Type 1 and Pasta.......

[robadob]

My 10yr old daughter was diagnosed type 1 about 6 weeks ago and yesterday had our first proper scare.
So far we've always had a handle on her carbs and our John Radcliife team have been brilliant at advising us and changing the settings in our tester to make sure her readings have always been pretty close to normal BUT yesterday it all got a bit scary.
My turn to cook and my Daughter loves Spaghetti bolognese, I worked out the carbs but was really surprised that spaghetti is sooooo high but stuck with it (54g carbs per 75g serving) and got a insulin requirement of 7.5 (this was for everything inc pudding and apple juice) which struck me as high but we've been told to trust it so gave her the jab and that was that.
Except it wasnt. She said she felt a bit trembly so we tested her bloods and she pulled a 1.5! Lowest ever reading.
Gave her 3 glucose tabs and its came up to 3.6 within 15-20 mins. Then in 15 mins 4.6
Tested her half an hour later and it was 5.6 so back to normal again but it was tough relaxing after that so although my daughter slept well, we didnt!!!

Now Ive double checked my carbs workings and I didnt make a mistake, I simply based it on what the carbs are on the packet so how did this very low reading come about?
Im thinking that the carbs listed on the pasta are incorrect but have looked at other pasta and its all very high.
I just want to limit this possibility happening again.

Any advice greatly appreciated.

 

[noblehead]

The fat content of the bolognese can delay the absorption of the carbs in the food, ask her DSN about split-dosing for such meals as often this is the only way round these types of food, either that or delaying the injection until after the food has been eaten, as said the clinic will advise.

 

[Type1Bri]

I have a maximum amount of 6 units novarapid that I will take in one go. Any higher than that I always split my dose, I am T1 in honeymoon phase. As noblehead said you Dsn will advise

 

[azure]

Sorry if this is a silly question, but did you check whether the carbs on the packet were for cooked or uncooked weight? Some packets can vary, and it can be confusing. The figures you've listed above look like for raw weight to me, which, of course, is difficult to measure once it's cooked and you're serving up, unless you were to cook hers separately.

Personally, after years of pasta-cooking and experimenting, I weigh my serving of cooked pasta and find that best. I also always cook the pasta for the same length of time so it doesn't absorb excess water. It depends what pasta you have (although most are quite similar) but I generally find that 13g cooked pasta is approx 5g carbs. So I decide how much cooked weight I want and do the maths. Yes, it means I usually have an amount divisible by 13, but it works fine for me : )

 

[robadob]

Wow, thanks for the rapid responses. This is the first Ive heard of splitting the jab so this could have saved a fair bit of panic and grief.
Ive double (triple.....) checked the packet and it doesnt state whether the amount of carbs listed are pre or post cooking, I did them post cooking so maybe that caused the problem.

We're seeing our (her) DSN this Thursday so will discuss it then and see what she says.
Big thanks to all.

 

[azure]

I'd bet money the figures on the packet were pre-cooking - ie a RAW weight of 75g pasta has 54g carbs.

It's the first thing that leapt into my head when I read your post. That would fit with my cooked weight weighing too, and would explain your daughter's nasty hypo.

Don't worry - sometimes food packaging is rubbish. You'll learn by experience, and you're obviously on the ball as you checked your daughter and treated her hypo perfectly.

(And I've just checked a packet of dried pasta that I have and the figures confirm that as they're very similar to the ones you gave, so definitely a raw weight)

 

[ono]

wonder if your daughter had hyperglycaemia about 3h later? usually pasta is about 71 to 75 carb per 100gr raw. I always split dose, as I experienced same thing as you , I inject about 30 or 40% right after eating, and the rest "on faith" two hours later, although it always varies depending on the sauce and level of physical exercise, pasta is a b@#*

 

[Stefano]

Hi robadob, the content of carbs in pasta is 71 carbs x 100 grams of uncooked pasta. cooked pasta has a very different ratio. Fresh pasta has a different ratio again. It's always better that you weigh your pasta before you cook it. Also I realised some labels are misleading (eg. Sainsbury pasta)....but 71 carbs x 100gr is the right ratio. If you weighed post cooking that explains your daughter's hypo.

 

[ewelina]

My 10yr old daughter was diagnosed type 1 about 6 weeks ago and yesterday had our first proper scare.
So far we've always had a handle on her carbs and our John Radcliife team have been brilliant at advising us and changing the settings in our tester to make sure her readings have always been pretty close to normal BUT yesterday it all got a bit scary.
My turn to cook and my Daughter loves Spaghetti bolognese, I worked out the carbs but was really surprised that spaghetti is sooooo high but stuck with it (54g carbs per 75g serving) and got a insulin requirement of 7.5 (this was for everything inc pudding and apple juice) which struck me as high but we've been told to trust it so gave her the jab and that was that.
Except it wasnt. She said she felt a bit trembly so we tested her bloods and she pulled a 1.5! Lowest ever reading.
Gave her 3 glucose tabs and its came up to 3.6 within 15-20 mins. Then in 15 mins 4.6
Tested her half an hour later and it was 5.6 so back to normal again but it was tough relaxing after that so although my daughter slept well, we didnt!!!

Now Ive double checked my carbs workings and I didnt make a mistake, I simply based it on what the carbs are on the packet so how did this very low reading come about?
Im thinking that the carbs listed on the pasta are incorrect but have looked at other pasta and its all very high.
I just want to limit this possibility happening again.

Any advice greatly appreciated.

I think your calculations were right. 54g of carbs per 75g uncooked pasta sounds ok.

For some, unknown me reason, I dont need much insulin for pasta. My normal ratio is 1:10 but for pasta I go for 1:15g. Maybe, the same thing happens to your daughter

 

[donnellysdogs]

Incidentally.. How long after the bolus for the pasta did your daughter go low?

 

[robadob]

Quickly, within 20 mins or so.

 

[Gary61]

Hi, I've been a Type1 diabetic for 36yrs and am currently on a trial for a continuous blood sugar monitor fed to an ipod I carry around with me. On the subject of pasta I can only say that it is the most difficult carb that I have ever learned to control. The reason for this is because of its high Gi factor which basically means the rate that the food you have consumed is absorbed in your body. I have observed that pasta can still be working up to 4 to 6 hrs after eating so I would advise not to inject the full amount of insulin initially, as it will work faster than the food can be absorbed resulting in low blood sugars but to split it as already suggested. Even after all these years I'm amazed at how the rate of absorbtion of different foods work when using my new monitor. One things for sure and that is that controlling Diabetes is not an exact science and that several factors have to be considered before calculating a dosage such as, your general health, if you've been exercising, the Gi index and the time of day you are injecting.
Diabetes isn't the easiest of illnesses to control but believe me when I say that it can be managed with a little vigilance and experience and just wish her the best of luck for the future,

 

[azure]

I think your calculations were right. 54g of carbs per 75g uncooked pasta sounds ok.

For some, unknown me reason, I dont need much insulin for pasta. My normal ratio is 1:10 but for pasta I go for 1:15g. Maybe, the same thing happens to your daughter

Yes, but it seems the OP thought that was the carbs for the COOKED weight, not raw. Hence the hypo - too much insulin for the carb amount.

 

[Robinredbreast]

Quickly, within 20 mins or so.

Hi it does sound like too much Insulin for the amount of pasta. I eat gluten free pasta occasionally and that is higher in carbs, so the first time I ate it, I took the amount of Insulin for the weight and like your daughter I hypoed, I am 1 unit to 10 carbs,so I take a little less. It's going to be swings and roundabouts with some of tweaking with certain foods, but you will get there, good luck at your daughters appointment, I hope it goes well. Take care

Best wishes RRB

 

[Engineer88]

My 10yr old daughter was diagnosed type 1 about 6 weeks ago and yesterday had our first proper scare.
So far we've always had a handle on her carbs and our John Radcliife team have been brilliant at advising us and changing the settings in our tester to make sure her readings have always been pretty close to normal BUT yesterday it all got a bit scary.
My turn to cook and my Daughter loves Spaghetti bolognese, I worked out the carbs but was really surprised that spaghetti is sooooo high but stuck with it (54g carbs per 75g serving) and got a insulin requirement of 7.5 (this was for everything inc pudding and apple juice) which struck me as high but we've been told to trust it so gave her the jab and that was that.
Except it wasnt. She said she felt a bit trembly so we tested her bloods and she pulled a 1.5! Lowest ever reading.
Gave her 3 glucose tabs and its came up to 3.6 within 15-20 mins. Then in 15 mins 4.6
Tested her half an hour later and it was 5.6 so back to normal again but it was tough relaxing after that so although my daughter slept well, we didnt!!!

Now Ive double checked my carbs workings and I didnt make a mistake, I simply based it on what the carbs are on the packet so how did this very low reading come about?
Im thinking that the carbs listed on the pasta are incorrect but have looked at other pasta and its all very high.
I just want to limit this possibility happening again.

Any advice greatly appreciated.

This is a problem I always have with pasta, it takes ages to absorb and often have hypos after injecting 'upfront'. i found injecting after pasta helped but the pump helps even more (i can extend the dose over 2 or so hours). failing that i would def inject after that particular meal.

quicker acting to give your daughter a liquid glucose (mini can of full fat coke or fruit juice) and will help her feel better quicker.

Good job though

 

[bellabella]

Quickly, within 20 mins or so.

If she went low witthin 20 minutes it may not have been due to that particular Bolus? Short acting insulin usually peaks within 2-2.5 hours. When was the last insulin injection she'd received prior to this? And how is her basal?

 

[itconor]

when i was low carbing i gave up pasta, i had it for the first time in 2/3 years recently and it effected me pretty well, no hard peaks and nice and steady, infact better than the low fat oven chips had been hittting me, im going to start reinculding it in my diet

 

[Peterrhoades]

Unclear information always catches me out. Before I ride I have soup with pasta in. The pasta works well for me. On the label for the soup it has all the info for cards and fats etc But that is for one serving, now to me a tin of soup is one serving I have never had half a tin or split a tin with the wife. But one tin of soup is two servings just to catch you out.