Type 1: Snacks and bolus

[shivles]

DDs dietitian told us that she can have a snack up to 15g between meals, how does she not need insulin for this? It makes no sense, if her ratio in the morning is 0.7 and she has 15g that's a unit of insulin surely? If I give her a snack like that without insulin obviously she's going to hyper unless she's coming down still from the previous meal which if the ratio is right shouldn't happen right?

 

[azure]

@shivles Speak to your DSN if that's not working for your daughter as we're all different.

I can have small snacks without a bolus if I'm active or my BS is dropping, but if that's not the case and I just fancy a snack, I bolus for it.

It wholly depends on the person and the circumstances.

 

[shivles]

Unless she's more active she shouldn't need the snack to prevent a hypo is that right?

 

[njd1980]

The diabetic nurse told me when I did the dafne course that I could eat 10g of carbs between meals with no bolus. This was because 10g could move bloods up between 2-3 mmols which would be ok. This seems to work for me but as said before everyone is different and is just trial and error.

 

[njd1980]

Unless she's more active she shouldn't need the snack to prevent a hypo is that right?

That's right, as long as the basel is set right her bloods shouldn't alter too much unless she is more active

 

[shivles]

The diabetic nurse told me when I did the dafne course that I could eat 10g of carbs between meals with no bolus. This was because 10g could move bloods up between 2-3 mmols which would be ok. This seems to work for me but as said before everyone is different and is just trial and error.

The thing is at 17mo it's going to move her a lot more than 2-3mmol, 5g she would maybe get away with but not 15g!

 

[azure]

Unless she's more active she shouldn't need the snack to prevent a hypo is that right?

Ideally, yes, but remember she's still honeymooning so may be randomly contributing her own insulin.

Edited to add that Type 1 always throws up curve balls, and with a growing child it will change even more. There's rarely stasis - something will be changing. Growth, illness, stress, activity, etc.

 

[njd1980]

The thing is at 17mo it's going to move her a lot more than 2-3mmol, 5g she would maybe get away with but not 15g!

Sorry I didn't read the first post properly I didn't realise she was so young 15 g does seem crazy for some one that small

 

[shivles]

Thanks, I think her morning ratio is too high as all week I've had to give snack for hypo, today is perfect example

 

[azure]

That could be some of own insulin. I had a similar pattern when I was diagnosed. My body would squirt out a bit of insulin but too late after a meal. I just had an appropriately sized snack to deal with that.

 

[shivles]

That could be some of own insulin. I had a similar pattern when I was diagnosed. My body would squirt out a bit of insulin but too late after a meal. I just had an appropriately sized snack to deal with that.

I wouldn't have thought it would happen every day if it was her own insulin?

It's a bit of a weird one because looking at the 1 and 2 hour numbers it seems she needs more insulin but then she hypo before the next meal

 

[azure]

I wouldn't have thought it would happen every day if it was her own insulin?

It's a bit of a weird one because looking at the 1 and 2 hour numbers it seems she needs more insulin but then she hypo before the next meal

Mine happened every day early on. My consultant said it was a sign of my pancreas trying to,struggle on. Of course, that's just my experience.

If a snack works for her, is that an option? I used to time mine so I had it just before the drop.

As you say, her earlier readings are higher so reducing the morning bolus might not be the best thing - unless you're advised to do that.

 

[shivles]

Mine happened every day early on. My consultant said it was a sign of my pancreas trying to,struggle on. Of course, that's just my experience.

If a snack works for her, is that an option? I used to time mine so I had it just before the drop.

As you say, her earlier readings are higher so reducing the morning bolus might not be the best thing - unless you're advised to do that.

If anything the DSN will suggest it goes up because she's still too high at 2hrs, I thought it was just taking too long for her to absorb the insulin though and didn't want to be chasing it with a snack IYKWIM? I thought if it was her own insulin it wouldn't happen predictably, learn something new every day!

 

[azure]

If anything the DSN will suggest it goes up because she's still too high at 2hrs, I thought it was just taking too long for her to absorb the insulin though and didn't want to be chasing it with a snack IYKWIM? I thought if it was her own insulin it wouldn't happen predictably, learn something new every day!

As you know, we can only say our experience, so it may be different for your daughter.

However, you can bear all the suggestions here in mind when you speak to your DSN : )

 

[shivles]

As you know, we can only say our experience, so it may be different for your daughter.

However, you can bear all the suggestions here in mind when you speak to your DSN : )

Oh yes it's just good to have suggestions of other possibilities, I'm still very new to this after all!

 

[shivles]

Update: DSN suggested upping breakfast to help with the big spikes and have a mandatory mid morning snack, hopefully this will improve things!