When to Enforce Eating Guidelines for Children with Type 1 Diabetes

Here’s a challenge that we all face, whether it’s for ourselves, because we have type 1 diabetes, or for our kids, when they have the condition: when to enforce eating guidelines, and when to let things slide?

Last night, circa 8:00 pm, I returned home from the supermarket. The kids were ready to go to sleep, but I stupidly began unpacking groceries, including a box of extra-healthy, but oh-so-carb-dense, Flax-4-Life muffins.

The kids had just had their night time snack (fruit and a cookie), but as soon as my son saw the muffins, he decided to take an uncompromising stand: “I want one of those muffins! I’m hungry!” I argued for a low-carb snack, but he responded with anger. He REALLY wanted one of those muffins. Oy. 

My wife and I vaguely remembered that something about Flax-4-Life muffins concerned us, but since they were so obviously healthy, we weren’t sure what to do. Clearly, a muffin before bed time was not a good idea; it would likely wreak havoc with the night time blood sugars. But Sacha had already begun to throw a tantrum – including running upstairs and slamming the bedroom door – and as my wife said, “perhaps he’s going through a growth spurt.” So we decided just to bolus him for the muffin, and hope for the best.  

In general, although we try to eat healthily and think a lot about carbs/fats/proteins, we also strive not to turn food and its diabetes-related implications into the centre of a family power struggle. We often fail, but at least we try. 

The muffin had 46 carbs, but 10 of those were fiber (wow). We also gave him a cup of milk (12 carbs), and thus bolused him for 48 carbs, total. 

That was at 8:30 pm; my wife said, resignedly, “we’re probably in for a long night.” She was right.

At 11 pm, Sacha was a whopping 540. (?!)I had fallen asleep by then, but my wife corrected, and went back to sleep. I awoke at 2 am, to discover that he’d dropped to 350. Another blood glucose correction, and by 4:30 am, he was down to 250 – still way too high – and stayed there, more or less, until breakfast. When he woke up, what was the first thing he wanted? Another muffin…..

The best thing would have been to avoid the whole problem by not buying the muffins in the first place, healthy though they were. Or, not unpacking the groceries just as the kids were going to bed. Those were my mistakes, no question about it. The rest, perhaps, was no-one’s fault? 

James Ron

James Ron is an American, Israeli, and Canadian academic, whose son, Sacha, was diagnosed with type 1 diabetes in 2009 at the age of two. Until then, James had never heard of the disease. Today, James is a member of the scientific and advisory group of Life for a Child, an Australia-based charity that supplies insulin and other diabetes supplies to children and youth in the developing world. James teaches international affairs and human rights at the University of Minnesota, and lives in Minneapolis with his wife, Emma, and their two children, Tessa and Sacha.

James Ron

James Ron is an American, Israeli, and Canadian academic, whose son, Sacha, was diagnosed with type 1 diabetes in 2009 at the age of two. Until then, James had never heard of the disease. Today, James is a member of the scientific and advisory group of Life for a Child, an Australia-based charity that supplies insulin and other diabetes supplies to children and youth in the developing world. James teaches international affairs and human rights at the University of Minnesota, and lives in Minneapolis with his wife, Emma, and their two children, Tessa and Sacha.