets for those with type 1 diabetes, especially a growing girl. She may be in a honeymoon phase, but that will not continue, and she will need to take insulin and to follow a meal plan individualized for her and her normal activity level. Please discourage use of the low carb diet and excessive exercise to try to put off insulin. She could run into major health problems.
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