OK, say you go out to eat with the family, my daughter goes and checks her BG, it’s 250 (high). Now she wants a piece of bread and a pasta meal and a glass of milk. Should we say, OK no bread, or bread and no pasta. Or no milk, water only? She gets a little angry when she can’t get a piece of bread and a glass of milk and the pasta dish she wants. Not all the time but sometmes (last night). Are we being too strict if we keep the bread from her or the pasta or make her choose? I just want her to be happy but I want her to be healthy too. She’s nine so the little things mean alot. It’s a catch 22 because sometimes the two are opposing forces. I did let her have 1/2 the bread and the milk and the pasta and her BG was fine later. Should I just avoid the conflict and let her have whatever she wants ( at a restaurant and not all the time)?
IMHO it’s not a big deal as long as you adjust the insulin dose to accomodate both the correction and the meal.
If you check before leaving for the restraunt and do a correction then, then you can be normal by the time of reaching the restraunt.
The bg numbers in the hour or two after the meal will be sky-high if you care to look but by the next meal things will have settled down.
I know some people worry obsessively about after-meal peaks, and blame them for everything, but putting up with a high bg right after a big meal is, IMHO, not the biggest deal. I’ve been T1 for 30 years BTW, still no complications!
Oh, and on the subject of pasta dishes and milk: dairy foods, especially high-fat dairy foods, can moderate and slow the absorption of carbs. So cheese (common in some pasta dishes) and milk can be used to advantage in limiting after-meal spikes. The fat and protein in the dairy stuff will eventually turn into a rise in bg but that’ll come hours after the meal. If she has a pump you might want to look up “dual wave bolus”.
For an example, google “pizza effect”.
I agree with Tim that if you are adjusting her insulin for the correction for her bg level and counting the carbs she is eating and including that in her insulin intake then it should be ok. As a female, I think most docs would agree that milk intact is very important and has been shown to be beneficial beyond bone growth/strength. Does she have an insulin/carb ratio for when she eats (which is done easily on a pump, but can be done with shots also)?
I think it helps to if the other people around her are showing restraint…e.g. if the family is eating at a restaurant and everyone (siblings and parents) can choose whatever they want, it can make the situation seem unfair and frustrating, especially at situations seen as a special occasion. But if other people are also making heathy choices, it becomes more a norm… like like I’m only going to eat the pasta and not the bread because I don’t need the extra carbs.
As others suggested if the carb and correction factors are working then you should be able to cover the meal. I think being happy and in control of her own health will utimately make her healthier.
i take a harder line. if my BG is 150 or higher, i don’t eat until it comes down. period. everyone is entitled to his opinion, but i simply don’t believe it’s smart to eat (especially a high carb meal) with elevated BG. you can pour on insulin by the gallon but it’s hard (if not impossible) to get it right. inevitably you go low then soar high again. i’ve been T1 for 50 years and have no complications. i firmly believe my approach to food is a big reason. and yes, i’ve heard worries about resentment etc but i think that discredits kids. there are lots of choices. so … skip the bread and pasta but find something else that’s appealing. the list of foods i’ve never eaten is pretty long (corn dogs, cotton candy, elephant ears, sundaes, pop tarts, among them) and i don’t think i’m traumatized.
I know it is hard to be a healthy kid with diabetes. I think letting her eat eat as she wishes at a restaurant is a good idea. I am sure you do not eat out all the time, so having carb-heavy meal a few times a month sounds like a good compromise. Making her feel like she is being punished or treated unfairly about food and BG can lead to some crazy, unhealthy psychological food issues. Keeping a strict diet all the time is near impossible… she is a kid…she can be happy and healthy!!!
I hate to ‘punish’ a high BG with my daughter (10 years) by withholding food but I would probably ask her what she thinks is reasonable to see if she can come up a compromise herself. Might skip the milk and have save it for the bedtime snack and ask for a smaller portion of pasta (something that she might normally eat rather than a typically overlarge restaurant sized portion). I would try to correct 15-20 mins ahead of the food arriving if possible. Also would consider planning a brisk walk/hike with the family for after dinner. Good for everyone and would help bring down the BG.
I understand your concern and the love you have for your daughter. My kids are only 3 and 4 so I don’t know what 9 year olds are like. But I was diagnosed with type 1 when I was 10 years old and my mom did not have the heart to tell me NO, she would give me the dose of insulin needed or suggested I guess that I should have with a higher blood sugar and that meal. I am a mother now and I understand how much you want your kids to be happy but I really wish my mom would have taught me a little more control. I had/have diabetes so I have to learn WHILE I am young that I just can’t eat like my friends or other people. It will pay off in the long run. I had horrible eating habits and would be up down all over the place for years and learned the hard way and taught myself in my 20’s that I was doing it all wrong, I think had my mom helped me earlier in life (and I am not upset with her at all, I know she did the best she could) but if her and my dad had been more strict it would be a habit by my 20’s not something I had to teach myself. When I say the hard way… I do not mean any complications, I have been a diabetic for 23 years have two great kids and no complications. And all that being said, yes at a birthday party for a friend or a special occasion, she should indulge a little but not just cause you are at a restaurant. Just my 2 cents take care
My parents rule was always, as we only go out to eat a fews times a month, is that I get to choose what I eat when we go to restaurants. This was a big deal to me when I was younger, because at home Mom and Dad chose everything I ate, and when. But now that I am older and eat what I want, and WHEN I want, it is not such a big thing. Of course things like the super size chocolate sunday are of limits, but I do still get the occasional McFlurry and then spilt it with my friend.
My daughter’s 10. She’s allowed to eat 45 carbs per meal, max. This is a number she helped to establish, and she’s not allowed to have only fast carbs, which the bread, pasta, and milk would all be. She decides what she would like to eat and what she would like to pass on and is a lot less resentful. I also think it’s reasonable that everyone moderate themselves - for example, her sister can’t have the 7 breadsticks she’d love to scarf down; she can have 1, just like everyone else. In addition, if Clara’s sugar was over 200, she would be eating a carb-free meal. “nothing tastes as good as healthy blood sugars” is a phrase we use.
I sometimes wish I developed type 1 when i was a child instead of at 24 for the very reason that my parents would have had to make sure my diet was healthy. Now as a busy adult who doesn’t cook as often as I should I find myself making shortcuts and then dealing with the consequences later, which isn’t good for my BS and leaves me exhausted sometimes. And when you want that delicious fast carb meal and know you can’t have it, you’re frustrated, at any age.
Its all about compromise… Since she is going out to a restraunt, which isnt an every day occurance, perhaps suggest she cut back on some things, but dont demand or force it on her… having to correct some and suggest things, will cause less fustration with your daughter, and you for denying it. How about if she was offered cake at a birthday party and everyone was having it… It would be fustrating and or upsetting to the child to deny it, but having only half or less of that slice of cake and correcting for it would probably make her feel like she still was a part of what was going on, but be better for her…
I’m sure you are a good mother! (Cause you sound a bit like mine and I was diagnosed when I was nine. ) You are definitely thinking the right thoughts! My opinion is: Don’t underestimate the frustration your daughter might have to experience when she is punished for a high blood sugar by not beeing allowed to eat what she wants (your are right in that small things mean a lot). Even if this is absolutely not your intention she still might experience it like this. A high blood sugar might cause by far less damage than frustration and demotivation might cause on the long term. But I really like some of the suggestions that have been made: If your daughter understands what the problem is, she might be able to restrict herself. It is important that it is her decision, but I think compromises are possible.
As long as we’re talking restaurants, I think she should have what she wants AS LONG AS she’s also willing to have something that’s good for her too. So, like, she can have pasta, but she needs to also eat broccoli with it, or some kind of lean meat. I agree with Vera J, you run the risk of making her so frustrated with having to choose blood sugar over enjoyment every time that she’s going to rebel when she’s older–particularly since she’s old enough to realize that nobody else in the family is subject to the same restrictions (she’s the only one with diabetes, correct?) The point is to teach her healthy eating rather than forbid her foods she likes. It’s OK to have bread and pasta as long as she’s a) taking enough insulin for them and b) also eating fruits, vegetables, lean meat, fish, etc. along with them.
They say to wait until your bloodsugar returns to normal, but that could take up to two hours. What I tend to do in these situations, is megabolus. I over bolus to bring the 250 down and then count my carbs for the meal and bolus for that.
Not sure if it is just me but I find having milk may be high carb, but its sort of stable/predictable… Now the pasta, theres rebound… milk tends to be a slow and steady thing at least for me…
I kind of like ultrapasturized milk. as well as keeping longer, it seems to taste better at the lower fat percentages than its “regular” counterpart…