my 3 year old just been diagnosed

[cairnsy]

Hi all,
I'm still in shock and feeling rather overwhelmed with our recent diagnosis. My son who's 3 had been acting up for a while but I thought starting nursery school and having a baby brother were the culprits. I took him to our gp as he was drinking and going to the loo way more than usual over last few days. His urine sample had sugar and ketones present so we had to go hospital for immediate blood tests.
My son and I spent few days in the children's ward as his initial blood glucose was 34.4 and he fought anyone who tried to come close (including me) to administer his insulin or test his blood.
Now at home he eventually lets me inject him with his magic pens but it's a constant battle and I am still awaiting our clinic appointment due to Christmas. I've had his diabetic nurse at the end of the phone every time he eats to give me correct dose of insulin but I have yet to understand his diet or needs and am feeling terribly unsure of this all.
His HbA1C was 10.3 does this mean he has been diabetic for a while? He's only just started to lose weight and has been drinking more than usual but looking back I can see some signs he wasn't himself.

 

[CambridgeLass]

Hi. I know as a parent it is very hard for you. It's a lot to take in and information can be overwhelming. It takes time but things will settle down and become better, though at this moment you can't see it. My 6yr old was diagnosed 3 weeks ago. The first injections took an hr to coax her and within a week we were down to 5 mins. Your DN will have told you what doses to give your son. I would keep a diary of BG results and what food he ate so you can correlate any patterns and see where high numbers may be carb related. We have cut out fruit juice. I give only a little at breakfast whereas before we were having it regularly with meals. Fruit itself has high sugars and we were used to having a lot as snacks, I try now to incorporate some as a pudding or give very little as a snack. We found out a big banana can be 30g carbs compared to a small one which is 15g, so now we buy the small ones when we shop. Sugar free jelly has gone down a treat. I look more carefully at good labels - note total carbs not just the sugars which they usually put on the front. These are the little changes we have made which haven't impacted so much. The first week out BG numbers were gradual to come down and now they are looking much better. I found it helpful to write down all my questions and concerns and take them to clinic. Certainly talking to others that have T1 children and their experiences help. I hope things become better for you. It's heartbreaking for a parent but kids are more resilient than we give them credit for. I cried for days at the start, now I'm full of fight that I'm not going to let this condition get the better of my child. We add the testing and injections to our day and carry on as normal. Hope this year is better for you. All the best! Tracy

 

[Spearmint]

Hi all,
I'm still in shock and feeling rather overwhelmed with our recent diagnosis.

My son and I spent few days in the children's ward as his initial blood glucose was 34.4

Now at home he eventually lets me inject him with his magic pens but it's a constant battle and I am still awaiting our clinic appointment due to Christmas. I've had his diabetic nurse at the end of the phone every time he eats to give me correct dose of insulin but I have yet to understand his diet or needs and am feeling terribly unsure of this all.

His HbA1C was 10.3 does this mean he has been diabetic for a while? He's only just started to lose weight and has been drinking more than usual but looking back I can see some signs he wasn't himself.

How you are feeling is completely normal, i was the same when my daughter was diagnosed at age 9.

Her blood glucose was over 45 on hospital admission and her 1st Hba1c was 15.something!
Hba1c measures the levels of blood glucose over the previous 2-3 months.

You will understand what he needs to eat and how to adjust his insulin in time.
What insulin have they started him on?

 

[Spearmint]

We have cut out fruit juice. I give only a little at breakfast whereas before we were having it regularly with meals. Fruit itself has high sugars and we were used to having a lot as snacks, I try now to incorporate some as a pudding or give very little as a snack. We found out a big banana can be 30g carbs compared to a small one which is 15g, so now we buy the small ones when we shop.
Certainly talking to others that have T1 children and their experiences help. I hope things become better for you. It's heartbreaking for a parent but kids are more resilient than we give them credit for. I cried for days at the start, now I'm full of fight that I'm not going to let this condition get the better of my child. We add the testing and injections to our day and carry on as normal. Hope this year is better for you. All the best! Tracy

Tracy, i did the same cut down on the fruit!
My daughter never has fruit as a snack but an apple or grapes tagged onto the end of lunch or dinner doesn't cause too much of a problem because the other foods slow down the absorption.
The best fruits to avoid big spikes are berries, strawberries, raspberries, cherries, some melon are very low carb.
Bananas are the worst fruit and we rarely have them anymore.

 

[JontyW]

Hello cairnsy,

I'm sorry to hear about your son's diagnosis, but as others have already said, you will get into a routine of measuring carbs and knowing how much insulin to inject etc, and then it wont seem so daunting. I have been a Type 1 for 43 years, since age of 27, and my sister was also diagnosed at age 3 and has now lived with diabetes for 58 yrs. In my case I have always taken diabetes very seriously and seemed to have managed it well with good control of HbA1c over all these years. The result of good control ..... no diabetes complications what so ever. It may be down to luck, but I don't think so since there is very strong evidence linking poor blood glucose control with a wide range of serious complications.

So my recommendation to you is ....
1) Get used to detailed carbohydrate counting. Buy this excellent book (only £9) that provides clear pictures of nearly every food you might need
Carbs & Cals: A Visual Guide to Carbohydrate & Calorie Counting for People with Diabetes
(http://www.amazon.co.uk/gp/product/0956443052/ref=oh_details_o01_s00_i01)

2) Download this document: Carbs count e-book – An introduction to carbohydrate counting and insulin dose adjustment.
https://shop.diabetes.org.uk/usr/downloads/Carbs-Count-2012-reduced.pdf
- this is the basis of the DAFNE (Dose Adjustment For Normal Eating) course which you will probably be hearing more about

3) Purchase a pair of scales that weighs accurately in small amounts. Always weigh all carbs that you are not sure of. At the start weigh all potatoes, pasta etc where it is not shown on the packet. For purchased items with nutritional labeling, you only need to know the CARBOHYDRATE for the portion weight you are serving, and ignore the "of which sugar" value shown underneath.

4) Purchase this book: "Using Insulin" Using Insulin: Everything You Need for Success with Insulin - book available from Amazon
http://www.amazon.co.uk/Using-Insulin-Everything-Need-Success/dp/1884804853/ref=sr_1_1?ie=UTF8&qid=1352832973&sr=8-1

It only costs £15 and although written by an American, so the BG units are different, I have found it really good in helping me to understand much more about managing insulin, particularly balancing the background insulin (basal) with the fast acting insulin (bolus). Although I've been T1 for 43yrs it is only recently that I've focused on these books and documents shown above, and my understanding, and hence control, has improved even better than it was.

I hope you find this suggestions useful, and finally, my sister did not take the same care as myself, and has had a quadruple heart by-pass a few years ago and is now having eyesight issues (retinopathy) also.

If you have anymore questions .. just ask

Jonty

 

[JontyW]

One more critical point that I forgot to mention .. record, record .... record.

I personally am very comfortable with computers and using Excel, so I have developed a detailed spreadsheet where I record EVERY DAY on my laptop ...

1) BG on waking and prior to every meal (breakfast, lunch & dinner) plus pre-bed
2) carbs planned to be taken with each meal
3) work out the Carb-Insulin Ratio (often called the Insulin-Carb Ratio or Carb Factor) for EACH meal, since this can vary for each meal during the day. This Ratio is the Carbs/Bolus insulin needed to get good BG readings about 4 hours after the meal.
4) Once you know this ratio for each meal, then it is quite easy to know how much fast acting insulin (bolus) is needed to match the carbs for that meal.

If you are interested I could send you a simplified version of my speadsheet to help you get going .. let me know.

You may be wondering why I am so keen to help you? Well, I have never contributed to this excellent forum, but often read what is being offered in terms of advise, and I know from my own experience that if you put in the effort to get educated and informed, then the the dire consequences of poor blood glucose control CAN be avoided.

And I have two grandsons who are both 3 yrs old .. and so far are healthy

Jonty

 

[CambridgeLass]

[/quote]Tracy, i did the same cut down on the fruit!
My daughter never has fruit as a snack but an apple or grapes tagged onto the end of lunch or dinner doesn't cause too much of a problem because the other foods slow down the absorption.
The best fruits to avoid big spikes are berries, strawberries, raspberries, cherries, some melon are very low carb.
Bananas are the worst fruit and we rarely have them anymore.[/quote]
Spearmint, out of interest what snacks do you give your daughter, I'm finding it hard to find good ones that are within a 10-15g carb range and are substantial enough until the next meal.

 

[Spearmint]

Spearmint, out of interest what snacks do you give your daughter, I'm finding it hard to find good ones that are within a 10-15g carb range and are substantial enough until the next meal.

Hi Again Tracy

What insulin is your daughter on?
That could make a difference as to the best snack ideas!

My daughter has had carb free snacks for over a year as that fits best with her current treatment.
Previous to that she did used to have snacks of about 10-15g carbs but like you are finding it is hard!
Weetabix oaty cereal bars i found were the lowest at 12.8g carbs & worked well.
Digestive biscuit 10g + half a cup of milk 5g = 15g

I did find some crackers which are quite low carb so a few of those with cheese make a good snack, i will go find them in the cupboard later for you.

 

[cairnsy]

Thank you for your replies Tracy, Spearmint and Jonty. It has been so good to hear from you and I appreciate your advice.

Firstly Jonty, I admire you taking good care of your health and I will buy those books you mentioned. I'm finding it invaluable to record everything my son eats, BG and insulin doses. I'm hoping to have an appointment with a dietician within the week so I can start understanding which diet would be best.

Tracy you seem to be doing incredibly well. Earlier when it took me an hour to give my son his insulin and we were crying and I was about to go mad, I did think of you and how it should become easier.

Spearmint my son is on 4 of levemir a day and between 2 or 3 of novorapid after each meal. What about your daughter? My son is constantly hungry and I feel bad i have to keep saying no to some snacks. I try and fill him up with ham, cheese plus 10g carbs at snack time and sugar free jelly has been a hit.

One day at a time.

Thanks again.
Cairnsy

 

[Spearmint]

Spearmint my son is on 4 of levemir a day and between 2 or 3 of novorapid after each meal. What about your daughter? My son is constantly hungry and I feel bad i have to keep saying no to some snacks. I try and fill him up with ham, cheese plus 10g carbs at snack time and sugar free jelly has been a hit.

One day at a time.

Thanks again.
Cairnsy

The hunger will eventually go as his body settles down, my daughter was the same when 1st diagnosed!
Yes we use carb free snacks, ham, cheese, chicken, hard boiled egg, cucumber, cherry tomatoes.

She has been on Levemir and Novorapid and i found it easier to keep her on carb free foods inbetween meals.
I found that a lot of breakfast cereals would spike her levels high for quite a while, as does white bread.