Low carb for kids

[azure]

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

Yes, carbs generally produce a faster spike than protein, but a delayed spike is still a spike. I'm not misunderstanding your point. I understand only too well. When I was diagnosed, like all Type 1s I went through a number of stages of anger, upset and trying to understand. I too thought not eating carbs would work great. But it's just substituting one plaster - to use your analogy - for another by eating protein. You will still need that plaster.

I promise you that correct carb counting and correct insulin type properly used will not produce spikes like you've described if you choose appropriate carbs at the right amount as part of proper meals.That's not a critisism in any way. It's a huge amount of information to get your head round.

Knowledge and experiencd are everything with Type 1. That holds true whatever level of carbs a person eats.

The best thing to do is to choose a rough daily carb amount, with the help of a dietician and paed, because your daughter is so young, and gradually build up a portfolio of meals that work and for which you know how much insulin your daughter needs and when.

 

[shivles]

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).

The 3.5 was because the insulin had kicked in and she had a slice of toast

 

[azure]

The 3.5 was because the insulin had kicked in and she had a slice of toast

Anything on the toast?

 

[shivles]

Yes, carbs generally produce a faster spike than protein, but a delayed spike is still a spike. I'm not misunderstanding your point. I understand only too well. When I was diagnosed, like all Type 1s I went through a number of stages of anger, upset and trying to understand. I too thought not eating carbs would work great. But it's just substituting one plaster - to use your analogy - for another by eating protein. You will still need that plaster.

I promise you that correct carb counting and correct insulin type properly used will not produce spikes like you've described if you choose appropriate carbs at the right amount as part of proper meals.That's not a critisism in any way. It's a huge amount of information to get your head round.

Knowledge and experiencd are everything with Type 1. That holds true whatever level of carbs a person eats.

The best thing to do is to choose a rough daily carb amount, with the help of a dietician and paed, because your daughter is so young, and gradually build up a portfolio of meals that work and for which you know how much insulin your daughter needs and when.

The spike is about half what she gets with carbs though

 

[azure]

The spike is about half what she gets with carbs though

I don't disbelieve you, but the action of protein can be difficult to cover, requiring further boluses. The less carbs you have with it, the harder it is to predict the rise, I've found.

Edited to add that I dint mean lots of carbs are necessary, but some help.

 

[noblehead]

carbs are the issue because they produce a high fast spike which I can't control,

A book that often gets a mention on the forum is Think Like a Pancreas, it goes into detail about reducing postprandial spikes by pre-bolusing to which many of us benefit enormously from.

However there is a book that is more children focused called Type 1 Diabetes in Children, Adolescents & Young Adults which by all accounts is very good, I'm sure much like Think Like a Pancreas it will go into bolus timings and such which you child may benefit from, here is some info about the book:

http://www.diabetes.co.uk/diabetes-...in-children-adolescents-and-young-adults.html

 

[shivles]

Anything on the toast?

Butter

 

[azure]

Butter

Butter is good : ) Some extra fat and protein would have helped slow the spike too. Bread is surprisingly variable. Choosing the right kind can make a huge difference eg with rye bread I can actually bolus during my meal and not rise above 6 at any time. I don't have a CGM but I've tested every 15 mins (I hate spikes too).

 

[Jaylee]

This is what I mean, at the end of the day she is 'carb intolerant' it makes more sense to have less carbs than fight the effects with medication if we can. Obviously this gets more difficult as she gets older but as her parent it's my job to educate her

I can empathise with this point.. I've had over 40 years of experience as a T1 & as a kid it was a case of "this is your dose, just feed the beast by snacking on carbs."

Then came "MDI".

I personally feel that as good modern "insulin therapy" is? It's still not a "magic bullet" no matter how accurate one boluses or get the basal bang on.. You just can't keep up diet wise with the "norms".. There are still too many outside "variables".

 

[Jaylee]

I don't disbelieve you, but the action of protein can be difficult to cover, requiring further boluses. The less carbs you have with it, the harder it is to predict the rise, I've found.

Edited to add that I dint mean lots of carbs are necessary, but some help.

With regards to protein..? Is this with the experience of a pumper?
I don't have this issue with multiple boluses for protein on MDI...

 

[Jaylee]

@shivles

Just found this for you.. Which may help.?

I may not be the lowest of carbers on this site.. But at the age of 48, I can still run rings around a 21 year old T1 colleague at the moment in a physical job, who sadly has been told he can eat anything..

 

[Indy51]

@shivles

Just found this for you.. Which may help.?

I may not be the lowest of carbers on this site.. But at the age of 48, I can still run rings around a 21 year old T1 colleague at the moment in a physical job, who sadly has been told he can eat anything..

@shivles
Further to this video, Lisa has a blog that has lots of low carb adapted recipes that she prepares for her son. One of the most interesting stories on the blog is how they've trained a border collie from a puppy to be a hypo-alert dog.

http://diabeticalien.blogspot.com.au/

 

[Indy51]

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

That's my feeling also. Given the fairly high incidence of dual diagnoses of Type 1 and coeliac disease, it may be a wise idea not to push that particular envelope.

 

[mcpound]

The 3.5 was because the insulin had kicked in and she had a slice of toast

Hi Shivles
In regards to the spike of 3.5 -14 just wondering what background insulin you are on?
When we have these large spikes after eating it indicates its time to increase his background insulin as no amount of bolus insulin would work if he's not on enough background. When my son was your daughters age it would sometimes be on a weekly basis we had to review how much background he was getting due to growth spurts then once he had passed through it we needed to reduce again to avoid multiple hypos. We still follow that rule now but not as often now he's older.
We have used continuous glucose monitoring at times to give a full picture of what's going on with bgs and also enables you to pin point peaks and troughs in your childs background insulin requirements regardless of what food they are eating. Most diabetes clinic have cgm they can loan you for a week or so.
When we were on MDI my son had Lantus and Novorapid. Lantus was tricky because over its 24hr action it has peaks and troughs so at times it would not be enough background for example with breakfast and at other times it would be too much so we had to learn when these times were and adjust our boluses accordingly.
Im not sure what background you are on with MDI but its certainly worth thinking about.

 

[mcpound]

That's my feeling also. Given the fairly high incidence of dual diagnoses of Type 1 and coeliac disease, it may be a wise idea not to push that particular envelope.

The official stats are 4-9% of Type 1 have coeliac so yes although more predisposed than those without type 1 it would be a bit extreme for people to completely avoid gluten for this reason alone.

 

[mcpound]

@shivles

Just found this for you.. Which may help.?

I may not be the lowest of carbers on this site.. But at the age of 48, I can still run rings around a 21 year old T1 colleague at the moment in a physical job, who sadly has been told he can eat anything..

That's great you have found a system that suits you but as you know all people with type 1 are different and what suits one person would not suit another.
From what I can gather from Shivles is her family already follows a low carb diet so as long as she has read up and researched paediatric diabetes to have a full understanding of the issues that's great. We use pump therapy to manage our sons type 1 and he does eat most things. We are not wrong and neither are you just different approaches.
Just to note we ate out last night. My son had a lovely carb laden pizza at 6pm. I used the extended bolus function on his pump over 6 hrs. No spikes and at 5am and his bg is sitting nicely at 4.6mmol which it has been doing for hours. We have cgm at the mo so I can see exactly what his bg is doing. We know what we are doing through trial and error. Its difficult with very young children because they have lots of extra factors to contend with and the management shouldn't be compared to that of adults with type 1.

 

[shivles]

@shivles

Just found this for you.. Which may help.?

I may not be the lowest of carbers on this site.. But at the age of 48, I can still run rings around a 21 year old T1 colleague at the moment in a physical job, who sadly has been told he can eat anything..

Thank you for this

 

[shivles]

Hi Shivles
In regards to the spike of 3.5 -14 just wondering what background insulin you are on?
When we have these large spikes after eating it indicates its time to increase his background insulin as no amount of bolus insulin would work if he's not on enough background. When my son was your daughters age it would sometimes be on a weekly basis we had to review how much background he was getting due to growth spurts then once he had passed through it we needed to reduce again to avoid multiple hypos. We still follow that rule now but not as often now he's older.
We have used continuous glucose monitoring at times to give a full picture of what's going on with bgs and also enables you to pin point peaks and troughs in your childs background insulin requirements regardless of what food they are eating. Most diabetes clinic have cgm they can loan you for a week or so.
When we were on MDI my son had Lantus and Novorapid. Lantus was tricky because over its 24hr action it has peaks and troughs so at times it would not be enough background for example with breakfast and at other times it would be too much so we had to learn when these times were and adjust our boluses accordingly.
Im not sure what background you are on with MDI but its certainly worth thinking about.

She's on one unit of levemir, it was reduced because it was causing hypos in the night

 

[shivles]

That's great you have found a system that suits you but as you know all people with type 1 are different and what suits one person would not suit another.
From what I can gather from Shivles is her family already follows a low carb diet so as long as she has read up and researched paediatric diabetes to have a full understanding of the issues that's great. We use pump therapy to manage our sons type 1 and he does eat most things. We are not wrong and neither are you just different approaches.
Just to note we ate out last night. My son had a lovely carb laden pizza at 6pm. I used the extended bolus function on his pump over 6 hrs. No spikes and at 5am and his bg is sitting nicely at 4.6mmol which it has been doing for hours. We have cgm at the mo so I can see exactly what his bg is doing. We know what we are doing through trail and error. Its difficult with very young children because they have lots of extra factors to contend with and the management cannot be compared to that of adults with type 1.

Honestly if the insulin was working as it should then I wouldn't low carb her because it is restricted but I feel like there isn't many options plus the DSN suggested reduced carbs (presumably because she knows we aren't keen on a pump for her just yet)

 

[mcpound]

Its really tr

Honestly if the insulin was working as it should then I wouldn't low carb her because it is restricted but I feel like there isn't many options plus the DSN suggested reduced carbs (presumably because she knows we aren't keen on a pump for her just yet)

Its a tough one. The thing is reducing carbs will make no difference to the back ground insulins peak and troughs and it could just run your daughters bgs higher if she's not getting enough which is what you want to avoid. Hopefully there is someone on the forum that has more experience with a young child on MDI and Levemir that will see this post and have some useful tips. X