T1D - Child - carb advice

[Norwich1947]

Hello everybody. This is my first post since my 13 yr old son was diagnosed 6 weeks ago. I wanted some advice regarding the quantity of carbs he consumes. We were started on carb counting as soon as he came home from hospital and seem to be doing ok with this as his readings, touch wood, are usually within the required 4-8 range at present. He has had a couple of lows (3.5's) and his highest in the last few weeks was (12.3) compared to when he first came home his readings were always over 13.9 and the highest 28.2 so it looks like we are doing things correctly.

However, I note that a lot of people on here are on low carb diets. My son has been told by the dietician that he can eat what he wants so long as we calculate the carb content and he is given the correct dosage of insulin to account for what he is about to it.

He is probably consuming around 300g of carbs each day! The dietitian does not seem concerned about this but as I can see a lot of you are limiting your carb intake, I wonder whether we should be doing the same? Any advice will be greatly appreciated.

Thank you and have a great day

 

[catapillar]

Low carb is really for type 2 diabetics. There is no need for a type 1 diabetic to change their diet or limit carb intake if they can manage insulin to cover the carbs they are eating. Some type 1s choose to low carb, but there certainly isn't a requirement to do this. Given your son is already dealing with getting to grips with diabetes it seems a bit unnecessary to also radically alter his diet of he is getting along fine with carb counting and eating just as he was pre diagnosis.

 

[Norwich1947]

Thank you #catapillar for your clarification. This has put my mind at rest that we are on the right track. Have a good day.

 

[Scott-C]

Welcome aboard, @Norwich1947 !

Low carb is a personal choice. T1 can be a pretty tough thing to get your head round and having to radically change diet as well would probably have pushed me over the edge if I'd had low carbers coming along and telling me I couldn't have toast and hash browns with a fry up.

I make a few accomodations - brown rice instead of white because the fibre slows down absorption (and it tastes nicer!), steer clear of potatoes because they're unpredictable, salted popcorn at the pictures instead of sweet, but other than that, my diet is surprisingly unrestricted, and I hope that proves to be the case with your boy as well.

Don't have the references to hand, maybe others can help, but I'm pretty sure there's been some studies suggesting low carb in children can have bad effects because of their need to grow, quite apart from the psychological affect which it can have in making a young un feel different.

I'm not saying he can go to town on cakes and juice to his hearts content, but with a bit of moderation, he can eat a pretty varied diet.

He's maybe in the honeymoon period at the moment - the pancreas picks up a bit and starts making insulin again for a while, can vary from months to years - and that sometimes makes it easier to deal with carbs. Once honeymoon is over, it can get trickier and it's maybe at that point that people start thinking about reducing carbs on the basis that there's sometimes less scope for error if you're taking smaller doses of insulin.

But even then, he's not going to be living like a monk. Me, I'll shortly be heading off for my usual Sunday curry lunch, poppadom, fish pakora, lamb jalfrezzi, naan bread, not remotely low carb, but I can deal with it perfectly well because I know how much insulin to take for it.

T1 is never going to be a walk in the park, there'll be a few messy hypos ahead, but please be assured that although it can be frustrating at times, this is a totally manageable condition, just takes a bit of forethought and planning. He'll be jumping on a plane to go back packing before you know it!

 

[Norwich1947]

Thank you Scott C for your response and advice. This is much appreciated. Have a great day and enjoy your curry. We're having a gammon roast.

 

[CathP]

Hi!

We've chosen to low carb with our t1 daughter who's 6, dx nearly 2 years ago. Although the advice is to eat what you want and cover with insulin, for some people that can be rather tricky. We managed 6 weeks regular/high carb, and realised it'd be less stressful and healthier for our daughter to reduce the carbs. She now eats about 30g carbs a day, and the fear, risk of highs and hypos has massively reduced, so she can concentrate on being a small child. There seem to be many different ways to manage diabetes, so you need to find what works for you and your family.

Bee wishes.

 

[Rach85]

Hi,

My daughter too was diagnosed T1 at age 6, back in Feb this year. We too were told that she can eat whatever as long as it was covered by her insulin. We kept a diary of what she was eating and compared this to the BG results and like Cath has stated the risk of Hypos and Hypers were reduced when the carbs were lower. She didn't have the big jump up with the quick drop down, stayed more level. Having monitored what she eats - Pasta is a massive jump up and quick drop, and you too will get used to the patterns with certain foods. I try to get her to chose the low carb and she does get excited when she picks a meal that requires no insulin. But if she doesn't chose carb free that's fine too (I don't buy the food that sends her high - like the pasta anymore), however once out of the honeymoon period, I will be following the carb free as much as possible for her. I could do it now, but really want to phase and her choose (as she is now 7 going on 19!) We have also made carb free snacks, such as cookies, they are rather nice and she was excited when she could have a cookie and a cup of milk with no insulin!

Good luck in finding what works for your family

 

[justadad]

He is probably consuming around 300g of carbs each day! The dietitian does not seem concerned about this but as I can see a lot of you are limiting your carb intake, I wonder whether we should be doing the same? Any advice will be greatly appreciated.

Hi @Norwich1947
I decided to reduce my son's carbs to 80-120 grams a day. No simple carbs at all, only when needed to treat a hypo, and even then, it is just a small amount, so that he doesn't go high either. Now, what I have witnessed, and I was asking for advice earlier last week, is that he is not gaining any weight at all, even though he's grown taller. Kind people on this forum offered reasonable suggestions, most mentioning the importance of calories. Kids need to grow, so I am starting to think that drastic cuts on carbs in a kid's diet is not such a good idea, but a more balanced approach and substituting simple with complex carbs and adding more protein should work well. At least for my son.
Hope you find what works best for you and your boy!

 

[tim2000s]

@Norwich1947, I was diagnosed back in the late eighties, when the low carb approach to T1 wasn't something that most people knew about, and the hospital advice was to eat carefully, and to carb count. Carefully meant substituting anything that was white, refined carbs for something that was likely to be slower absorbed and lower GI (as we would think of it now). I've now been Type1 for nearly 30 years, and whilst having background retinopathy, I don't have any other complications.

The key to this is being sensible in what and how you eat, and how you manage your condition. I'd suggest that being supportive of your son,. and assisting him in learning how to look after himself and the appropriate courses of action to take in various scenarios will ultimately benefit him more than switching over to a low carb diet as a 13 year old. He is at an age that it will make him stick out from his friends, and having T1, that will be the last thing he further wants to do, which is what a low carb approach will do, even though in the long run it may be a better option. Teens are notoriously difficult...

 

[ringi]

Given the number of calories children need, it is very hard (maybe impossible) to limit their carb intake much if you are fearful of fat. Having all the calories as protein is not healthy and will anyway result in their body converting the proteins into glucose, so may give even more unpredictable changes to BG then carbs.

This is a video from the parents of a child with Type1 who have 24/7 remote BG monitoring and is using low carb.

 

[Snapsy]

Gosh, thanks @ringi - just watched that while having my (low carb) lunch - what an eloquent chap. Thanks for sharing.

 

[CathP]

That video is one of my all time favourites, along with this one...

 

[GrantGam]

Moderation is key.

I don't have kids yet, but I am a T1D and remember what it was like to be 13 years old. It can be a tough time and I wasn't even diabetic at that point... As @Scott-C has said, T1 is tough! It's easy to feel alienated from your non-diabetic pals. I'd imagine that feeling can be amplified when you're a child. And even more-so when a heavily restrictive diet is thrown in. Your son may not feel that way at all, but I know I would have done - and still would.

I'm very surprised @tim2000s never mentioned this, but you might want to have a read of this fairly recent thread; and a summary from his blog:

http://www.diabetes.co.uk/forum/thr...e-diets-for-t1d-children.122090/#post-1486050

http://www.diabettech.com/low-carb-...e-the-effects-reviewing-some-recent-research/

I choose to follow a moderate carb diet. It's usually around 150-200g per day and that works well for me. I can keep my fat intake within the recommended guidelines and most importantly, my BG in check. So I'm happy and exclude nothing from my diet. Those carb values work for me and keep my weight stable, your son's ideal carb intake would likely differ - but if it's more carbs, that in no way means poorer BG control. It's about eating the right things and dosing accordingly.

Through trial and error, combined with regular testing, you and your son will be able to work out what foods wok best for his BG management and what ones don't. Smart substitutions and a good understanding of diabetes management can, and do, give great results. There is no need to put your son on a restrictive diet unless that's something which you would both like to do

Here's evidence that BG can be well controlled on a moderate carb diet. My upper limit is set at 8.5mmol/l and the lower 4mmol/l. I had an apple for breakfast and a sausage roll with chips and beans for lunch. I'll have 100g or so carbs for my dinner tonight (not sure what yet), so I'll be just over 200g carbs for my day - that's if I don't have dessert

 

[tim2000s]

@GrantGam Due to the biased nature of the study and its poorly drawn conclusions, I deliberately didn't raise that one.

 

[GrantGam]

@GrantGam Due to the biased nature of the study and its poorly drawn conclusions, I deliberately didn't raise that one.

Fair enough Tim, would you prefer if I edited my post to remove both links?

 

[tim2000s]

You're fine to leave them there, but it's just worth making clear that the content of the study is one sided (which we've already done)!

 

[ringi]

To save other peoples some reading….

• The study was based on six T1 children chosen because they did not get on well with low carb, so not very blanced
• The children are often stated as being hungry
• the energy intake of the children cited was not high enough, and that there had been no compensatory energy intake when carbohydrate was removed.
• What they show is that badly handled, restricted carbohydrate diets underfeed required energy and nutrients that a growing child or adolescent needs.

You can't just remove the carbohydrate from a standard children's diat keeping the rest of the diet the same and expect to get good results. The doctors are blaming the parents, I blame the doctors for not excepting that “low carb” is a valid option and hence not providing the support needed.

 

[noblehead]

@Norwich1947 , all I would say is give your boy a say on what diet he wants to follow, at 13 years old he is quite capable of being involved in this decision making.

 

[Norwich1947]

@Norwich1947, I was diagnosed back in the late eighties, when the low carb approach to T1 wasn't something that most people knew about, and the hospital advice was to eat carefully, and to carb count. Carefully meant substituting anything that was white, refined carbs for something that was likely to be slower absorbed and lower GI (as we would think of it now). I've now been Type1 for nearly 30 years, and whilst having background retinopathy, I don't have any other complications.

The key to this is being sensible in what and how you eat, and how you manage your condition. I'd suggest that being supportive of your son,. and assisting him in learning how to look after himself and the appropriate courses of action to take in various scenarios will ultimately benefit him more than switching over to a low carb diet as a 13 year old. He is at an age that it will make him stick out from his friends, and having T1, that will be the last thing he further wants to do, which is what a low carb approach will do, even though in the long run it may be a better option. Teens are notoriously difficult...

Thank you Tim2000 for your response. I have taken on board the advice you have given. I'm glad to hear that after 30 years of being T1 you have no other complications. Well done for keeping everything under control. An inspiration

 

[Norwich1947]

@Norwich1947 , all I would say is give your boy a say on what diet he wants to follow, at 13 years old he is quite capable of being involved in this decision making.

Hi. Absolutely agree with you. My son chooses what he eats for breakfast lunch and dinner. He knows what he likes and what he doesn't like. I am the one that calculates the carb content of his meals and was just asking if I should be concerned about the amount of carbs he was consuming. Wasn't planning on asking him to drastically change his diet. Many people have suggested that it is normally type 2 that are on low carb diets so my mind was put at rest.