Daughter just started LCHF - bolus for protein Type1

[Penfold_Dad]

Hi guys we have just done our first week of LCHF with my five year old daughter (in fact the whole family) and we have been bolusing for protein and carbs. Protein at 50% calculations and we have seen a huge improvement in blood sugars and the low numbers have allowed us to see specifically which food cause spikes as it has become very obvious.

Does anyone have any advice on the protein bolus? Do you calculate it for everything? We hid have a night time hypo last night and we had the fat head pizza for dinner last night which has so much protein it required a huge dose of insulin. I guess this defeats the object but it was nice and if we do it again we will just serve a much smaller portion with more salad.

Any advice from experience would be gratefully received! We are hoping to have a glucose meter for a while which should help with the calculations as we will see the real time info which I am looking forward to

Thanks, Stuart

 

[azure]

Have your diabetes team given you any advice about managing insulin? Swapping to LCHF is a big change so I hope they have explained the boluses and things to watch out for, including excessive weight loss, hypos, growth, etc.

Do ask if they haven't.

 

[Mrs Vimes]

Different types of protein get into the blood faster. I think it's a bit different for everyone.
Personally things like white chicken breast, feta cheese and mozzarella hit roughly an hour after for approx 2 hours.
Really fatty stuff hits me upto 4 hours later like pork belly and lamb.
I'm on a pump so I can fiddle with that.
When I was on mdi, I'd calculate the dose for fast acting then split it. Some before the meal and some after. Took a couple of goes to nail it but I get the impression you are very thorough and are measuring and testing to spot patterns.

I think I've mentioned typeonegrit Facebook page. They are experts on this, and to make sure their kids don't lose weight they up the protein.
Hope that helps.

Glucose meter? If you mean cgm I self fund. It has been fantastic for protein spikes.

 

[steve_p6]

If you look at Polish method here http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2901033/. It gives some useful information on how Fat/Protein content extends the absorption and recommended duration for bolus if on a pump.

 

[Penfold_Dad]

We are injecting which I guess excludes the above. Would anyone consider injecting post meal due to the slow release proteins or maybe splitting the bolus? We are having much lower numbers to work with which is great but also still hypo ing

I have been reading the type1grit Facebook and also low carb for the type 1 parents but findin them only so useful as you can't post it is just information to read not really discuss

 

[TorqPenderloin]

Serious question: why do you have a 5 year old girl on a low carbohydrate diet?

 

[ewelina]

We are injecting which I guess excludes the above. Would anyone consider injecting post meal due to the slow release proteins or maybe splitting the bolus? We are having much lower numbers to work with which is great but also still hypo ing

I have been reading the type1grit Facebook and also low carb for the type 1 parents but findin them only so useful as you can't post it is just information to read not really discuss

I think it depends on what your daughter is eating. If its protein without much fat you can inject shortly before or at the time of eating. If its fatty meal I would recommend splitting the bolus. Its a bit of trial and error I think

 

[Mrs Vimes]

@Penfold_Dad I've sent you a message.

 

[azure]

We are injecting which I guess excludes the above. Would anyone consider injecting post meal due to the slow release proteins or maybe splitting the bolus? We are having much lower numbers to work with which is great but also still hypo ing

I have been reading the type1grit Facebook and also low carb for the type 1 parents but findin them only so useful as you can't post it is just information to read not really discuss

Your daughter's diabetes team are the people best placed to give advice @Penfold_Dad

 

[Penfold_Dad]

We have her on a low carb diet as her blood sugars are all over the place on refined carbs. What we have done is remove bread, rice, pasta and potatoes from our diets. We aren't no carbing just low carbing. Less insulin hopefully equalling less hypos and hopefully lower blood sugars equaling less chance of diabetic complications later in life

 

[Penfold_Dad]

The diabetes team advise eating carbs with every meal

 

[azure]

We have her on a low carb diet as her blood sugars are all over the place on refined carbs. What we have done is remove bread, rice, pasta and potatoes from our diets. We aren't no carbing just low carbing. Less insulin hopefully equalling less hypos and hopefully lower blood sugars equaling less chance of diabetic complications later in life

Have you spoken to your team about a pump @Penfold_Dad ? That's an option a number of Parents here have taken. None of my children have diabetes, but if they did that'd be one of the first things I'd consider as I myself have a pump and it has smoothed my blood sugar and improved my life no end compared to MDI. For me, the key is the basal flexibility and the ability to give fractions of units of insulin.

My HbA1C is 33 - that is, in the 5s.

Your daughters control will improve. It takes a few months to get insulin doses to an appropriate level, especially as caution is advised in initial doses. You may also consider talking to your daughter's team about timings of boluses, depending on when she has high sugars.

It's not necessary to do LCHF to get very good control. We all eat varying amounts of carbs. If you do choose to give you daughter a LCHF diet, it's important her team know so they can support you and her and monitor her health. A variation of LCHF is sometimes prescribed for children with epilepsy but they are always monitored on the diet and get help from a dietician.

 

[Penfold_Dad]

We don't really have a team. We have a nurse who is there to support but his geographical area of support is enormous and his workload ridiculous

 

[TorqPenderloin]

I follow a low carb diet too, but that doesn't mean it's okay for a child.

Even ignoring the diet itself, this is directly going against the doctor's advice and implementing this diet without the knowledge or supervision of a professional. That's downright reckless.

If people want to experiment with their own bodies, fine...but you're experimenting with your daughter's life but she doesn't get a choice in this matter. She's going to listen to whatever "Dad" tells her.

I'm sure this will get deleted because it's not "pleasant" but that doesn't make it any less true.

Talk to a doctor about this...for your daughter's sake...

Edited by a mod to remove deleted post

 

[Penfold_Dad]

Both sides of this argument are relevant and I'm not easily offended and I'm certainly not a fundementalist and would happily do what is best. Id also like to say that I am an educated person able to deliberate on choices I make and my wife is a health care professional. These choices haven't come easy

 

[Penfold_Dad]

Can I also add this is a family decision and I am also following this diet as are my wife and other two children 5&3. I have so far lost 8 kilos and feel superb. Breakfast today was natural yoghurt with pistachio kernels, raspberries and strawberries. Turn the clock back three weeks and it would have been a bowl of cereal and milk (causing a mid morning spike of perhaps 12-20 mmols)

 

[azure]

@Penfold_Dad One thing that most definitely comes across in your posts is your determination to help your daughter. I know you've made a number of posts here and immediately started researching to help your daughter when she was diagnosed. Your love for her and concern for her future health is obvious.

It's very bad that your daughter doesn't have the support of a team. Is there any way you could push for that via your GP? Sometimes people, even children, are left to 'get on with things' unless they make themselves heard.

I eat cereal and my 'spike' is around 6.5. It took me time to get it that low, and I largely did it myself through careful experimentation with timing of boluses, etc. if you feel you have to limit your daughter's carbs so much to achieve good control, then my feeling is you're not getting the support you and her deserve.

 

[CollieBoy]

@Penfold_Dad,
have a look at this site: http://diabeticalien.blogspot.co.uk/ This mother tries tp control her son's T1 on low carbs! 9lots of great recipes)
i understand that you are trying to do the best for your daughter and wish you all the best in getting the best of control.

 

[Mrs Vimes]

@Penfold_Dad,
have a look at this site: http://diabeticalien.blogspot.co.uk/ This mother tries tp control her son's T1 on low carbs! 9lots of great recipes)
i understand that you are trying to do the best for your daughter and wish you all the best in getting the best of control.

She is awesome.

 

[phoenix]

You have cut your carbs and lost weight but your child does not need to do this . Insulin is needed for growth of bone, muscle, brain cells (everything really) so you have to get the balance right providing sufficient energy as well as minerals and vitamins.
Not eating junk food is important for everyone and there is certainly nothing wrong with removing refined carbohydrates from a diet ( caveat: for most days,) Neither potatoes, nor brown rice are actually processed (other than washing and cooking)
A very restricted diet could be isolating for a child who is already 'different' in that they have to inject; All too soon your five year old will want to visit friends, go on school visits away from home, She will have to eat in situations where the food is not specially prepared . In just a few years she will want (need) to be independent . Learning to use insulin effectively with a variety of types of food and situations means being in control of diabetes rather than the other way around.
May I suggest you contact this group of people http://www.childrenwithdiabetesuk.org/ It is a large group of parents who have already been there.