Lentil soup

[Kuba85]

Hiya.

The post is about T1d and our 5yr old daughter. She has CGM. We had been monitoring her for a week now and her nights were always really good; staying in the 5-10 range. However last night was less so as she had 4 hypos.

In the evening she had BG 7.4. She then had a dinner which was lentil soup with croutons + green beans + strawberries + blueberries. Her level raised briefly post dinner around 6pm and then by 9pm was 4.1 CGM and finger prick showed 2.8. We gave her glucose tablets - 1.5 or 6gr of carbs. We then had to repeat this 4 times throughout the night… She took a total of 32gr of carbs overnight - there is no way we could have miscalculated the carbs during dinner by that much.

I will speak with our NHS team, but in the meantime, wondering if anyone had any experience with lentil soup (other stuff she ate during dinner she had before and we had no issues).

Oh in terms if her activity level, it was not more than other days. She was less energetic in the evening however which is probably due to the low BG level.

 

[ViktoriaM]

Hi,
I need to use less Insulin with somerhing like lentils or other beans. I believe they are one of those type of foods everyone reacts differently to. I suggest you talk to your medical team and ask them about it. After a lot of trial and error I have found out what works for me in regards to lentils. When I calculate the carbs in them i normally dose for only half or even a third of the carbs.

You are doing a good job as a parent. I have been diagnosed around the same age as your daughter so I understand how hard it must be for you as a parent but I can assure you it does get better. It takes time and a lot of trial and error and sometimes it is just frustrating as there is no obvious reason why something went wrong. The thing is TD1 is unique to everyone and what works for one person might not work for another you have to figure out the best plan for your daughters own individual needs together wit a hopefully supportive medical team.

Sorry for the long post. Good luck
You got this

 

[Kuba85]

Thank you! Very interesting.

And I am sure we will get there as realising the new tech indeed helps a lot all sorts of analysis.

I am just asking here + medical team to help us get there faster. I understand as you say there is a lot of trial and error, but we are trying to solve for minimum trial and error on her. I know some is inevitable but ideally we get to the steady state sooner rather than later - even if deviations are part of life (e.g. we gave up on porridge after trying different timings for insulin and always spiking to 13+; someone here has similar experience so it helped to understand this is not uncommon).

Our 24hr chart from before last night already looked very promising after a week (was far more volatile the week before). Now we need to learn how to live life a little more and still stay within the ranges.

 

[Deleted member 527103]

Some people digest pulses such as lentils and chickpeas which means our bodies breakdown the carbs from them.
However, other people find the pulses "pass straight through" so we need to take little or no insulin for them.
Unfortunately, there is no way to tell what type of digestive system we have without some trial and error.
It sounds as if your daughter has more of the "pass through qualities" when it comes to pulses.

It is a shame your team were not able to explain this to you - it was explained on my DAFNE course - but I guess there is so much information to impart and consume that some needs to be de-prioritised (albeit some times unintentionally).

 

[Kuba85]

Nice. Yeah, nobody discussed this with us. But we will call our diabetes/dietitian team today and will ask about this topic. Thank you!

 

[ElenaP]

I expect that your 5-year-old’s Diabetes Team gave you useful advice yesterday, to help reduce her night-time hypos.
They probably advised you to adjust the low-alarm on her CGM to a higher level, so that she has time to have some carbohydrates before readings fall to 4.0.

I am reluctant to say much, in case it contradicts what the experts have advised, but the following may be useful:
If readings are heading low during the night, a small amount of honey from a teaspoon is easy for the child to take when half-asleep. Say, ¼ to ½ teaspoonful. Dextrose tablets could be crushed between two spoons to a powder.
I have followed the recommendation (from my team) to have some carbohydrates after treating a night-time hypo, to prevent further hypos. In my case, half a digestive biscuit or half a small banana is sufficient. A small child would need fewer carbohydrates. Your team will have an opinion.

You already know that treating Type 1 is trial and error, taking various factors into consideration. As my Tai Chi teacher would say “it depends on the situation”. Good luck on this journey.

 

[Kuba85]

I expect that your 5-year-old’s Diabetes Team gave you useful advice yesterday, to help reduce her night-time hypos.
They probably advised you to adjust the low-alarm on her CGM to a higher level, so that she has time to have some carbohydrates before readings fall to 4.0.

I am reluctant to say much, in case it contradicts what the experts have advised, but the following may be useful:
If readings are heading low during the night, a small amount of honey from a teaspoon is easy for the child to take when half-asleep. Say, ¼ to ½ teaspoonful. Dextrose tablets could be crushed between two spoons to a powder.
I have followed the recommendation (from my team) to have some carbohydrates after treating a night-time hypo, to prevent further hypos. In my case, half a digestive biscuit or half a small banana is sufficient. A small child would need fewer carbohydrates. Your team will have an opinion.

You already know that treating Type 1 is trial and error, taking various factors into consideration. As my Tai Chi teacher would say “it depends on the situation”. Good luck on this journey.

Thank you.

Unfortunately our NHS dietitian was off sick all the past week. So that didn’t help. But realising this is a marathon rather than a sprint so trying to take a deep breath and wait.

Oddly the last 2 nights/days have been anything but the same. She is having hypos after each meal now. Evening is the worst. She had 38gr of carbs and adequate insulin base on bolus advisor and then she had two hypos within half an hour of each other. We only stabilised her levels by giving her literally the same about of carbs she ate for the dinner but have done so without insulin.

It appears as if though we may be in what our NHS team called ‘honeymoon’ period where her pancreas has temporarily started working.. I just can’t see how else she can be fairly stable only after double dose of carbs vs insulin level.

In any case, this is off topic of the lentil soup. We are waiting for Monday and hoping for the NHS staff to be back. The silver lining is that she has been within 4-10 range last week or so, already 95%+ of time. But the number of hypos is telling me that this is not the way to get to the desired range….

 

[Kuba85]

For those who may be interested in the final/conclusive answer. Foods which are rich in fiber (like lentils), need reduction in insulin vs the carbs stated. Our NHS dietitian recommended to half the intake of carbs.

A really interesting book which I am reading now - “Think like a pancreas” (highly recommended) - is stating one should deduct grams of fibre from the stated carbs. See photo of the relevant section.

 

[Kuba85]

Hi,
I need to use less Insulin with somerhing like lentils or other beans. I believe they are one of those type of foods everyone reacts differently to. I suggest you talk to your medical team and ask them about it. After a lot of trial and error I have found out what works for me in regards to lentils. When I calculate the carbs in them i normally dose for only half or even a third of the carbs.

You are doing a good job as a parent. I have been diagnosed around the same age as your daughter so I understand how hard it must be for you as a parent but I can assure you it does get better. It takes time and a lot of trial and error and sometimes it is just frustrating as there is no obvious reason why something went wrong. The thing is TD1 is unique to everyone and what works for one person might not work for another you have to figure out the best plan for your daughters own individual needs together wit a hopefully supportive medical team.

Sorry for the long post. Good luck
You got this

And on this post - looking at nutritional values of lentils, fibre is 32% of carbs… So the adjustment you suggested is perfect.

We use an app to calculate carbs for us and it also gives other nutrients like fibre, fat, protein.

Going forward, we will be calibrating our ratios based on total carbs stated minus the fibre. We think it will lead to more accurate outcomes when we go into extremes, e.g. eat only a lentil soup or eat no beans/fibre at all in a given meal. Adds a layer of complexity - and over time may become second nature - but the app calculates it anyway when we input the meal.

Getting there

 

[KennyA]

For those who may be interested in the final/conclusive answer. Foods which are rich in fiber (like lentils), need reduction in insulin vs the carbs stated. Our NHS dietitian recommended to half the intake of carbs.

A really interesting book which I am reading now - “Think like a pancreas” (highly recommended) - is stating one should deduct grams of fibre from the stated carbs. See photo of the relevant section.

View attachment 69885

Be careful with this.

In the US and for US packaged foods this is good advice - the carb content is stated on packaging and combines fibre amounts with carbohydrate amounts - so you deduct the amount of fibre.

In the UK the fibre amount is already deducted from the carb content on packaging, so you don't subtract it again.

 

[Kuba85]

Be careful with this.

In the US and for US packaged foods this is good advice - the carb content is stated on packaging and combines fibre amounts with carbohydrate amounts - so you deduct the amount of fibre.

In the UK the fibre amount is already deducted from the carb content on packaging, so you don't subtract it again.

God all this is sooo confusing…

But basically if cooking from raw ingredients and eating fruit, one can/should deduct fibre. So lentil soup cooked from lentils.

Anything packaged that states fibre content in the UK already (like canned lentil soup), will already exclude fibre from carbs… Is how I understand it.

 

[Antje77]

But basically if cooking from raw ingredients and eating fruit, one can/should deduct fibre. So lentil soup cooked from lentils.

Depends where you find the nutritional information.
If you use google to look up the carb content of, for instance an apple, the first result coming up often states the source being the USDA. In this case you do subtract the fiber.

US sources read as 'carbohydrates of which fiber', which means the fiber is included in the total carbs and should be subtracted.
UK sources state the carbs and fibre separately, no subtracting (which could even result in a negative amount of carbs, which would be impossible).

Easy clue is in the spelling, fiber in the US (subtract), fibre in the UK.

As for the lentils and going low, pulses are odd, and many people find they need to dose less than you'd expect, according to their I:C ratio.

 

[Deleted member 527103]

But basically if cooking from raw ingredients and eating fruit, one can/should deduct fibre. So lentil soup cooked from lentils.

Confusingly, if you are reading nutritional information on labels in the UK, the fibre is already deducted.
If you are looking up the nutritional content on a US-based internet site, the fiber has NOT been deducted and you need to do so yourself.

The hint is in the spelling
- in the UK, we spell it as fibre and this has been excluded from the total carbs. So you can ignore fibre.
-in the US, it is spelt as fibre and this is included in the total carbs so you must deduct it.

Think Like a Pancreas is often recommended but we need to remember that the author is American.

I agree, it is a minefield of little tips like this to remember.

 

[KennyA]

God all this is sooo confusing…

But basically if cooking from raw ingredients and eating fruit, one can/should deduct fibre. So lentil soup cooked from lentils.

Anything packaged that states fibre content in the UK already (like canned lentil soup), will already exclude fibre from carbs… Is how I understand it.

As others have already said, that depends. It depends on where the values you're using for your lentil calculation are taken from. The internet can be unreliable as you will sometimes find UK sources quoting US figures, I assume often without realising it. Social media sources are particularly poor.

The fiber/fibre thing is usually a good clue.