From Hawkinsville, Georgia, USA:
My two year old grandson does not want to eat his meals as he should. What should we do? We have already given him his insulin, then he won't eat. This causes a low blood sugar. I guess I am looking for answers in any direction I can get it. My grandson's blood sugar went from 39 mg/dl to 403 mg/dl [2.2 mmol/L to 22.4 mmol/L] in less than six hours! We really need help. Any information you can help us with would be appreciated.
We also need more information on any local support groups. We feel like we are alone in this. I have been in touch with the ADA. They have been helpful.
It is very difficult to eat what "we should" and even more so for a toddler that doesn't understand the importance of it. Having diabetes myself and a toddler, I certainly empathize with you. As I'm sure you know, battles over food will usually backfire as toddlers like things their way! It is best to have an insulin regimen that will let you give insulin based on the food consumed and not have to eat to match up with the insulin.
What type of insulin regimen is your grandson on? If he takes rapid acting insulin with meals (such as with an insulin pump or a multiple injection regimen with Humalog/NovoLog/Apidra with meals and Lantus/Levemir as basal insulin), you can usually take the meal insulin after the meal and adjust it depending on what he ate. Even if you have to travel quite a distance, I would really try to see a pediatric endocrinologist. He or she should be able to adjust your grandson's insulin to fit around his unpredictable eating (which is certainly normal not only in toddlers but in most people!) A dietitian and diabetes educator will also be essential to help you learn about counting carbohydrates, various insulin regimens available and how to adapt them to fit a toddler's lifestyle. There are several insulin regimens in which you would count the carbohydrates he has eaten and then give insulin immediately after the meal based on how much he ate. These regimens take more time (both for families and the diabetes health care providers) and education, but will allow more flexibility and should improve blood glucose control. Please discuss this with your grandson's diabetes team.
Getting in touch with the ADA is a great step. It may also be helpful to try and connect with another family who has a toddler with diabetes and you can share your experiences. There is also a Diabetes Camp in Macon, GA that may also be of interest for your grandson in a few years.
Original posting 27 Sep 2006
Posted to Daily Care
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