(1) Such patients must take sufficient food after insulin injection because insulin lowers blood sugar level instantly and to offset the effects thereof, food must be taken, with reasonable amount of carbohydrate, to compensate for the ravages caused by insulin. Insulin is given to growing children and also to indoor patients due to be operated (who are diabetic). In such a situation, blood sugar level should be continuously watched and, if necessary, matched by proper and requisite intake of food.
(2) For growing children, it is a knotty problem because if we reduce their diet quantity, they will get weak and be unable to carry out their studies, games and other physical activities. Child’s physical and mental activities and faculties must be preserved.
(3) The parents should educate, guide and mentally prepare the child about his having diabetes and precautions and restrictions he would be required to follow, without creating any fear in his mind (called a Diabetic Niurosis). A child (1-10 years) will require 1000 calories diet, and after he has crossed 10 years, addition of 100 calories per year of age, should be added. And for 11 years onwards a diet having 2000 calories will suffice. From 15th year, add 200 calories for boys and 100 calories for girls (per year of age).
(4) It is not possible to restrict a child from taking sweets or sugar. Strenuous exercises and games, where too much energy is expended, should be compensated by (Before and after physical exercises and games) food items like biscuits, sandwich, matthi, Bara, samosa etc. In any case, hypoglycemia states should not be allowed to surface, because child cannot be expected to self-management of such extreme stages. The child should not suffer from ‘Fear psychosis’. As the sugar level is controlled, insulin intake will be tapered and as a result thereof, the child can return to his near normal diet, but precaution is still a watchword. So, while prescribing diet for an insulin dependant child, factors like his age, health, infection to certain diseases expected and actual amount of labour put in, his study-load etc. should be borne in mind.
(5) periodical guidance is a pre-requisite for the IDDM patients because, as soon their blood sugar changes (whether higher or lower) , his insulin and diet intake would required to be changed as per chemical tests. The child should never feel let down or dismayed. Instead his moral should always be boosted.
(6) As for the elderly IDDM patients, management is not difficult but expert counseling cannot be ruled out. Regular check-ups, chemical tests, constant or periodical contact with the physician and strick regimentation are all the more necessary, Elderly persons can easily follow the instructions of their doctors. They, too, should restrict excessive food which is rich in carbohydrates but not after taking the insulin injections, they must take enough food to offset bad effects of insulin. In any case extreme situations should always be prevented from happening and if any such situation occurs, timely action by reducing or taking excessive intake will meet the emergent crisis.