Online dietician recommendation?

SimonP78

Well-Known Member
Messages
386
Type of diabetes
Type 1
Treatment type
Insulin
In my n=1 experience of dieticians and children (I was 7) I found them distinctly unpleasant and useless. YMMV of course.

They were completely mainlined on no sugar anywhere (despite my being very active and running low all the time with an old-school HbA1C of ~4.7, so rather low), I often got told off when I admitted I had sugar on my Weetabix for breakfast and that I ate chocolate bars (e.g. Penguins and other normal foods available at school at breaktime). Not very a useful approach for anyone but least of all for a child IMO. As soon as I no longer needed to go (out of paediatric care and into the adult system) I stopped going.

Perhaps the mantra has now changed, but certainly then they were inflexible and read from their sheet of teachings even when a little bit of common sense might have indicated that not everyone should be treated the same, and not everyone's diabetes is the same.

Avoid, imo, just eat sensibly and bear in mind that things that are sweet should probably be treats/hypo treatments. Life is easier nowadays with MDI, you can dose for sweet things. I wouldn't go low carb, especially not for a growing child, though sometimes eating less at a given meal makes life easier as any errors in carb-insulin ratio produce a smaller high or low (the latter being of more concern). But this very much depends on ratios and how much your daughter is eating - it's more a thing for adults I'd say. e.g. I could eat 150g of carbs at a single meal, but then taking the 15U of Novorapid I'd typically require would not work, it would need to be split into ~3 doses and any inaccuracies would cause massive under/overshoots. Equally unless I'm doing exercise (so don't need the bolus anyway) eating this many carbs isn't very good for you at all, so it goes back to eating sensibly and not mainlining on solely carbs.
 

Hopeful34

Well-Known Member
Messages
2,020
Type of diabetes
Type 1
Treatment type
Pump
Writing as an adult, the dietitian that used to be present at endo hospital appointments, was totally inflexible on carbs per meal/day, and I learnt to listen and ignore very quickly.

Food isn't the only thing to affect blood sugar, there are 42 other listed factors. I don't eat a high carb diet, but when I tried to go lower I was having to bolus for protein, and every different type of protein required a different insulin to carb ratio, so it ended up being too stressful for me.

As well as stress raising my blood sugar, things like excitement and happiness do, so we're all different. Basal rate testing has shown that the amount of basal insulin I need varies quite a lot, and I know a few people on the forum have said the same.
 

Kuba85

Active Member
Messages
26
Type of diabetes
Family member
Treatment type
Other
In my n=1 experience of dieticians and children (I was 7) I found them distinctly unpleasant and useless. YMMV of course.

They were completely mainlined on no sugar anywhere (despite my being very active and running low all the time with an old-school HbA1C of ~4.7, so rather low), I often got told off when I admitted I had sugar on my Weetabix for breakfast and that I ate chocolate bars (e.g. Penguins and other normal foods available at school at breaktime). Not very a useful approach for anyone but least of all for a child IMO. As soon as I no longer needed to go (out of paediatric care and into the adult system) I stopped going.

Perhaps the mantra has now changed, but certainly then they were inflexible and read from their sheet of teachings even when a little bit of common sense might have indicated that not everyone should be treated the same, and not everyone's diabetes is the same.

Avoid, imo, just eat sensibly and bear in mind that things that are sweet should probably be treats/hypo treatments. Life is easier nowadays with MDI, you can dose for sweet things. I wouldn't go low carb, especially not for a growing child, though sometimes eating less at a given meal makes life easier as any errors in carb-insulin ratio produce a smaller high or low (the latter being of more concern). But this very much depends on ratios and how much your daughter is eating - it's more a thing for adults I'd say. e.g. I could eat 150g of carbs at a single meal, but then taking the 15U of Novorapid I'd typically require would not work, it would need to be split into ~3 doses and any inaccuracies would cause massive under/overshoots. Equally unless I'm doing exercise (so don't need the bolus anyway) eating this many carbs isn't very good for you at all, so it goes back to eating sensibly and not mainlining on solely carbs.
Thank you.

My intention was not going low carb for instance (especially for a child), but switching to better carbs that are most suitable for diabetes (say those that take some time to break). Our daughter never eats white toasted bread with jam for bfast as an example. Here, after being diagnosed in the hospital, day 1, and they bring over white bread + jam + juice (which she doesn't drink either), and they say "oh it's ok, just increase the amount of insulin"... I mean, that advice to me seems wrong and borderline crazy (not least due to wide spread issue of insulin shortages).
However, as I read all this, and as per my previous post I am starting to think that modern tech advances allow you to eat unhealthy whilst with diabetes basically because you can dose insulin as you please, especially in the UK where it is for free (not all countries offer it for free). So this goes back to one's choice about lifestyle.

In this context, I hear what some here (and also NHS) may say "don't worry about strict diets, you can adjust your insulin and you will be fine".

Much appreciate all the input to help me think through all this clearer in my head - very very helpful.
 

ElenaP

Well-Known Member
Messages
458
Type of diabetes
Type 1
Treatment type
Pump
.... and they say "oh it's ok, just increase the amount of insulin"... I mean, that advice to me seems wrong and borderline crazy...
I agree with you. I am crossing my fingers that another parent, or a specialist, would see your post and give information about an good, T1_child-friendly, dietician.
 

SimonP78

Well-Known Member
Messages
386
Type of diabetes
Type 1
Treatment type
Insulin
Thank you.

My intention was not going low carb for instance (especially for a child), but switching to better carbs that are most suitable for diabetes (say those that take some time to break). Our daughter never eats white toasted bread with jam for bfast as an example. Here, after being diagnosed in the hospital, day 1, and they bring over white bread + jam + juice (which she doesn't drink either), and they say "oh it's ok, just increase the amount of insulin"... I mean, that advice to me seems wrong and borderline crazy (not least due to wide spread issue of insulin shortages).
However, as I read all this, and as per my previous post I am starting to think that modern tech advances allow you to eat unhealthy whilst with diabetes basically because you can dose insulin as you please, especially in the UK where it is for free (not all countries offer it for free). So this goes back to one's choice about lifestyle.

In this context, I hear what some here (and also NHS) may say "don't worry about strict diets, you can adjust your insulin and you will be fine".

Much appreciate all the input to help me think through all this clearer in my head - very very helpful.
Theoretically you can eat whatever you want, but the faster absorbed carbs require more planning (early and split dosing) due to absorption differences so eating slower absorbed carbs and mixes of macronutrients with meals simply makes life easier as well as being better for you. I would be tempted to try to eat the healthier end of the spectrum though I don't like e.g. wholemeal bread so eat granary and accept this generates a bit more of a spike (I used to eat white bread as a young adult but my tastes have changed as I've got older). Having two (non-diabetic, fingers crossed) children myself, getting them to eat something they like and that is vaguely good for them is more important than it being completely optimal, especially as kids tend to burn off lots of energy anyway so spikes tend to be less pronounced.

Also for your daughter having the mindset that being diabetic isn't a massive problem and you can live life normally is quite important imo (regarding all things, not just food). Eating healthily is a good thing and important for everyone not just a curse of being diabetic.

Good luck, it'll all be fine :)
 

becca59

Well-Known Member
Messages
2,970
Type of diabetes
Type 1
Treatment type
Insulin
To be fair, up to a certain age with children they advise against wholemeal bread etc. as it fills the small stomachs up too easily before they have eaten enough. I remember reading that what we apply to ourselves as adults is not always appropriate for a growing child. Plus slower absorbing carbs are often harder to sort out dosing for. I think talking to a dietician especially for children with diabetes is a good idea. Just to point out also. Insulin is not our enemy but our best friend. Correction doses will become a big part of life with type 1 and I know I for one am not having any problems with supply issues.
 

Jaylee

Oracle
Retired Moderator
Messages
18,456
Type of diabetes
Type 1
Treatment type
Insulin
To be fair, up to a certain age with children they advise against wholemeal bread etc. as it fills the small stomachs up too easily before they have eaten enough. I remember reading that what we apply to ourselves as adults is not always appropriate for a growing child. Plus slower absorbing carbs are often harder to sort out dosing for. I think talking to a dietician especially for children with diabetes is a good idea. Just to point out also. Insulin is not our enemy but our best friend. Correction doses will become a big part of life with type 1 and I know I for one am not having any problems with supply issues.
I remember vividly as a kid, my mum & I at an appointment having a "run in" over diet with a dietitian.

I was asked what I ate.
I loved wholemeal bread & salad. (Still love a nice Greek salad.)
The response was shocking.

Pretty much scorned & labeled "hippies."
 

Zhnyaka

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Messages
706
Type of diabetes
Type 1
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Insulin
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but being 39yo I cannot imagine chomping quietly on some sweets even when at work, when my 5yr old daughter at her school or home isn’t able to.
Why not? You don't have diabetes and it doesn't make it any easier for your child that her family is suffering too. People are generally poorly able to provide support when they feel bad themselves, so do something nice for yourself. She needs a happy parent much more than the feeling that the whole family is suffering because of her. Well, sometimes with diabetes it is really possible eat a cake
 

ElenaP

Well-Known Member
Messages
458
Type of diabetes
Type 1
Treatment type
Pump
Why not? You don't have diabetes and it doesn't make it any easier for your child that her family is suffering too. People are generally poorly able to provide support when they feel bad themselves, so do something nice for yourself. She needs a happy parent much more than the feeling that the whole family is suffering because of her. Well, sometimes with diabetes it is really possible eat a cake
I don't think that not having sweets is suffering. I come from a family of seven siblings, but only two Type1 diabetics. There were no sweets in the house except when some visitors brought some. We had healthy home-cooked food with lots of vegetables and berries. As a result, all of us siblings have good teeth, and none of us even like sweet things.
I have an excellent dentist who comments on how good my teeth are. She has never given her (non-diabetic) son sweets. The boy is now ten years old, and declines sweets if he is offered some.
 
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Kuba85

Active Member
Messages
26
Type of diabetes
Family member
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Other
Thank you both.
I don't think that not having sweets is suffering. I come from a family of seven siblings, but only two Type1 diabetics. There were no sweets in the house except when some visitors brought some. We had healthy home-cooked food with lots of vegetables and berries. As a result, all of us siblings have good teeth, and none of us even like sweet things.
I have an excellent dentist who comments on how good my teeth are. She has never given her (non-diabetic) son sweets. The boy is now ten years old, and declines sweets if he is offered some.
Thank you Elena. This is exactly the house/family (like yours) that I would like to recreate if possible. And if she/we still gain weight then let it be, but I have done everything to keep us healthy in the context of our circumstances.

Fwiw, I gave up sweets last year and was fine - after 2 weeks of craving, you don’t care any more. Restarted them after that year at much reduced level, as didn’t see much motivation to keep going. But this situation is different.

Anyway, I feel like we are entering some morale argument. To each its own. My decision was to have a healthier diet for our family and just asked here for dietician recommendations not to add another layer of burden on ourselves. Maybe my 2 year old will hate me one day for it, or will appreciate we came together as a family in a tough situation. Only time will tell.
 

AloeSvea

Well-Known Member
Messages
2,177
Type of diabetes
Type 2
Treatment type
Other
What constitutes a healthy diet is indeed a fascinating question, and why we indeed live in very interesting times. And why such discussions are so important. Great thread.
 
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Outlier

Well-Known Member
Messages
1,828
Type of diabetes
Type 2
Treatment type
Diet only
Not too far offtopic, but sweets used to be a rare treat in my day, and it wasn't just about sugar rationing. Several times a day eating sweet stuff is rather a new concept.
 
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