This issue tends to get people very excited. I am not trying to convert anyone to low-carb, nor am I going to defend my choices. I am only trying to connect with any other parents who restrict their child's daily carbs to, say, under 100.
I wouldnt say we restrict my sons carbs. It is very rare that his carbs go over 100. Usually that happens on pizza or pasta night. He chooses what he wants to eat and how much and whatever the carbs are, so be it. He is 12 years old and I would rather let him have higher carbs then make him walk away from the table hungry. The thing that has been hammered into my head is to allow him to feel as normal as possible. If I limited his carbs, then his food would feel like a diet, rather then what it is. If his dinner carbs are high and he wants a dessert with it, I do tend to ask him to pick something on the lower side.
same with us Carol...we were not told to limit carbs. We were told to let him eat what he wants as long as we count the carbs and give the proper amount of insulin.
As a matter of fact, they changed his snack carbs to 30 grams without giving insulin. At first it was 15 and he was going to bed hungry. He is a growing boy. Not overweight, or underweight....just 12 years old and has a hearty appetite and is very active.
We do no limit our daughter's carbs, although I do the same as Jerod's Mom, asking her to choose which carb item if she wants a higher carb meal + dessert. Our Endo team does not ask us to limit her carb although I do feel conflicted about this at times when I read the low-carb discussions. I want her to be as steady as possible in her BGs, but to also be as normal as possible.
Dang it ! I typed up this whole big but then accidentally erased it.
As I said originally, I am looking for parent-friends who also limit carbs. It's not common, and my low-carb adult friends offer me lots of support, but (obviously) they're all adults, not parents of T1 kids. The reason I wasn't excited about discussing the "whys" of the matter is because I've been involved in a few discussion on the adult T1 forum about limiting carbs, and people always seem to lose their minds and the discussions get out-of-hand.
Nonetheless, we limit carbs because of research I've done, not because of what my endo recommends. My first taste of the variations in what is taught and know about D came from the book Blood Sugar 101 by Tu member Jenny Ruhl. On page 67, Jenny has a chart of the BG numbers of a person without D, what the Amer Assoc of Clinical Endos (AACE) recommends, and what the ADA recommends. A person without D has BG of 85 two hours after a meal; the AACE recommends 140, and the ADA recommends 180. That's a huge difference. Jenny also has a website http://www.phlaunt.com/diabetes/
During our own experimentation, I came to believe that tight control and unlimited carbs were not compatible (even giving insulin to cover). I loosely follow the teaching of Dr. Bernstein http://www.diabetes-book.com/ and adhere to his therory of small numbers, which says the fewer carbs you eat, the less insulin you'll have to give, and the fewer (and smaller) any mistakes you make will be.
As for eating what other kids eat, I asked my daughter. She doesn't care. What she cares about is having steady numbers. In Weight Watchers, there's a saying, "Nothing tastes as good as being thin" (or something like that). For Clara, that saying is "Nothing tastes as good as having steady numbers."
We do limit my 3-year-old daughter to 40 carbs per meal and 15 carbs per snack only because that's what we were told she is allowed when we were in the hospital with her in October. We have not been taught to adjust her insulin based on how many carbs she ate. We are taking the Take Charge diabetes class at Children's in March. I was told that they will teach us that when we go to the class. How did you all figure out how to adjust her insulin based on what she eats?
You have to do what works best for you and your child. If limiting carbs to give less insulin, keeps your childs numbers in check...then wonderful...that is the end result everyone is looking for. For now...and I realize my son is still in the honeymoon stage and things will change once that ends, we don't limit carbs and since we left the hospital we have had very few lower then 80 or higher then 150 BG's. I don't want my son to ever feel like he has restrictions or is on a diet. That would result in him feeling different and our goal is to have his life as normal as possible. But if you child doesnt care then again, it is what works for your family.
How old is your daughter? How long ago was she diagnosed with Type 1?
I am not sure if I understood your question but I will try. We have a carb ratio that the doctor/nurses change as needed. Right now my son is at 35 carbs per unit for breakfast and dinner and 30 carbs per unit for lunch. When we originally left the hospital it was 20 carbs per unit, but that has been changed since then. Our dietician actually frowned on limiting carbs. With a 3 year old, 40 carbs per meal is probably sufficient, but for us with a 12 year old active boy, growing as I type, there are days he is more hungry then others. Tonight we had tilapia, rice and green beans along with cucumbers marinated in red wine vinegar dressing....that all came to 62 carbs. But last nights dinner was 87. We cook pretty much the way we did prior to him being diagnosed. He is actually eating more because he rarely ate breakfast. He would drink carnation instant breakfast and that was about it. Now he has cereal and fresh fruit almost every day...some days adding in toast with peanut butter.
She'll be 11 on Friday and her 1 year dx anniversary is on Monday.
I'm sure your diatician did frown on limiting carbs. That's not what RDs are taught. It is a misconception, though, that your child will be hungry with fewer carbs.
How did you get 62 carbs tonight? Was the tilapia breaded or did he eat a really big serving of rice?
If Clara eats cereal, she goes to over 200. Breakfast is our most carb-limited meal of the day.
I think this is a perfectly valid question and one that deserves its own discussion. I'm sorry that you have to wait until March, though. That's crazy. We started adjusting right out of the hospital. I got help for the first month or so and once during the summer when she suddenly was high all the time, but other than that, I make all changes without consulting the endo. For us, it's largely a disease of self-management, with CDE support when needed.
No the Tilapia was not breaded.....I use a herb spice mix and bake it. He did have a cup of rice...that was I believe 52 carbs....
I dont believe that a child will be hungry with fewer carbs and honestly I dont think that is what our dietician believes either. Her frowning comes into play because if we limit, then their are restrictions that arent necessary. If he is hungry, he should be allowed to eat the amount of food that fills him up. Certainly he could have had more of the fish and less rice but as long as his BG is controlled, which at the present time it is, then I don't see why I would tell him no to the rice.
My son typically has cereal in the morning for breakfast and his average BG before lunch is 110. We have not had to do a correction dose since we left the hospital. We have had to treat some lows (no lower then 70) but usually that was because he was more active. Breakfast is definately his lowest carb meal but not because of any limitations. He just isnt a big morning eater so usually just eats something small, enough to give at least one unit of insulin.
I'm with you. I guess I didn't know how lucky we were when my son was diagnosed 8 years ago (at age 20 months). We met with our Dr. and CDE in the hospital, had a crash course in T1D control (of course there was much more to learn beyond this), had frequent calls with both of them the first month or so for advice on adjusting basals and ratios and then pretty much were self-sufficient from there. I feel very strongly that you need to have the information to be able to make these decisions for yourself. There are so many factors that challenge us every day (illness, exercise, hormones, etc) that if you had to call in for every change, you'd spend your life on the phone. If it were me, I would push for an earlier class or an individual meeting with a CDE as soon as possible.
We do limit his carbs..his meals are under 30 carbs each and his snacks while more of a judgement call, are generally under 10.However, we do have extenuating circumstances since he is morbidly obese (doctors words) which since we don't have primary custody (yet!) we can only assume how that occurred. He is 21 months,diagnosed at 9 months. This regimine was ordered by his endo.
No, we don't limit, but we do manage. Give four meals, breakfast and lunch 40 grams carbs (because she is truly not hungry then and we don't like to give a lot of insulin when at school). Large afternoon snack about 60. And, lately, very large evening dinner 70 or 80 grams. She is a teen and very hungry. However, despite the fact I am against low carb, I looked over her pump recently and was surprised at the number of days she ate 130 to 150 grams a day. She eats 150 grams a day almost as often as she eats the larger gram amounts. But it is her choice. I also noticed she still spikes on the 130 to 150 gram days... It is the larger carb load at dinner, usually. I can get around this by overbolusing and filling in with a few carbs at the two hour mark. The high blood sugar spikes in the evenings that cannot be controlled by overbolusing are usually due to hormonal growth spurts, which I will discover if she does not come down with a correction. I like the Blood Sugar 101 website too; such a wealth of information there. But cannot really eliminate highs as many of the highs are not always caused by food.
I was told not to restrict carbs when my son was diagnosed a year ago. He is 14 and growing quickly! I would say to do whatever works for you but to be careful about going to low. Carbs are the bodies source for fuel and as long as you give the right amount of insulin and stay away from too many simple sugars, I think it's okay. I am only going by what our endocrinologist told us and so far it works for my son. He craves carbs and if we tried to limit them, he'd probably starve. He also is very thin and needs to gain weight so I'm all for letting him eat as much as he wants. His a1c levels are still very good so I'm not concerned. But do whatever works best for you and your child.
We don't limit my son's carbs, but I do want to say that I get the whole low carb thing and I don't think it's horrible - especially if your daughter is on board with it. However I'm pretty sure my son wouldn't be. I am worried about him sneaking food and getting more upset with his diabetes than he already is, which is why we have decided to put his current psychological needs above what might be the very best for him physically. My husband and I went very low carb for a while and I know I felt better and think it's a good way to live, and although we've maintained some of those habits we aren't as hard core as we once were mostly because it took more effort and my husband is gone a lot and I'm burned out with three kids, a part time job, and diabetes!
Then I also wonder about the extra protein - which can put a lot of strain on the kidneys just like diabetes! We basically eat a pretty healthy diet with mostly "good" carbs, and usually encourage second helpings of salad instead of more carbs, but my son has already started pointing out that his friends have much more unhealthy lunches and he wishes he did too. : ( He does love healthy food and he will eat almost anything we put in front of him - but he wants the freedom to be like his friends.
Lastly, my son has gone to a pretty carb-free breakfast for that reason though - he wants to be able to have a snack at school at 10:30 since so many of his friends do (why? I don't know!) but with a spike even from toast in the morning, I did make him choose between eggs and turkey bacon for breakfast with a snack at 10:30 or toast for breakfast and no snack. In that case he definitely went for the eggs!
We also try to get more protein packed snacks - like trail mix, protein bars, etc. for his snacks, but they do still have carbs. His high carb meal is always lunch - both because he feels more normal at school, and because he doesn't spike much after lunch due to recess and a lower basal need in the afternoon I guess.
Well that's a lot of babbling just to say I'm not against the idea, and I try to implement it where I can, but I don't think we could pull it off completely here!
My son is 17 and was diagnosed last year at almost 16, so we are in a different place than most of you. But it may give you some insight to where you may be headed as your children go through the teen years.
In order to avoid the sneaking and rebellion common with T1s at this age, we have not restricted most carbs. He is not suppossed to have "real" sodas or syrup but is allowed pizza, cookies (only 1 individual package at a time), baked chips and other fast foods that he has a carb count for. He tests many times a day, especially since he is now driving and playing hockey, and then takes the appropriate amount of insulin. He does err on the high side at times because according to him being shaky and low in front of your peers is the ultimate humiliation. He loves carbs and has said that if he also had to restrict carbs it would be the final straw!
With that said, we are in the process of transitioning his care to him by the next year and a half when he will leave home for college. We have gained permission to change his CDE from a motherly/grandmotherly person that has been a great help to me to a younger CDE in the office that works with athletes and has a better rapport with him. I hope with her continued influence (she has him drinking skim milk) that he will see that a better diet is in his best interest and make changes. But, it will have to be his decision because I will no longer have much control over his eating.
If he was diagnosed earlier in life, we may have tried the low carb.
A very good point you have is that limiting can cause sneaking. My son is 12 years old and while I am extremely proud of how well he is managing his diabetes, I can't say that if we had limits, that he wouldnt sneak. Yesterday he had an appointment and his AIC was 6.6. I am pleased with that number as was the doctor. It isnt like he is eating foods that are terrible for him. Just allowing him to have as much as he wants. Mind you, I am not talking about desserts or junk food. If he wants double mashed potatoes, then we let him have it. He picks a small treat to have after dinner that gets counted with his carbs. I bought the small ice cream sundae cups and that is a weekly after dinner treat. Othertimes he might go with a couple cookies (not sugar free). We found that Krogers has a carb yogurt that is only 4 grams of carbs and my son likes it. Makes it very nice for an evening snack. I truly believe that each situation is different, and what works for one, wont always work for the other. I just know that if I limited carbs, my 12 year old would be back to feeling like he was different. As long as his BG stays where it belongs and AIC continues to be in range, I am good with the way we are managing things right now.
My son was also diagnosed as a teen last year (at age 13) and I agree that it's much different than if your child was diagnosed earlier and "grows up" with diabetes. Teens are so worried about being "different" and anything you can do to help them feel "normal" is so important. Also, they are growing at a tremendous rate and need food, food and more food. My son eats constantly and is still super thin. We try to encourage healthy choices and do not buy regular pop or super sugary treats but he does eat pizza, fries, cookies, waffles, etc.. and his a1c is low 7s - with all the growing he's doing, I'm pretty happy with that number. Bottom line, do what's best for your child but keep in mind that being super restrictive may backfire. I've never had "off limits" food for my kids and they've never abused it.