I am interested in carb reduction. Not carb restriction. My son is in honeymoon with 1 unit of Lantus only. How many carbs are safe so that his carb amount is not too low with the low amount of insulin that he is taking?
I certainly do not want DKA.
And the carbs I do choose will be low glycemic.
I know that there are those that follow a Paleo plan. So, that even takes it to another step when the body is running on protein and fats.
This confuses me.
Thank you
My advice is to ask your diabetic team. Do you see a dietitian? It took us a few months and different Dr. visits to put all the information together. This is what helped me think things out.
You have 3 types of Carbs
1. Fiber
2. Starch
3. Sugar
Many Dr.'s will have you subtract the fiber off of the Carb total to get your insulin dosage as fiber doesn't effect BG levels, some don't. Do what your Dr's say to do.
Example- Total Carbohydrate 19 grams
Fiber = 3 grams
Sugar = 10 grams
Most packages don't have the Starch content on the package. But as there are only 3 types, Starchy carbs are the ones left over.
Starch = 6 grams
So the carbs that effect the Blood Glucose are the 10 Sugar and the 6 Starch
Sugars are the quick carbs. Quick up and quick back down. Much like a rocket going to space, it explodes and travels quickly. But it very short lived and the numbers quickly drop back down.
Starch are the gliders. They can span many minutes even hours. Much like a plateau rather than a mountain spike.
Now you can add in your Fats and your Proteins that effect what he eats as well. The more fat that is in the food - as in lots of cheese or fried foods. The longer it takes the stomach to get those carbs out and into the body. These foods can take 2-3 hours to fully effect your BG numbers.
Protein can act the same way as lots of starch. It can take the sugary carbs in the stomach and prolong them so they don't spike and last longer.
Going high is not good, as going high for a long period of time can cause DKA. But going low causes a more serious effect. So you must find that happy medium.
I always look at it as a air filled balloon. Some carbs make the balloon go much higher, some make it float for some time, but you NEVER want the balloon to touch the ground.
I hope this helps some.
Also I would add... I wouldn't restrict the diet unless ordered so by a Dr. I let our son eat what ever he wants in moderation. Kids need to be kids, and hell people need to be people. You don't want super high numbers, but you also don't want super low numbers. If he eats a ton of carbs, give more insulin, if he eats less, then watch for hypoglycemia. Instead of eating 3 big meals a day, eat 6 smaller ones. 3 main meals with 3 snacks in between.
I will respond to both of your posts. Our endo does not have a team. They cut short of nutrition and say: "Talk to a dietician". I am not interested in working with a dietician because they follow the USDA ADA Food Plate/Pyramid. Which is grain/dairy heavy as well as recommends a high amount of carbs per meal. I have been looking for a nutritionist that can take an entire approach to nutrition and the type 1 including carbs amounts. But I am asking out in Type 1 land to see what individuals have done to find balance.
As far as a restricted diet? We have always eaten cleaner than the average american. Little processed foods and geared toward what our grandparents ate: A Whole Food Diet.
I have not restricted what he is eating or eats outside of the home, particularly as a teen, but I am advising that he has choice. I have three years before he goes off to college. That's three years of education to the choices he can make to work with his type 1. I am not a believer that you eat what you want and turn up the insulin. I am teaching him to listen to his body. Understand the way he reacts to certain kinds of food. And last but not least - to begin to make choices for the best of his health and the best of his future.
Thank you for the breakdown of carbs, sugars and starches.
We also follow a lower carb lifestyle. I try very hard to avoid all processed foods. We've had 2 dietitians in 4 yrs & both have pushed the high carb ADA recommendations. Interesting that they encouraged us to "eat as you always did" until they found out our lifestyle, then all bets were off & they pushed upping the carbs.
My daughter is 15 & has been encouraged by her gyn to follow a low carb meal plan to help manage weight gain & insulin resistance from PCOS. She was averaging 30g per meal before, & has cut that down to 20g. She limits grain products & tends to get most of her carbs from vegetables, & occasionally some fruits (mostly berries). That said, she's 15 & very much a typical teen. When she's out with friends, she eats as they do (unfortunately)but she's beginning to notice how bad her body feels the day after that pizza party, & she's starting to be much more choosy even when eating with friends.
Thank you for sharing. Two children of the same age. One boy and one girl. Thank goodness for it seems that the girls are more apt to look at their own body and that of other young women at this age. Many a time it is about the health and nutrition connect that they can make with their friends if the influences are good.
For boy's that may come around sports and "it's all about the ab's". Since my son's insulin is so low in honeymoon he can eat what he wants and still stay skinny and does not have the connect to nutrition. But he know's that is lowsy to feel low and to feel high.
I never realized that our seemingly intelligent health care system was and is so archaic to the relationship of food and health.
Thank you for sharing.
At this time I am just trying to figure out the amount of carbs he needs per meal, while hungry and growing leaps and bounds. While not getting in trouble for going too low. How low is low?
So I have to understand the science of carbs to know when and if he can get into trouble. It's only the ADA that has told us that we have to eat grain carbs and it is those carbs that are most times processed, addictive and wreak inflammatory havoc on the immune system.
Not an easy job to change what society and the world has told us is right!
I think I have some links to info on nutrition needs for kids, but they're on my home computer. I'll see if I can find them & share. I only have daughters, so no experience with boys at all. I do know that the endo (also T1) who runs the D camp my daughter attends believes in meal plans for anyone on insulin, regardless of diabetes type. All kids at the camp are placed on the "constant carb" meal plan (60g carbs per meal & 3 15g snacks for girls, boys get 75g carbs per meal) to help manage BGs during the week of activities. It works well for my daughter's BGs, but she's not nearly as active at home, & she does complain about the types/amounts of food she has to eat while there.
I know some families who follow Bernstein religiously. While I don't doubt the very low carb diet they follow keeps BGs in "normal" range, I also think it's far too restrictive for kids, particularly teens. You might find more info/advice in the Bernstein group here.
I do not or will hot follow the ADA advise. The only group that told us that we had to eat grain carbohydrates and in what amount came from the other ADA (American Dietetic Association) that is married to big pharma who is married to government who is married to large food corporations. MONEY.
I think that answer here is appropriate choice of carbohydrates. Who in the heck sits down to 75 carbs per meal? A sandwich is almost 40. I rather give my son a sandwich and salad and nuts than cereal and processed foods. And let's not forget the Splenda!
And from choosing the appropriate carbohydrates than one can add low glycemic carbs.
Not only science but sense!
Our dietician that partakes in our diabetes clinic is wonderful. But we are also in Canada.... so who knows?
I would ask your Endo about the amount of carbs per meal and snack they are going to go with. Depends on age of the child, along with activity level and body, health, family history all into one.
Our son is almost 7 now. Diag. at 2 1/2. Was on injections until last year where we went onto the pump. He's 48 in tall and weights about 46 lbs. We can't seem to add any weight to him if we tried. He is a super energetic kid. He also has ADHD which adds to the hyperness of everything. He burns so many calories and carbs, that it's a struggle just to keep him fed.
Carb wise his breakfast is about 35-45g depending on the amount of fresh fruit involved. Whole grain cereals, oatmeal, toast...
He usually gets a snack around 10:30 before school recess. This is about 10-20 carbs. Depends on what he is asking for for a snack. If I know they have a gym class on certain days, I will have him eat a granola bar, or some whole grain crackers, with cheese as the protein. Along with 4-8g of fruit. Strawberries, other half of banana from his breakfast or a kiwi.
Lunch is anywhere from 25-50 carbs. Average is about 35g. Also depends on what he wants or is getting tired of. Soups with rice or noodles, sandwiches, wraps or pitas are a big hit. For sides he always gets a serving of fresh veg. Cut up carrots, broc, cucumbers, cauliflower, zucchini, mushrooms, radishes. Sometimes it will be in as a salad. Greek salad or add the veg to lettuce and he takes some ranch with him. Usually gets a serving of fruit again as he loves fruit. Then he gets to pick a treat for himself if he eats all his lunch. A sugar free cookie, bunny grahams, dried fruit. If the treat is starchy I will sub out the carbs in the main course. If it is sugary I will sub out some of the fruit carbs.
If there is an afternoon recess or gym I will send along a 14-16g sugar free yougurt drink to have before he goes out. Dan Actives are a good size for him.
Afternoon snacks are only if he is hungry. This is where he gets to choose what he wants to have. Also has to be reasonable. Most of the time he wants more fresh fruit. Other times he wants some baked chips or cheeseballs. 10-15g at the most
Dinner is anywhere from 25-90g I would say on average it stays about 40 though. But about once a month we might be out and get fast food or out to a restaurant. Or if we are having homemade lasagna or fish and chips down on the beach. Lots of carbs and fat. Most of the dinners consist of Chicken and Fish, seldom we have pork or beef. Always a serving or two of veg, and a starchy carb, in the form of pasta, rice, or bread. He also loves milk, so if he asks for it, he gets a glass.
Then there is the bedtime snack. This is a habit from out injection days, which we are still doing to this day. Carbs are 10-20 The worst part of the day is getting through the night with out those lows. *2am tests* :( It's always a starchy carb - wheat thins, graham crackers, small sized granola bar, half peanut butter sandwich, or one of my freshly made cookies or breads or muffins. He loves ones with fruit in them. He goes to bed around 8pm and we get him up around 10:30-11:30 for a BG check and restroom break (we are trying to night time potty train still) If he is still running a bit high then he gets a correction bolus at that time. Otherwise he goes back to sleep and is fine till morning.
It seems like a lot of food and carbs, but he is always on the go. He plays hard and gives 100% at anything he does. He has been in hockey since Sept and what little fat we had to do his pump site changes in are gone. His belly is now abs and hard to get the needles not to bend when injecting the cannula in him. If he spends 30 min of physical activity, it has to be planned around a meal or snack. He usually drops 7 mmol points in that time. (250mg down to 125mg) Before every hockey practice or a game. He gets a snack 15-20 carbs either before or after depending if he is running a bit above normal or right at normal. We test directly after his practice. (usually 60-70 minutes of activity.) Then we do a temp basal of 50% for 90-120 minutes depending on the amount of activity he was doing. His adrenaline always makes his BG rise during games, then sharply drop off after for up to 3 hours. But in that time frame he is getting a meal or a snack to refuel.
Each person is different in how they burn energy and what their bodies need. We give our son great choices to keep him healthy and full of energy. He even gets to sneak in a treat now and again, as I said before, kids will be kids and they need to be. Fully frosted cupcake at a school birthday.. sure why not. Friends pizza party and he eats three pieces at 27g each... Sure... To each their own and what works for you and your family.
Thanks for sharing. A 7 year old is in quite a different place than a 15 year old. My interest is to create bg stability and not the use of insulin. But as I mentioned he is now in honeymoon so very little insulin is needed. My sights are out of the Standard American Diet and I am more connected to the Bernstein lower carb interest.
Thanks.
And I do not have interest in working with Dieticians because they follow the ADA pyramid/plate. I have been looking at find natuapaths and clinical nutritionists to work with.
Our endo office has given only the advise to "eat healthy"., so that takes us back to square one.
Thank you for your information. You are spot on with my interests and ideas for exactly where I want to change up what my son is doing. Paleo and or even GAPS diet as opposed to all raw. Hence - cleaning up the gut and giving the Pancreas a chance to rest. Keeping numbers in balance. It's no different than how any one should eat!
I've started to bake with almond/coconut as you. I have increased fats - nuts, nut butters, coconut, etc. I am looking for grain alternatives and agree that they are best left out of the diet for most for many reasons. I have been looking for docs because what mom preaches and teaches isn't quite going over strong with my son.
But I am back to the same question. Even if I completely change up his diet and reduce the amount of carbs that he is eating - I am trying to understand how low to go so that the carb amount and insulin amount are not to low to get him in to trouble. DKA if carb too low and insulin too low is what I have been hearing. So, it means understanding the science of it all.
Can anyone clear this up?
Endo's teach the Diabetic that it is all about the amount of carbs.
How many carbs (particularly in honeymoon and on only one unit of Lantus) does he need?
I am sure that if I further reduce his carbs, he will not need any Lantus at all.
I am hearing and reading that a small amount of Lantus or insulin is good. I guess it reminds the Pancreas to keep on working.
Confused on this one!
And yes... I am looking for a good Naturapath. I just found a Functional Integrative Practitioner. I may take my son to him next week. I have not found a great Naturapath in my area. In the state of IL they are not as widely acknowledged.
School has just ended and summer begins. I really want to tackle the diet and have him come on board!
He is the driver of his bus (body and health).
Thank you for your support and information!
We live in a grab and go society. Getting a 15 year old male to slow it down and sit down for some Paleo is a hard request.
Our society taught us well! Grains, addiction to those grains.
I new right off from the beginning that carb amount was everything. When I told that to the Endo she screamed "Carb Restriction" and I said LooK: 30 or 40 carbs per meal is not carb restriction. They follow rules of the ADA. Gotta have those grains they say! I do not agree.
So, yes. The next step is to take it down one notch and see how that goes.
But then, again, back to my original question. How low can I go without causing any problems such as DKA or is DKA not even a thought?
I need to understand and read more about the science of DKA.
My daughter is 12 (5 ft 3 and 80 pounds)and her endo said she should get at least 120 carbs per day for growth/energy, etc. So would a 15 yr old boy need more? I find 120 carbs a day is really not a lot, and she eats between 130 - 150 per day total. She is also VERY active (which I think is critical for maintaining a healthy A1C and avoiding insulin induced weight gain.) Breakfast is her carbiest meal of the day becuase she seems to produce more insulin in the morning (Insulin/carb ratio is 1/85 in morning) and needs less Novolog to cover her meal. Also, I want to make sure she won't go low during the school day. Lunch is also a bit carby as she goes out with her frineds, and eats "normal." Dinner is usually less than 40 carbs, and most of the carbs come from veggies and milk. Snack is usually fruit and/or cheese depending on her bg. So while she is not very restricted, I have cut out pasta, rice, significantly reduced bread, french fries, etc. She eats those foods on occassion (I fear if she feels too deprived, she will want it more), but not like she used to. I also think it is crazy that endos tell us "She can eat anything, just cover for it." No, that just doesn't work. We went out to dinner on Wed and she had a burger, fries, and half a piece of cake. She was high for two days after - and she covered for everything. Big mistake and we are back to "reduced" and healthy carbs.
Our DD was diagnosed at 8 years and was put on 180 grams of carbs a day. However, we did not give the same amount of carbs as they suggested; we gave small breakfast, small lunch, large afternoon snack and large dinner because this is the way her appetite dictated. Now 16 she has reached her adult height and is 100 pounds. Our endo said not to allow her to go lower than 120 grams. She usually eats anywhere between 100 and 150 a day. She is free to eat what she wants and she has eaten more carbs at times. Teenagers grow like weeds, always hungry. Your teen may easily eat 180, 220 grams a day, probably more for a male teen. Their insulin needs will be very high, regardless of what they eat, because of the raging growth hormones at this time of life. Probably not a good time for you to restrict carbs; wait until they are adults and they will still need some guidance in this area. If you are prolonging the honeymoon, i.e., he is not yet on insulin, I would still not go below 150 grams probably. Honeymoons are very short in children usually. You may get lucky. Adults who have LADA can prolong the honeymoon for quite some time.