Hello,
I have a Newly Diagnosed Type 1 15 year old 2/12/2013. He is in honeymoon and his insulin amount is 1 unit of long acting Lantus ONLY. So this is a good time to keep it that way!
But I am new to Bernstein and can't read fast enough to digest all of this.
How do I handle a 15 year old that is in honeymoon?
Is there a way to keep him in this happy place with little or no insulin?
I know there is talk about fat burning that can cause trouble?
How can you guide me?
Thank you!
I was dxed as LADA, or Type 1, earlier than most. I suddenly became very thirsty, blurred vision, dry skin, foggy...and was tested for antibodies because I already had an Endo. I was told about Bernstein at the beginning of my journey. I went ultra low carb immediately. It is now 2013, and my last A1c was 4.9. I am not wasting away. I have difficulty losing weight, but I'm almost 60yo. I exercise more than my kids, even my 18yos. I have no complications, and the restriction on my drivers license that required me to use glasses to drive was *removed*. I'd keep a lot of protein, protein drinks, and a list of ready to eat foods like tuna and mayo. He will need portable food. I use cheese sticks and almonds, but he will need more food than I do. I'd suggest looking at the athletic diabetic list on Tu. Those guys may have insight. There are groups that are low carbers on Tu, as well. I forgot to say that I am not on insulin or any other oral drugs, but I really am strict.
When I reduce carbs he goes low (lower than 40 per meal if he is active or semi active. He is only two months into this. In honeymoon. On 1 unit of Lantus only. No insulin for food. So I dont know what low carb should be for him and what he should use for his carb sources. I am beginning to experiment to see how many carbs may work per meal.
I don't go high, but I don't go lower than 70. I do not take insulin, therefore I really could go without eating carbs and be ok, for now since I still make a very little bit of insulin. You need input from others that take insulin, but I think that Bernstein makes it clear that you have to adjust insulin as you go low carb. I would have to look it up in the book which is not easy for me to get to at the moment, but Dr. B. takes a very small dose of insulin to stay on his diet. Others here have methods of making adjustments. You should not do this on your own without reading up. In other words, your son may be taking too much insulin in relation to the number of carbs. Be careful. You may have to go slowly. I'm certain others will chime in here. (My husband is very sick with the flu and just went to bed, where my book is. Otherwise, I'd look it up. My memory thinks the dose Dr. B takes is so small that it is fractional.) Do not make any changes until you know more. I only go low when I exercise too hard or eat to little in relation to how intense my workout was, but I am not on insulin.
Honeymoons can be difficult as insulin requirements change. But following Dr. B's regime may actually help extend a honeymoon by keeping your blood sugar in a normal range. Dr. B recommends injecting insulin as soon as you need it. And he suggests that many people have very small insulin needs (although that apparently isn't true in my case). So for kids, he often recommends diluting insulin as a way of attaining more accurate control. If your son's fasting blood sugar is rock steady at 83 mg/dl without a basal insulin, then Dr. B would not recommend starting basal. But if his fasting rises to like 90 or 100 mg/dl, he would advise starting a basal.
And despite claims, Dr. B does recommend his 6-12-12 for kids, even growing teenagers. You may need to increase protein markedly, but he still recommends 30 g/day. And fat burning (ketosis) is not a problem, it is actually natural.
Lantus cannot be diluted. I don't believe that either Lantus or Levemir can be diluted. Humalog and Novolog can be diluted with a special order diluent. Dr. B recommends NPH and R, both which can also be diluted. The diluent for NPH and R is a much simpler formulation. Diluents can be special ordered at your pharmacy or your doctor can special order a compounding pharmacy to prepare the diluted insulin. In either case, you should work with your doctor to consider diluted insulin and get training from your health care team.
My son is on 1 unit of long acting Lantus only. So his diabetes is basically controlled by diet. I think that if I reduced his carbs his blood sugar would lower. He probably need none! But some say there is a good reason for taking it. Still confused about that. I was told only to give him humalog is he goes over 250. Diluting? My doctor would not assist me with that. The endo seems to feel like he is fine just where he is. My son wakes up around 120 or so. He feels low in the 70's. What do you mean by 6 12 12?
What is basal? You mean giving an insulin dose? We have been looking at anything below 100 as heading towards the lows. Confused of your post
I am feeding him protein at each meal. It seems that if I don't give him carbs he drops. I am confused of what to do.
i don't adjust my diet unless I am close to 70, but I don't take insulin. My blood sugar will rise with weights and somewhat with cardio. I don't eat until I'm at least 90ish. I do take more carbs if I am to get behind the wheel of a car, but I'm talking maybe 5 carbs. My bg would go high if I ate more carbs, and not that much more. My Endo did not want me to go over 120, but I keep it way below that. You will feel low in the 70s if you are used to running higher. I test often if I begin to get cold and spacy, but the cold feeling is more predominant if I am dropping no matter what the number is. The goal is to keep it about 83-85.
There are so many variables. Do you have a copy of Dr. B's book, 2011? Look at page 268 where he describes syringes, Lantus, Dawn Phenomenon, and everything to do with insulin and low carb, as well as exercise. I still have to go back and read this slowly.... read multiple times until you really understand these topics.
Any reference to "6-12-12" refers to Dr. B's central diet recommendations, 30 g of carbs/day, split into 6-12-12 over breakfast, lunch and dinner respectively. i would really recommend that you obtain and carefully read the book, "Diabetes Solution." Few endos will have the same view of diabetes that Dr. B does. Many endo's think it is just fine to shoot up to 2-300 mg/dl after a meal as long as you come down later and they think an A1c of 7% is absolutely great. Not Dr. B. He believes that we have a right to a "normal" blood sugar which almost never goes over 140 mg/dl and our A1c should be less than 5%. So you need to decide what your goal is. If it is to normalize your son's blood sugar and extend his honeymoon potentially forever, then don't just accept the endo's targets. Make your own decision.
That being said, if you read the book, it will describe a basal/bolus regime. A basal regime is the amount of insulin required to keep your blood sugar flat and normal (83 mg/dl) when you are fasting. By fasting, I mean not eating for a while. So if your son is having to eat so he doesn't go low on his current Lantus level that indicates that his basal is too high. Waking up at 120 mg/dl is still high. It happens when you have diabetes, as Sheila indicated, it is called Darn Phenomenon. If you were Dr. B's patient, he would have you take insulin to address the morning high.
So again. Please obtain and read the book. It is at most public libraries. And the situation you describe suggests that your son is getting too much basal.
I personally know two families with teens on Bernstein. If you would like send me a personal message I would be happy to get you connected.
Hello,
Yes I would be interested. I asked for you friendship so that you could forward me your email.
Thank you.