Low carb for kids

Me again Shivles
I strongly urge you to consider a pump. I'm not sure why you are waiting untill she is older to have input. You have to do the best for her to live a full life whilst managing her diabetes as best you can. Limiting diet rather than a pump may not be doing that.
My son had a pump very early on and it didn't bother him or any of his peers what so ever. Young children are so difficult to manage with all their growth spurts, boughts of illnesses,changeable routines and food fads. A pump makes all that so much easier and then there is the question of school. Pumps are very easy to manage. My son's preschool had no problems at all. My son's bg used to go through the roof at breakfast but now he has a much higher background insulin for that time programmed into the pump and it's solved that problem. We simply wouldn't be able to cover it with the bolus alone.
I'm not sure how good your diabetes team and how pro active they are about pumps but if you haven't already maybe do a bit of research yourself about what's out there. I have a DPSN at the moment that does not support my choice of pump and quite frankly doesn't know what's she's talking about. If your not already be aware they don't always know best.
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Just a note, I've noticed that you are referring to your daughter as carb intolerant. Why do you think this?
If it's because she goes high after eating carbs it's because she is a young child with type 1. Very young children and puberty are the hardest manage. This is one of the reasons Nice have approved and recommended pumps for children under 5.im just concerned you've been side tracked by thinking your daughter is carb intolerant when maybe it's the insulin regime she's on that's the issue?
Beside the pump issue believe me I know how difficult it is to have a young child with type 1. All you want to do is the best for them and their future. It can be exhausting!

I'm also not sure that "carb intolerant" is a good label for type 1. I'm type 1. I don't take insulin as medication to compensate for carbs. I take insulin to keep me alive, regardless of what I am eating. I adjust my insulin dose taking into account carbs and protein and activity and hormones and stress.

Type 1s who very low carb and are in nutritional ketosis still require insulin.

shivles said:

I would rather try and control her blood sugar with diet before trying the pump as an option, I wanted to hear from people doing this not advice on if it's okay, as I say I'm working with her team as this is the plan for now

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Do have a look for type 1 grit for advice from parents who are using low carb - they have Facebook, Pinterest, YouTube. I think there are probably type 1 grit for parents/kids groups.

I guess my concern on low carb for such a little one is the social exclusion, that they don't get equipped with how to eat "normally" and manage insulin, so it could make that hand over to self management when they are old enough to make their own decisions on what to eat etc a bit more problematic and, since I've reduced carbs I've not had a period (which I'm convinced is related to the dietary change) so that makes me nervous about the potential developmental impact of cutting out a food group for little ones who are growing.

The type 1 grit groups swear by low carb though so have a look there for practical tips. But do be open to it not being the only way.

If someone had asked me two/three years ago if I wanted a pump I'd have said no way. Now, I love my pump and I don't know what I'd do if I couldn't have it. Equally, if someone had asked me two years ago about changing my diet to lower carbs I'd have said no, I have now reduced carbs (that's not done anything much for my blood sugar control) and I'm researching nutritional ketosis.

I'm all about exploring all options. Sorry if it felt like anti-low carb

shivles said:

But in the instance of going from 3.5 to 14 there's only one thing that would help and it's eating something different, I can't give it any earlier if it's already sending her hypo from waiting?

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@shivles It's hard to give specific advice a) over the internet, and b) for a young toddler who you can't explain things to, but the basic premise holds true. Correct manipulation of insulin will reduce/control the spikes along with appropriate carb choices. For example, I don't eat cornflakes for breakfast because they're high GI. However, that doesn't mean all cereal is bad. I've found that a mix of granola or muesli and a bran-based cereal works well. I wouldn't give bran to a young child, but I think a muesli mix might work ok, along with full fat milk.

I was thinking about this as I made my son's breakfast this morning (similar age). I'd give him a low GI breakfast with added fat. You could also try something like seeded bread with chunks of cheese and hard boiled egg.

I absolutely undersatnd your panic about the spikes. I'd hate them too (although I'd be happy with spikes to 10 or so for such a young child if they were mine) but I promise you as you get the hang of the whole balancing act and experiment with food combinations things will get easier.

There's another mum here with a young child - both Type 1. I can't remember her name but I'll tag her if I do. Meanwhile @mcpound has given some useful,advice above.

Im sure you wont like this but I think you are wrong in going down this route with your child purely because as she gets older and goes to school it will make her even more different!

Its going to be hard enough for her to deal with her diabetes without the bullying that will almost certainly accompany eating a totally different diet to every other kid at school.

This is only my opinion so feel free to totally ignore what I have said but thats the way I see it.

shivles said:

I don't think grains are an appropriate food for anyone, never mind a diabetic

Why put a plaster over the issue (carbs) when I can just remove the issue?

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The issue isn't just carbs. If it was that simple, we'd all be laughing. Not being sarcastic there - I mean that. I've been Type 1 for more than 20 years and if somebody told me eating raw carrots standing on my head would take away the nuisance of it, I'd do it. I've read a lot about LCHF and keto, and it's not as easy as you'd think and the results aren't as good as I was hoping for Type 1s.

In the absence of carbs, the body will turn protein into,glucose. This is harder to allow for than carbs. It can cause unpredictable and delayed spikes necessitating extra boluses or extended boluses if you have a pump. I used to think that a carb-free meal would be easier, but actually it was more hassle and less predictable than having a small amount of carbs (note my emphasis on small - I think excessive carb intake makes control hard).

Then you have liver dumps and waking rises - which are nothing to do with what you eat. As an example, I once thought skipping breakfast would make the mornings easier - no thinking, no BS to,control - but it doesn't. My body will pump out glucose even if I don't eat and my BS can be in double,figures by late morning.

If you don't want to eat grains, then that's your choice. There are other options for carbs. As long as your daughter is getting an appropriate amount of vitamins than that wouldn't be a problem. I sometimes enjoy a buckwheat breakfast. Buckwheat, despite its name, isn't a grain. That gave me a nice, steady BS too : )

shivles said:

Why put a plaster over the issue (carbs) when I can just remove the issue?

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I think you might be over simplifying type 1 diabetic management by looking at carbs as "the issue".

Yesterday I had a hypo from walking, it wasn't a low low, over 3.5 so I thought I would experiment by treating with protein. I had 30g of cranberry Wensleydale and 25g bacon: 4g carbs15g fat 18g protein. It brought my blood sugar up, unacceptable slowly, for a hypo treatment, to 5.5 plateau and then I got a delayed peak of 8.8 about 2.5hrs later. Obviously as I was experimenting with treating a hypo I didn't have any insulin with that. But if I was just having it as a snack starting off with normal blood sugar, I would need to use an extended bolus to cover it. Does that mean I should now think of protein as an issue to cover with a plaster? I'm not so sure that's a great way of looking at type 1 diabetic management long term.

My conclusion from my experiment is that protein isn't a good way for me to treat a hypo. It acts far too slowly. It is important to treat hypos quickly. And this certainly isn't an experiment I would suggest for a child where the priority should be getting blood sugar back up with fast acting glucose (dextrose tablets). I was just trying a thing and it's easy for me to try a thing with me, because im the only one im going to hurt if it doesn't work - luckily there was nothing hurt from trying, I was just hypo for longer than I would have liked, which is not good for maintaining (or recovering, for me) hypo awareness, and I was annoyed by the unexpected spike.

The list of things that won't affect blood sugar will be vanashingly small, I don't think any type 1 could live a full life and eliminate everything that does impact blood sugar. So my view is, why not manipulate insulin dose and timing (the most responsive way to manipulate insulin being via pump) to suit life? For me personally, "the issue" is I don't make any insulin and the best plaster I have for that is a pump. Although you can micro bolus with MDI and a half unit pen and look and where and when you are bolusing.

And, non diabetics also have spikes, so if the aim is to get normal/non diabetic blood sugar it might also be good to try and have a look at cgm traces for non diabetics who will spike, less dramatically, in response to food.

You could also look into experimenting with different insulins - both basal and bolus. Not every insulin suits every person. Some act quicker than others, even if they're the same type eg Humalog is usually considered to,act faster than Novorapid. For basals, some get on better with Lantus than Levemir and vice versa. Others use different basals than either of those two popular ones.

Just another thing to think about

When I first joined this forum there was a member who was a Gp with a son with type 1 diabetes. She gave a link to an article she had written for the BMj about type 1 diabetes, it out may have been a letter. Her reasoning was by low carbing side he minimised his insulin therefore avoiding the risk of hypos.
This would have been 2008/9 I will try and find a link. I might have remembered things incorrectly but will have a look as it might be relevant to you.

shivles said:

You're misunderstanding my point, carbs are the issue because they produce a high fast spike which I can't control, whereas the rise from protein is slower, more predictable and much easier to control.

I was told Novorapid was one of the fastest if there is another that's faster I will definitely look into it

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I think you have a lot of knowledge about diabetes and what foods do what and your doing the best you can to control her BS levels and educate yourself

I am on novolog and eat VLC so I do gluconeogenisis faster than when I eat protein with carbs but it is a much slower and lower spike and for me

I think that if your DSN told you to cut carbs and is willing to work out a plan with you then I would at least give that a try. I would think, at least hope, the DSN is knowledgable when it comes to children.

This is your child and I am not recommending any type of diet that doesn't suit you or your child. I do think talking with yiur DSN and discussing your options will help put your mind at ease in making a decision.

I don't think grains are a healthy food for anyone either but that of course is just my opinion.

What is she eating that she gets those spikes?

@shivles - In my position as a resolved T2 who has never taken any medication, I wouldn't try to comment on diet or medication for your daughter, but in July I attended the Public Health Collaboration UK Conference (PHCUK). The PHCUK isn't about diabetes, but about making healthy choices.

At the conference, as well as many diabetics there were many health care professionals and others. Amongst the professionals there were a number of specialist nurses, and dieticians who promote and encourage the use of a low carb diet for people with epilepsy, including children. I'm not suggesting that makes it perfect for everyone, but saying it is out there, being used for more than just diabetes, for all ages.

PHCUK website is here: https://phcuk.org/ and their YouTube channel, hosting a number of presentations from the conference is here: https://www.youtube.com/channel/UCZO0WD6hn02_6b0_MNTKPgQ/videos

I hope you find a positive way forward for your daughter. It can't be easy with such a little one.

shivles said:

Grain products spike her the most, rice a little less and potatoes a little less again but all of them to drastically to control.

Basically I need an insulin for her that will drop her from 14 to a normal level in about 20 minutes but not send her hypo lol

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What did she eat when she went from 3.5 to 14ish? If the 3.5 was because her insulin had already started working, then it's unlikely she'd have spiked because the insulin would be acting (and quite strongly too).