I do think that diets that don’t restrict amount/timing of food are probably less concerning—what was messed about the old exchange system was that it essentially taught kids to disregard their internal satiety cues as irrelevant information. I know of a lot people who had lasting difficulties from that type of set-up.
My favorite every other day breakfast is a Trader Joe’s Belgian waffle. It’s just 13 carbs and I top it with whipped cream and sliced fresh strawberries. One slice of bacon and a cup of non-sweetened French vanilla coffee and I’m good to go!
Incidentally, I buy the already cooked bacon from Costco, try and remove as much fat as possible and nuke it for 23 seconds, wrapped in a paper towel to absorb grease.
So, as it happens, I was recently in Brussels for work and was able to have a genuine, honest-to-goodness Belgian Waffle 
It destroyed my BG, but was probably worth it (in the long run) to try once. I find the frozen American versions to be not comparable, but my wife loves them!
Often I will avoid food stuff that spikes my bg, but on special occasions I will just bolus for it and hope for the best. Grains are the absolute worst for me.
Ever since I got a CGM 11 years ago, I’ve found I had to pre-bolus by 20 minutes for everything. After a few weeks it’ll become a habit.
As an long-term diabetic, I avoid or limit to very small portions high glycemic index foods like sweets, but living in the southwest and loving enchiladas and chile rellenos, I find the dual-wave bolus or even a super-bolus very helpful. The book “Pumping Insulin” explains what a super-bolus is and I’m sure there’s a how to article on this site.
Best of Luck!
I tend to limit foods that spike me, but not avoid them. If there’s some reason that I really, really want to eat something and it’s a special occasion, or even just a moment of craving (as long as those don’t come along often), I’ll attempt to bolus for it by using a super-bolus, pre-bolusing, exercising before or after, and making sure I measure out the carbohydrates exactly. Since I eat these things so rarely, my efforts often fail spectacularly, which motivates me to not repeat it for a while. (Thinking back to eating some dried mango on Monday as part of lunch; so, so good, but spiked my blood sugar to 23.6 mmol/L or 425 mg/dl in under an hour despite “extra” insulin.)
Like others here, I grew up with diabetes during the old exchange diet and fixed insulin regimen days. Even back then, my parents would occasionally let me eat something “not allowed” like vanilla ice cream and just deal with the high, but in general we were very strict around diet. I remember going to birthday parties and either not having cake at all or, if it was a fairly basic cake, eating a very thin slice with the icing scraped off. I also grew up with a severe food allergy that imposed additional dietary restrictions, and those were the truly “never” restrictions in that even a trace would cause an immediate (and unpleasant) reaction.
Unlike others, I really do not resent growing up with a restricted diet or wish that things had been different. The experience provided me with tools, such as an understanding of the importance of food in our diabetes management toolkit and an ability to eat food that differs from those around me, or turn down food entirely, without it bothering me. The one downside was, as others have mentioned, that when I was suddenly told in my mid-20s that I could “eat whatever I wanted” I had no idea how to actually eat. I went crazy for five years and ate food just because it was available and I’d been “given permission” by my doctors. Of course, I gained a significant amount of weight doing that, which I’m still trying to lose ten years later. It’s difficult for me to tell how much of the issue was the restrictive diet and not being able to read my body’s internal hunger cues and how much relates to the fact that Type 1 diabetes screws up internal hunger cues regardless. In either case, I’m not sure that being given an unrestricted diet as a kid would have resulted in any different outcome. To this day, I really wish that instead of being told I could eat whatever I wanted as a twentysomething I’d instead been told that rather than being stuck at an A1c of 7.5%, I could hit an A1c of 6.5% with the new method of dosing insulin and no changes in the way I ate.
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I was diagnosed as an adult and I realize there’s a significant difference between self-imposed food discipline as an adult and one imposed by parents on a child.
I avoid some foods that make me spike, like cereal. Having said that I had some meatloaf last week made with some breakfast cereal and my post meal blood glucose was well behaved. I did my usual pre-bolus and calculated my insulin dose to cover the added cereal and ketchup.
I also avoid or limit to small portions potatoes, rice, bread, and processed carbs. I do eat berries and also allow some limited addition of table sugar, like sprinkling of berries that are sometimes tart. I also eat meat, fish, eggs, dairy, nuts, seeds, limited amounts of peanut butter, and the less-carby vegetables like broccoli.
Someone mentioned about parents using the “type 1 grit” diet for children as an example of imposing an extreme food discipline and possibly unintentionally setting up an eating disorder. That’s a real concern.
Type 1 Grit is a Facebook community dedicated to following Dr. Bernstein’s way of eating for diabetes. This method limits carbs to 30 grams per day and distributes them to 6 for breakfast and 12 each for lunch and dinner.
This may seem like an almost impossible discipline, especially when imposed on children. But I’ve got to tell you that the creativity and energy in this group has identified and posted hundreds of recipes that make living with this protocol possible and enjoyable. It turns out that kids exposed to a wide variety of low carb foods (and treats!) do not feel deprived. I think this protocol can be implemented without the attendant risk of eating disorders if the family is willing to eat this way, too, and if the child has many favored meals to look forward to.
Type 1 Grit is a group that limits membership and I would not encourage parents of T1D children to join without first reading Dr. Bernstein’s Diabetes Solutions. This way of eating is not for everyone but don’t force yourself into a take-it or leave-it false choice. This method can be adopted in a graduated fashion, something I’ve done for the last five years. Bernstein’s method limits carb grams to 30/day while I have consumed a 50-75 grams/day with great BG success. Carb limiting simply works, an impressive tool to control blood sugar in diabetes.
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Terry, I think that is a very important point that is often times overlooked. I could not agree with you stronger.
I also think the whole insulin regiment back than also caused problems. While the exchange diet was a challenge, my biggest problem was having to eat at a certain time whether I was hungry or not because the insulin was peaking. I remember when I finally went on a pump around 1990, I rediscovered what hungry felt like. I remember walking with my family and I stopped because my stomach hurt and was making weird noises. I really didn’t know what was happening. And when my husband heard the noise he said, “well your stomach is telling you to eat”. And laughed because it had been so long since I had felt the hunger signals that ones body sends you. I was now feeling the hunger feelings. How strange and how cool. I no longer had to eat to the insulin.
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Agree. I never lived under the exchange system, but there’s no question that matching insulin to food is infinitely better than doing it the other way 'round.
I agree with @Sally7 that time was a huge factor in the restrictiveness of the exchange system (and the available insulins 20-30+ years ago), and that was a big part of the problem. I still remember the juggling of insulin doses, snacks, and meal needed just to eat out at a restaurant an hour later than my usual dinnertime.
I think there’s a big difference between a parent outright banning a kid from eating something and letting them help make the decision gradually. A lot of kids will make the decision themselves not to eat something if they know it will make them feel sick and are given an alternative that still tastes good. That was certainly my experience growing up.
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The exchange diet was GRIM. Not only did you have to eat at fixed times, but you had to eat exactly the right amount of each exchange. My problem was never having to eat when I didn’t feel hungry. I was diagnosed in my 20’s and was very active. I remember training for running a marathon and being limited to 2500 KCalories per day (and any carbs for keeping my BG up during runs of up to 20 miles had to be taken out of my next meal allowance). Basically I was starving hungry most of the time. Mind you, I never had a weight problem 
We lived in NL in late 80’s, early 90’s. Ate one once as that’s all there was for a breakfast meeting. I backwards computed one with no syrup or fruit was ~70g of carbs. I felt sick all day.
I also try to avoid foods that spike me, basically any high carb food, like potatoes, bread, rice. I do eat fruit though, in small quantities. I’m still experimenting there. I recently underwent a fasting to reconfirm my basals, and as a result have also rearranged my diet a bit. For example, I was eating one cup of yogurt and berries and fruit for breakfast. I switched that to 1/2 cup of the same ingredients but added 1/4 via pudding, as recommended here on the forum by several members. That is working well. So it is an ongoing experiment but maybe you can substitute some of the spike producing foods while not avoiding them all together.
I have had to eliminate steel-cut oats, because they simply make me spike. I used only steel-cut oats and fresh Blueberry and it would spike 70 to 100. My Nutritionist finally agreed after reading my numbers and told me not to eat them anymore
Same here I eat a small bowl and im at 280 1 hour later, go figure all that fiber. Its a real bummer because steel cut oats taste so good 
Oh well its eggs and bacon for breakfast…
I tend to have a reasonable number of foods that spike me as well. My doctor once suggested prebolusing for me, but that didn’t work out, so I just do the regular boluses, and even though I get the spikes, it still comes back down. Whether or not you should worry about the spikes depends mostly on whether they cause a problem BEFORE they come back down (frequent urination, pain, etc.). Making them come back down to the right number obviously requires you to do the right bolus, so knowing the carbs, doing a BG, and having the right ratios when eating is very important as well, so you’ll need to figure those out for yourself, sometimes it just takes a little experimenting and time to tweak you numbers and settings, especially for certain foods. One other suggestion I was give to use for prebolusing (on days where I didn’t know what I would be eating at the time I did the BG and usually bolus) was to do a bolus for the minimum I expected the carbs to be, this helped let the insulin start working sooner to avoid the spikes.
Big thumbs up on that !!!
It doesn’t have to be an “all or nothing”.
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I always try to prebolus with spiking foods, I also try to prebolus if I have higher blood sugar before I eat. It seems to work well for me although sometimes I have to eat more than I had planned or take more insulin because I hadn’t taken enough. But thats standard adjustments for me anyway.
To answer the OP’s question - I both prebolus and limit the foods that spike me. I avoid the foods that spike me but may have some on a special occasion (like a piece of moderate carb cake with whipped cream on a birthday.). I am using Fiasp now, so I actaully no longer prebolus if I am eating moderate GI foods. I will prebolus 10-15 minutes for high GI foods like beer (not that your kid has to worry about that).
Reading this thread brought up those bad memories of childhood and the exchange system and twice a day R/NPH.
So true! - Having to eat when you were not hungry was terrible. My mom (bless her heart) followed the rules and would actually measure out the butter in a Fat choice. Of course the amount of fat choices I had would never be enough to cover the whole piece of bread or bun that I was eating which was one of those major disappointments in life I always had to live with.
On a funny note, when I was first married I was still on the exchange system and measured everything down to one exchange. At that time I figured out (on my own) that really the startch and fruit and veg choices were the only food choice that made a big difference to BG. My wife would get frustrated that I would leave little bits of things in the fridge because she considered this impolite (like I would measure out a cup of milk and leave 1/4 cup in the milk jug, or I would measure out a cup of cereal or rice and leave 1/4 cup behind in the box.) She would say - just eat the little bit left. Of course, she knows better now 
Yup - devastating to the young person’s mental health (which of course was not talked about at the time) - or having to make sure the birthday party meal was at an exact time you needed to eat / or you would need to bring your own food so you had something or enough carbs . And never getting to eat treats in the treat bag etc.