Low carb for kids

[shivles]

Its really tr
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

But also if she's not on the glucose roller coaster all day it's much easier to see if there's issues with her basal dose, I've give her low carb dinners before so I can see how the levemir is working through the night. As far as we can tell her basal does work nice and steady over 24hrs

more heartbreaking than the readings is seeing how her personality changes over the day as she goes up and down

 

[shivles]

@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/

Now this is very interesting, we plan to get a puppy in future and I wondered if we could train it like this as we have 2 type ones in the family now it would be extremely useful!

 

[Indy51]

Now this is very interesting, we plan to get a puppy in future and I wondered if we could train it like this as we have 2 type ones in the family now it would be extremely useful!

If you search the blog for "Maya", it should brings up posts about the dog

 

[CathP]

Hi Shivles, I posted on your other thread on parents, so won't repeat everything I said there, but I totally get where you're coming from. We low carb with our 5 year old, because essentially diabetes is an inability to process carbs, so it makes sense to limit them. We're also MDI, as Freya has a dexcom already (which we view as essential) and we don't want to attach her to anything else. We low carb as a family, so Freya's twin sister and little brother all eat the same. We've been to a couple of parties, and Freya asked me to make her a packed lunch to take to the last one, as she didn't want the party food. She wanted to bring some birthday cake home though, so she had that. We're flexible, but encourage her to make healthy decisions.
Buy the Bernstein book and join TYPEONEGRIT, you'd find such support there.x

 

[Dillinger]

Hi,

I haven't had time to read through all the posts so this might have been shared with you already; but here is a great blog of an Australian mum and her low carb super well controlled Type 1 boy.

http://diabeticalien.blogspot.co.uk/

Best

Dillinger

 

[shivles]

Hi Shivles, I posted on your other thread on parents, so won't repeat everything I said there, but I totally get where you're coming from. We low carb with our 5 year old, because essentially diabetes is an inability to process carbs, so it makes sense to limit them. We're also MDI, as Freya has a dexcom already (which we view as essential) and we don't want to attach her to anything else. We low carb as a family, so Freya's twin sister and little brother all eat the same. We've been to a couple of parties, and Freya asked me to make her a packed lunch to take to the last one, as she didn't want the party food. She wanted to bring some birthday cake home though, so she had that. We're flexible, but encourage her to make healthy decisions.
Buy the Bernstein book and join TYPEONEGRIT, you'd find such support there.x

Thank you its encouraging to hear it can work!

 

[shivles]

Very frustrating talk with the dietitian, I'm sure you can all imagine how it went, apparently wholegrain toast is nice and healthy and I should carry on giving it despite the 14+mmol readings :/

Anyway she is at least going to request us use of the CGM while we do food diaries.

I'm left annoyed and worried about the effects this is having on her in the meantime

 

[CathP]

We've had to agree to disagree with our dietician. When we told her shortly after diagnosis that Freya spiked to 20mmol straight after eating porridge, we were told it didn't matter and we shouldn't be testing until 2 hours post meal anyway! So you're supposed to ignore what the food is doing in between tests, despite the havoc it is playing with their little bodies...great approach. They don't approve of our low carbing, but they can't argue with the results we're getting, so we all avoid the subject of food now!
Great news on getting the loan of a cgm, the info you'll get will be amazing. We borrowed one for a week about 6 weeks post dx, and ordered our own immediately as we couldn't imagine coping without one again. We went low carb at the same time, as seeing the effects of food on blood sugars in real time is shocking.x

 

[shivles]

We've had to agree to disagree with our dietician. When we told her shortly after diagnosis that Freya spiked to 20mmol straight after eating porridge, we were told it didn't matter and we shouldn't be testing until 2 hours post meal anyway! So you're supposed to ignore what the food is doing in between tests, despite the havoc it is playing with their little bodies...great approach. They don't approve of our low carbing, but they can't argue with the results we're getting, so we all avoid the subject of food now!
Great news on getting the loan of a cgm, the info you'll get will be amazing. We borrowed one for a week about 6 weeks post dx, and ordered our own immediately as we couldn't imagine coping without one again. We went low carb at the same time, as seeing the effects of food on blood sugars in real time is shocking.x

Yes I got the 'well that will happen if you test before 2hrs' too

It's something I was considering for her anyway tbh, this will tell me if it's worth the expense anyway

 

[shivles]

15.6mmol and she's not eaten since 12:30, sod this, I can't do it, she's having a low carb dinner

 

[azure]

The loan of a CGM is great news I hope that's helpful, particularly overnight so you can see what's happening to her sugars.

I wouldn't be happy with a spike to 20 - not for me myself or for a child of mine. My instinct is that if the spike is that large then the insulin is wrong. I've tested after eating on a few occasions just to see what happens (I can't afford a CGM). I've never spiked that high even shortly after eating. However, I do pre-bolus, which makes a big difference.

@shivles Have you been able to speak to your daughter's consultant to ask about the spikes and her insulin dosages? Sometimes it can be helpful,to get as many opinions as possible, and it's definitely good to get all your questions answered. You should be receiving answers to all your concerns, and be given explanations.

I know you've said that your daughter's basal was reduced due to hypos. Obviously, you don't have much space for adjustments when you're working in half unit changes, but have you asked about different basal insulin, for example? Or splitting the basal dose?

I think the biggest difficulty with such a young child is the manipulation of tiny insulin doses. I don't think the paediatric (diluted) insulins are available any more, but you could check to make sure.

 

[azure]

15.6mmol and she's not eaten since 12:30, sod this, I can't do it, she's having a low carb dinner

What was she before and after lunch? Was she ok and then the rise has happened through the afternoon even though she hasn't eaten? If so, that sounds like not enough basal (or basal running out).

 

[Kristin251]

If you want to give her some carbs BF might not be the best time as we are most insulin resistant then. I always have a small spike even with just fat and protein at BF. Later in the day would probably be better.

 

[shivles]

What was she before and after lunch? Was she ok and then the rise has happened through the afternoon even though she hasn't eaten? If so, that sounds like not enough basal (or basal running out).

Before was 10, 2hrs after 13.8. Her basal dose went up yesterday :/ she has been coming down in between but soon as she eats it's back up

 

[mcpound]

Hi Shivles, I posted on your other thread on parents, so won't repeat everything I said there, but I totally get where you're coming from. We low carb with our 5 year old, because essentially diabetes is an inability to process carbs, so it makes sense to limit them. We're also MDI, as Freya has a dexcom already (which we view as essential) and we don't want to attach her to anything else. We low carb as a family, so Freya's twin sister and little brother all eat the same. We've been to a couple of parties, and Freya asked me to make her a packed lunch to take to the last one, as she didn't want the party food. She wanted to bring some birthday cake home though, so she had that. We're flexible, but encourage her to make healthy decisions.
Buy the Bernstein book and join TYPEONEGRIT, you'd find such support there.x

Hi Shivles, I posted on your other thread on parents, so won't repeat everything I said there, but I totally get where you're coming from. We low carb with our 5 year old, because essentially diabetes is an inability to process carbs, so it makes sense to limit them. We're also MDI, as Freya has a dexcom already (which we view as essential) and we don't want to attach her to anything else. We low carb as a family, so Freya's twin sister and little brother all eat the same. We've been to a couple of parties, and Freya asked me to make her a packed lunch to take to the last one, as she didn't want the party food. She wanted to bring some birthday cake home though, so she had that. We're flexible, but encourage her to make healthy decisions.
Buy the Bernstein book and join TYPEONEGRIT, you'd find such support there.x

Hi CathyP
Each to their own and if a low carb diet works for you then great but I just can't help commenting on the statement that type 1 is essentially the inability to process carbs. This just isn't true. If someone couldn't process carbs why would their bg spike after eating them? Everyone spikes after eating carbs type 1 or not. Obviously those without type 1 have their pancreas doing all the hard work of regulating the bg. With type 1 all it tells us that the person is not on the right insulin, the correct dose of background or boluses, the right regime or is very sensitive to that particular food or the way its cooked.

 

[mcpound]

Before was 10, 2hrs after 13.8. Her basal dose went up yesterday :/ she has been coming down in between but soon as she eats it's back up

Hi Shivles
What time does your daughter eat breakfast because unless its around 6am it looks from that graph that the basal is too low around early morning because of the steep rise. The size of spike from 10 to 13.8 is actually good. There will always be a small spike no matter what but its the starting number you need to get down so if that bg of 10 had been a 5 a spike up to 8.8 then down to 7 would have been ok so that tells us your bolus with lunch was actually the correct dose. The rise in the afternoon to 15.8 looks again to be down to the basal. After a background change its always best to wait a couple of days to log the trends then make further changes incase one day was an anomaly but it certainly looks like you might need to either up the background again( this may be a temp measure as your daughter may be having a growth spurt) or do extra corrections of novarapid between meals certainly in the afternoon. My son bg tends to go up in the afternoon and we have to give more background or correct it.
Its great your getting cgm from your dpsn. Its changed our lives. Not sure which one you will have but we use the Dexcom. I keep the handset by my bed and it connects with my son in the next room. I set a high and low alarm so although some nights I have to get up quite a bit it gives peace of mind at times when things have gone a bit haywire.

 

[shivles]

Hi Shivles
What time does your daughter eat breakfast because unless its around 6am it looks from that graph that the basal is too low around early morning because of the steep rise. The size of spike from 10 to 13.8 is actually good. There will always be a small spike no matter what but its the starting number you need to get down so if that bg of 10 had been a 5 a spike up to 8.8 then down to 7 would have been ok so that tells us your bolus with lunch was actually the correct dose. The rise in the afternoon to 15.8 looks again to be down to the basal. After a background change its always best to wait a couple of days to log the trends then make further changes incase one day was an anomaly but it certainly looks like you might need to either up the background again( this may be a temp measure as your daughter may be having a growth spurt) or do extra corrections of novarapid between meals certainly in the afternoon. My son bg tends to go up in the afternoon and we have to give more background or correct it.
Its great your getting cgm from your dpsn. Its changed our lives. Not sure which one you will have but we use the Dexcom. I keep the handset by my bed and it connects with my son in the next room. I set a high and low alarm so although some nights I have to get up quite a bit it gives peace of mind at times when things have gone a bit haywire.

She had breakfast around 6.30 today, she has a rise like that every morning and after most meals, the lunch one was a bit of a fluke. The basal got dropped before because it was sending her hypo in the early hours

 

[azure]

Before was 10, 2hrs after 13.8. Her basal dose went up yesterday :/ she has been coming down in between but soon as she eats it's back up

Ok - that's really useful to see : )

I think a big part of the problem is she's running highish a lot, so meal time imsulin on top of the higher sugars isn't working so well. I can only talk for myself, but I aim to be under 7 before meals. If I'm not I find my sugar can go unnaturally high, even if I include a small correction with my bolus eg if I was 10 before lunch and then bolused and ate.

It's also worth bearing in mind that sugars above approx 12 means you usually need a higher correction rate (check with your DSN) as the body is more resistant to insulin with sugar at that level. The insulin will also take longer to,start working. If I correct a 10, my blood sugar will stop dropping at approx 90 mins, if I correct a 15 it can take 2 and 1/5 hours or more to start going down.

So if you could work out what was causing the high sugars and get them lower, then the meals would work better and not give such spikes. I hope that makes sense?

A correct basal is the foundation of good control. Ideally it should keep sugars within range day and night. You then build on that basal by adding appropriate boluses for food. If you try to build on an incorrect basal, it's much harder.

I know Noblehead has recommended a very good book about Type 1 in children to you. For your own reading, you might also like Think Like A Pancreas. It's aimed at adults and adult control, but you'll get an idea of Type 1 and it's a useful reference book. Of course, your husband may already have it. It's the book I go back to most.

 

[shivles]

Ok - that's really useful to see : )

I think a big part of the problem is she's running highish a lot, so meal time imsulin on top of the higher sugars isn't working so well. I can only talk for myself, but I aim to be under 7 before meals. If I'm not I find my sugar can go unnaturally high, even if I include a small correction with my bolus eg if I was 10 before lunch and then bolused and ate.

It's also worth bearing in mind that sugars above approx 12 means you usually need a higher correction rate (check with your DSN) as the body is more resistant to insulin with sugar at that level. The insulin will also take longer to,start working. If I correct a 10, my blood sugar will stop dropping at approx 90 mins, if I correct a 15 it can take 2 and 1/5 hours or more to start going down.

So if you could work out what was causing the high sugars and get them lower, then the meals would work better and not give such spikes. I hope that makes sense?

A correct basal is the foundation of good control. Ideally it should keep sugars within range day and night. You then build on that basal by adding appropriate boluses for food. If you try to build on an incorrect basal, it's much harder.

I know Noblehead has recommended a very good book about Type 1 in children to you. For your own reading, you might also like Think Like A Pancreas. It's aimed at adults and adult control, but you'll get an idea of Type 1 and it's a useful reference book. Of course, your husband may already have it. It's the book I go back to most.

The team have never give proper instructions for corrections and have told me only 'if she's over 7mmol and the dose works out at 1.6 units round it up to 2' ! So after lots of reserch out of desperation I'm working it out myself with the help of the mysugr app.

It's the food causing the high blood sugar surely? Her overnight didn't creep up last night it was fairly steady so I think basal is okay?

I've ordered the bernstein book but will have a look at the others thanks

 

[Kristin251]

I get the same thing as @azure. The higher I am to start the less the insulin and corrections work and I'm not even talking high bs, just higher for me. It doesn't take much for IR to show up for me. I inadvertently fasted last week to see when my insulin started lowering me and I ended up injecting a whole days worth within 3 hours of waking. I don't understand it but I won't be fasting. With a 16 mo old it is hard to control activity and nap times etc which can also effect bs spikes and drops. I too would work on getting her starting point lower. I am worst at BF always so I have to split boluses so I don't hypo. I test again after I eat and then an hour or hour and have later and take a xorrection to stop me from continuing to rise. On occasion i need two corrections after BF so I'm in a good place before lunch and then the rest of the day runs smooth. You might try giving her the same BF everyday at around the same time and then you might be able to find a bolus routine.

Also agree getting basal right is huge. My basal doesn't last anywhere near 24 hours so I use bolus for food. I can't take more basal or I hypo during the night. Getting basal right allows to to figure boluses out better. Using different basal doses only complicates boluses.