Juice box Podcast

@ClaudandDaye I listened to a podcast today that made me think of you. Scott Bennet is the stay-at-home dad of Arden who was diagnosed at age 2 about ten years ago. In today’s podcast Scott interviewed a mom of a 2-1/2 year
old toddler who was diagnosed at 18 months. Some of the things she talked about are similar to some of the things you have written about.

Most of Scott’s podcasts are excellent and if you are not listening to them, you might enjoy them. @Terry4 was a guest last spring (winter?).

http://www.ardensday.com/juicebox-podcast/

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I agree with @Laddie’s recommendation. Scott Benner’s daughter, Arden, was diagnosed at the age of two. As a stay at home dad, he took ownership of the role to manage his daughter’s diabetes. His nice conversational style makes for easy listening. He has definitely mastered the art and science of insulin dosing for his daughter. His daughter uses the Omnipod and a Dexcom CGM.

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Thanks! I did receive this recommendation from another member a month or so ago and I have his page set as a favorite! I haven’t listened to episode 83 yet but I’ll make it something I definitely do before the weekend is up!

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I was able to listen to it and there were a lot of similarities. I kind of broke down a little when she was describing her daughters BG at diagnosis as it was the same as our sons. She sounds like she’s got a great handle on her daughter’s BG, but she’s doing something that isn’t practical for my household. :frowning: She’s going low/no carb for the entire family. With a family size of 7 (5 boys 13 and younger) in my house, going low carb just isn’t practical for us. I wish it were though because I know that would be a “sure fire” way to control the spikes.

I think learning all there is to know about basal/bolus rates, how to define them properly and when to bolus/eat, temp basal/bolus rates, extended bolus, etc., will give us the kind of control we’re looking for without sacrificing food options. If we find that not to be the case, we’ll have to consider other options (low carb) as a last resort.

You know, I wouldn’t sweat the low-/no carb issue. For a few months after diagnosis, I would see all these posts of flatlines from people who were going low-/no carb for their kids. I seriously debated whether that made sense, and, like you realized that it wouldn’t make sense for our growing kid and his older brother.

But I felt really torn, like maybe I was worsening his life and increasing his risk of complications. I imagined him being 17 and dealing with kidney disease, and knew I would feel incredibly guilty if I hadn’t done everything in my power to prevent that.

Then I started actually doing a few low/no carb meals and noticed that they actually spiked my kid higher than the equivalent high-carb meal I just bolused for… I started crunching numbers and found no correlation between his daily carb intake and his time in range, TDD, avg bg, or glucose variability. (Granted, there is a confounder in that, when someone is running high you tend to avoid giving them carbs, while when they’re running low they need lots of carb corrections, which could wash out the effect of carbs on his numbers.)

As for low-carb, it takes a whole different approach to bolusing and my guess is there’s some threshold. If you go below it, maybe you can achieve that flat line, but if you’re above it, you achieve the same level of swings without getting to eat very enjoyable foods. There’s also a rough transition period where BGs may actually be worse as the body interprets the lack of carbs as starvation and amps up insulin resistance.
And when I meet adults who have these crazy low A1Cs, they’ll say they become so sensitive to carbs that they may take 1/4 of a glucose tab to treat lows!!

I don’t want my son on a diet where a wayward gram of carb here or there would be the difference between a 150 and a 60! It just seemed too restrictive for him, not to mention his non-D brother.

I also started asking people in real life I met who had achieved good A1Cs for their kids, and none of them actually did low/no carb. Instead, they were super meticulous about tracking/logging everything and knew their kids responses very well. Their kids also stuck to routines, eating similar foods every day at the same time, and practiced good BG hygiene. For instance, not eating while high, waiting to come into range, not snacking at night, etc.

I am realizing it IS possible to get a great A1C without restricting my son’s diet beyond the reasonable limitation on junk food. In the past two weeks Clarity has changed its A1C estimate for my son from 6.9 to 6.4 – all we did is up his basals and strengthen his carb ratios, and we actually let him eat MORE carbs. He’s in range pretty much all day, and between 70 and 160 about 75 percent of the time, with 2% of the time spent low. So that has made me realize it’s possible to actually get a decent A1C relatively easily. Of course, we are using openAPS which helps, but I think it is still possible using CGM to achieve similar feats.

All that is to say: Take heart and don’t feel you’re short-changing your son for not doing a low-carb diet! I am positive it’s possible with all the technology at our disposal for your son to achieve great blood sugar control. Maybe not an A1C of 4.9 to 5.4, but a 6.0 or 6.2 for sure. Also remember that no studies have demonstrated a reduction in complications for type 1 diabetics who are running this low compared to those with, say a 6.0 A1C – because so few people with type 1 diabetes have historically been able to achieve these levels.

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My decision, like you, was based on my whole family, but I also considered whether I want to begin going down this slippery road where we’re giving little or no carbs and as he grows up, who knows how this will impact him, his development, his growth, his mental state! What if he wants to grow up and eat foods like everyone else? We’ve just spent an entire lifetime making another decision for him. If he grows up and decides alone, of his own fruition, that he wants to go low/no carb, then we will; of course, support that.

We do limit his junk food and we feel that this is one of the most major things that will help us control his BG’s…what kid doesn’t love sugary junk foods…already taking this away (99.9% of it) is already “punishment” enough I feel.

I wish those people great success who do the No/Low carb diets, but it’s very much like everything else Diabetes…YDMV.

Great news on our end is that we’ve just BROKEN through the 7’s and achieved our first 6.9 A1C (14 day average)! That’s the lowest we’ve had since diagnosis. We’ll continue refining and I think we can make sure he’s got a solid start on life, and be as healthy as possible while still allowing him to “eat like everyone else (for the most part.)”

Thanks so much for your post…it made me feel much better about the same considerations that I had going through my head about possibly making his diabetes worse as he gets older by NOT going low/no carb.

While I found limiting carbs to be a great tactic for me, I realize that some people can manage a higher carb diet. The Juice Box Podcast’s Scott Benner has encouraged his daughter to mostly give up her breakfast cereal but he is very liberal in allowing a wide range of foods including higher carb choices like pancakes. He has learned how to adapt his insulin dosing to keep his daughter in range.

He sounds like he’s very “loose” with how he allows his daughter to eat, and how he boluses her…I don’t know if that’s something I’ll be doing…at least not in the near future! He sounds like someone who’s able to be this loose because he’s got a firm handle on understanding the ups and downs, when to do things, etc.,

Yes!