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From Aurora, Illinois, USA:

My 10-year-old daughter has had type 1 since 15 months of age and has had good control on her insulin pump. She has always had good A1cs. She was diagnosed with Juvenile Rheumatoid Arthritis one and a half years ago and is on sulfasalazine, sodium and Voltaren for a recent flare-up of her arthritis.

My chiropractor has been suggesting that I start my daughter on a fish oil supplement, which is a three step program that involves "cleansing," fish oil and a diet. He also wants to have her tested for allergies. He told me he thought that she would benefit from it, especially with the inflammation from the arthritis. He also said it would help her blood sugars. I told him that I need to check with her endocrinologist first, especially because with any changes in her diet, I would worry about "lows." I also worry that any type of "cleansing" would have the same effect as diarrhea has on her, low blood sugars. What do you think?


I cannot comment specifically as to this "three-step" diet and the supplements involved. I cannot comment as to any efficacy of this "cleansing" as might pertain to her JRA (now called 'JIA') or type 1 diabetes. Nevertheless, with ANY change in diet (or exercise program), you still want to monitor the glucoses, as you already know, and adjust from there. Looking superficially at the proposed changes, I see no reason not to try the new diet; if the glucoses drop, you can drop the insulin rates. That's the beauty of pumping.


Additional comments from James Michael Schurig, RD, LD, CDE:

I would agree with Dr. Schwartz that you should monitor blood glucoses carefully with any change in diet or exercise. With that said, some studies have shown a positive anti-inflammatory effect of omega-3 fatty acids with rheumatoid arthritis. The supplement you are referring to [name removed, ed.] contains omega-3 fatty acids EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). For omega-3 fatty acids in foods, select cold-water fish such as salmon, tuna, and trout. Some plant foods are also sources of omega-3 fatty acids. They include walnuts, tofu and soybean products, flaxseed and flaxseed oil, and canola oil. More recent findings show that the higher intake of omega-3 fatty acids with the Mediterranean diet, a diet consisting of large amounts of fruits, vegetables, olive oil, and fatty fish high in omega-3s, may be linked to the improvement in rheumatoid arthritis symptoms.


Original posting 6 Oct 2008
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