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Advice needed regarding my 13 year old grandaughter

G

Grayo20

Member
Messages
12
Type of diabetes
Type 1
Treatment type
Insulin
Hi All,

I have been a type 1 diabetic for 42 years and have good control of my diabetes. My 13 year old granddaughter has recently been diagnosed with type 1 diabetes and apparently she has been told that if she does not feel like eating she does not have to and also does not have to have her insulin injection in other words she can miss it if she does not want to eat. Now me being diabetic for 42 years have always been told to miss your insulin injection can cause major problems so my question is have the rules been relaxed or has she been given wrong advice.

I must point out that this is my step granddaughter (not blood related) my daughter is her step mum. Her own mother seems to let her do and eat anything she wants and to be honest I don't think she has a clue about how to manage a 13 year old newly diagnosed diabetic.

Any advice would be gratefully received..............Thanks
 
Hi there, don't take this as the gospel... but that's the advice I had as well.

I was told to dose by the amount of carbs eaten & my blood results with respect to correcting. Thus, if not hungry, miss the dose and allow your long acting to carry on... going on my blood readings, on the odd occasion I've missed a meal it's been ok.

hope this helps.
 
Hi Jackois,

Thanks for the reply. Being diabetic myself and being told it's dangerous to not have your dose of insulin at the right time I found it hard to believe what she was saying but perhaps this is the way things are going these days. There have been many a time I didn't want to eat myself but have forced myself to eat and have my insulin.
 
Really depends what regimen your on. If your having pre mixed insulin (20/80 or 30/70 is common) they yes you have to eat no question. If you are on multiple daily injections (MDI) then as long as you are doing your long acting insulin and it's the right amount it's fine to skip a meal. It's also ok to snack and eat whatever you want as long as you eat a healthy diet and inject for what you do eat.

Things have changed massively over the years.


Type 1 diagnosed 1990
HBa1c current 8.3
Pump and CGM used (animas vibe)
 
Hi Engineer88,

Thanks for your reply. I'm on four jabs a day the last one at night is the long acting one, my step granddaughter is on the same amount of jabs and also the last one being the long acting one. It just doesn't seem right that she can miss a jab especially when I have always been told not to do this so it seems things have changed massively over the years. Thanks for the information
 
You can not miss your basal (background) insulin. If you are not eating then obviously you do not use your bolus insulin (before meal) If you do so and do not eat then in hospital you will land.
 
Hi Grayo20'

First off. Agreed with comments above do I.... "Yoda" lol.
I'm old school of 38 years.. Lantus Novo rapid. (Memories of peeing in a chemistry set & religiously eating to schedule as a kid.) & I occasionally skip a meal these days... Mainly a late breakfast/no lunch.. (I could never do breaky first thing.)
As long as the basal is there, bolus for the lunches actually eaten.

Your last comment about letting the kid "eat what she wants"...? I still hold dear that a regime of laying off the "bad circle food" & cutting the carbs down is a better long term health option than bolusing as a short term Mcfix or an Easter egg... ;)

But what can ya do....?!!
 
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I agree jaylee, but I think a kid these days would be very difficult to refuse the 'normal' foods they are used to.

I didn't know any different to what I was allowed as I was diagnosed at 2.5. Think it could be a bit much to expect perfection straight away!


Type 1 diagnosed 1990
HBa1c current 8.3
Pump and CGM used (animas vibe)
 
Thanks all for your replies. I to remember the old days of having to weigh everything on a little set of scales we were issued with and counting the peas on a table spoon which were all counted as points lol thank god things have moved on from those days. The thing that concerns me thou is the missing of the insulin in all the 42 years of me being diabetic I have never missed having a jab. Perhaps I had better take some diabetes education lessons from her and catch up with the modern way of doing things lol.
 
Engineer88 said:
I agree jaylee, but I think a kid these days would be very difficult to refuse the 'normal' foods they are used to.

I didn't know any different to what I was allowed as I was diagnosed at 2.5. Think it could be a bit much to expect perfection straight away!


Type 1 diagnosed 1990
HBa1c current 8.3
Pump and CGM used (animas vibe)
Click to expand...

In fairness I would concur with yer point Engineer88. I was diagnosed on my 8th birthday..
In the same way I empathise with a T2 diagnosed at 50.. It would be hard..
& there is nothing worse than being the "special case" for something that isn't own fault..

It was more a regard for overall long term quality of diabetic life... :)
 
Grayo20 said:
Thanks all for your replies. I to remember the old days of having to weigh everything on a little set of scales we were issued with and counting the peas on a table spoon which were all counted as points lol thank god things have moved on from those days. The thing that concerns me thou is the missing of the insulin in all the 42 years of me being diabetic I have never missed having a jab. Perhaps I had better take some diabetes education lessons from her and catch up with the modern way of doing things lol.
Click to expand...

Have you ever done dafne? Might be worth doing just so you can see what's about now? I would expect your granddaughter should be offered a pump and that could really throw you!



Type 1 diagnosed 1990
HBa1c current 8.3
Pump and CGM used (animas vibe)
 
Grayo20 said:
Thanks all for your replies. I to remember the old days of having to weigh everything on a little set of scales we were issued with and counting the peas on a table spoon which were all counted as points lol thank god things have moved on from those days. The thing that concerns me thou is the missing of the insulin in all the 42 years of me being diabetic I have never missed having a jab. Perhaps I had better take some diabetes education lessons from her and catch up with the modern way of doing things lol.
Click to expand...


The book Think Like a Pancreas is a good place to start to catch up on modern insulin management techniques.

You've done extremely well no to have missed an injection, but as others have said on basal/bolus you can miss meals when you don't feel like eating providing you also miss the insulin dose, I sometimes miss lunch and have my tea earlier if too busy.
 
Hello sorry to hear of your step granddaughter. As others have said it has changed over the years and I do weigh foods as I carb count.

At 13 your GD will probably have raging hormones which could possibly affect her blood sugars and also time of the month as well:(. It's trying to balance it out and also if she could come on the forum, there are a few teens on here who are in the same boat and it's good to have a chat or a moan with others for help, support and advice.

I wish her well and it will take a little time to comes to term with a diabetes lifestyle.

With best wishes..
 
noblehead said:
The book Think Like a Pancreas is a good place to start to catch up on modern insulin management techniques.

You've done extremely well no to have missed an injection, but as others have said on basal/bolus you can miss meals when you don't feel like eating providing you also miss the insulin dose, I sometimes miss lunch and have my tea earlier if too busy.
Click to expand...


Thanks for all your replies it seems I am well out of date with the modern way of controlling diabetes. For a start I have never heard of basal or bolus please can you tell me what this is ??? I bet your thinking god he's thick but honest I'm not I look after myself pretty good I think, on my last diabetic review my HBa1c was 7.6 which I think is good but by the sounds if it I need educating a lot.

Edit: I have just looked up basal/bolus on the internet and found this: http://www.diabetes.co.uk/insulin/basal-bolus.html
 
Grayo20 said:
Thanks for all your replies it seems I am well out of date with the modern way of controlling diabetes. For a start I have never heard of basal or bolus please can you tell me what this is ??? I bet your thinking god he's thick but honest I'm not I look after myself pretty good I think, on my last diabetic review my HBa1c was 7.6 which I think is good but by the sounds if it I need educating a lot.

Edit: I have just looked up basal/bolus on the internet and found this: http://www.diabetes.co.uk/insulin/basal-bolus.html
Click to expand...

Your not 'thick' at all so don't put yourself down, there's a lot I've learnt since joining the forum and the same can be said for everyone who has joined, like all things in life we never stop learning.

The following is from the DCUK community pages and gives a good comprehensive list of the abbreviations and terminology used in diabetes:

  • Amylin (Islet Amyloid Polypeptide) - Slows the rate at which digested carbohydrate appears as glucose in the blood and thus reduces total insulin demand
  • Basal - referred to as the slow acting insulin used to cover your bodies own glucose stores
  • Beta cells - Pancreatic cells responsible for the production of insulin, amylin and C-peptide
  • BG - blood glucose (this is the measurement of glucose circulating in the blood)
  • Biphasic insulin - An insulin mixture containing both fast acting and slow acting insulin, usually injected twice daily
  • Bolus - referred to as the fast acting insulin used to cover food, typically carbohydrates, some cover for protein as well.
  • BP - Blood Pressure
  • Brittle diabetes (labile diabetes) - Most often seen in type 1
  • BS - blood sugar (as above)
  • CHO - Carbohydrate (Carbon Hydrogen Oxygen)
  • C-peptide - A by-product of normal insulin production
  • CTS - Carpal Tunnel Syndrome
  • CVD - Cardiovascular Disease
  • Double diabetes - Comprises symptoms of both type 1 and type 2 diabetes
  • DSN - Diabetic Specialist Nurse
  • ED- Erectile Disorder
  • FS - Frozen Shoulder
  • Fulminant type 1 - An idiopathic subtype which has a very rapid onset and no honeymoon period
  • G.I - Glycemic index. A G.I value tells you how rapidly a particular carbohydrate is turned
  • G.L - Glycemic load. A G.L value takes into account not only G.I, but also the total quantity
  • GAD (Glutamic Acid Decarboxylase) - Antibodies test
  • GDM - Gestational Diabetes Mellitus
  • Glucagon - A hormone produced in the alpha cells of the pancreas
  • Glycogen - The storage form of glucose in animals and humans
  • Glycogenesis - Glucose storage, mainly in the liver and muscles
  • Glycogenolysis - The breaking down of glycogen stores in liver and muscle tissue
  • GNG (Gluconeogenesis) - The generation of glucose from non-carbohydrate carbon substrates
  • HBA1C - HbA1c is the scientific shorthand for Glycosylated Haemoglobin
  • HCP/HP - Health care professional
  • HDL - High Density Lipoprotein (the "good" cholesterol)
  • Honeymoon period - The period of time after a diagnosis of type 1 diabetes when there is better than expected blood glucose control
  • Hypo - hypoglycaemia (this means blood sugar level is too low)
  • Insulin - A hormone which causes most of the body's cells to take up glucose from the blood
  • Insulin analogues - Genetically altered versions of insulin
  • Insulin antibodies - An immune response to exogenous(injected) insulin
  • Insulin resistance - Normal amounts of insulin are inadequate to produce a normal insulin level.
  • Ketoacidosis - A severe accumulation of keto acids in the blood, resulting in acidosis
  • Ketones - Ketone bodies are acids left over as a byproduct of ketosis
  • Ketosis - A process in which your body converts fats into energy
  • Lantus - Long-acting insulin analogue used as a basal(background) insulin. Normally injected
  • LDL - Low Density Lipoprotein (the "bad" cholesterol)
  • Levemir - Long-acting insulin analogue used as a basal(background) insulin.
  • LHB (Local Health Board) Welsh equivalent of a PCT (Primary Care Trust)
  • Liver dump - The common term given to glucose production from the liver
  • Low-carb diet - A proportional reduction of dietary carbohydrate
  • MDI - Multiple Daily Injections - an insulin regimen adopted by the majority of type 1 diabetics
  • MODY - Maturity Onset Diabetes of the Young refers to a number of dominantly inherited, monogenic defects of insulin secretion. There are currently eight different varieties of MODY
  • Nephropathy - Damage to or disease of the kidneys
  • NICE - National Institute for Clinical Health and Excellence
  • NSF - National Strategic Framework
  • PCT - Primary Care Trust
  • Peripheral neuropathy - Damage to the nerves of the peripheral nervous system
  • PP - post prandial (this means a period of time after eating, usually recorded as 2 hours but often 1)
  • Pump - Insulin Pump, used as an alternative insulin delivery method to MDI. The pump is connected to you 24/7 and pumps tiny doses of insulin thorought the day, with the ability to give extra doses at meals times and with snacks.
  • Retinopathy - Non-inflammatory damage to the retina of the eye
  • SHA - Strategic Health Authority
  • Somogyi effect (rebound hyperglycemia) - A high blood sugar (hyperglycemia)
  • TG or Trigs Triglycerides - the main component part of VLDL and a significant cause of strokes and heart attacks
  • Type 1 (autoimmune) - The most common form of type 1 diabetes
  • Type 1 (idiopathic) - All forms of type 1 which occur without a known cause
  • Type 1 (surgical) - Diabetes caused by partial or complete removal of the pancreas
  • Type 1.5 - Latent Autoimmune Diabetes in Adults (LADA), also known as slow onset type 1
  • Type 2 - Diabetes mellitus type 2 is most often attributed to insulin resistance and relative
  • VLDL - Very Low Density Lipoprotein (the "very bad" cholesterol)
  • Young-onset type 2 - Anyone diagnosed with type 2 under the age of 45 is considered young
 
Thanks for the vote of confidence and also the list of all the abbreviations they're going to come in handy in the future lol. Today for the first time ever I missed my lunchtime jab, I was doing a bit of work on the house and just didn't feel like eating so I gave it a miss. I had my next jab at 5:30pm and my BS was 4.7 so I'm quite happy with that and also don't feel so stuffed lol.
 
Daibell said:
Yes, you can miss the Bolus (rapid) dose if no carbs taken but the Basal shouldn't be missed
Click to expand...

Ok thanks for that but does it mean if I don't feel like eating lunch every day I can miss the lunch time jab every day or just now and again. And the same for the evening meal jab I understand the Basal (long acting) should not be missed.
 
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