My daughter was just diagnosed with type 1 and I’d like to now how she’s supposed to eat more than 30 grams of carbohydrates for snack and 60 grams of carbohydrates for meals. She is so hungry, but I don’t know what to do. Is there a list I can get for free foods? My daughter is not fat, but if she is to put some weight on, this is never going to work. All I know is that she is very hungry and it’s making her upset and moody. She currently takes Humalog and NPH.

First of all, if you are not followed by a pediatric endocrinologist with access to a Certified Diabetes Education (CDE) team, please ask for a referral. Your question is a good one and a common one, but one best addressed by your Diabetes Team nutritionist and/or physician.

Having said that, it is very, very common for children with type 1 diabetes to have an accelerated appetite in the first weeks after diagnosis and the early treatment with insulin. How long the increased appetite lasts may depend upon whether or not the child experienced any, and to what degree of, weight LOSS prior to the diagnosis. The body will often try to “catch up” for the lost ground. Then, what commonly happens, is that the body does catch up and the appetite slows! During this “catch-up” phase, the glucose levels may run rather high and thus require that the child receive larger and larger doses of insulin. When the body has caught up and the appetite decreases, the insulin doses can often be decreased also. This is sometimes part of the “diabetes honeymoon.”

Different pediatric endocrinologists may handle this differently. Some might say to adhere strictly to the carbohydrates as you are doing. Some would liberalize the diet and just adjust the insulin as needed.

All this, and the potential required changes in insulin dosing, etc, emphasizes that you should maintain close contact with your diabetes team.

DS

[Editor’s comment: See also a previous question about free foods.

BH]