YDMV, diabetes truth or dodge?

Or in my case, imagine the psychological trauma of a 28-yr-old upon being told he can never have beer again! Just joking. You’re totally right, and especially about this:

I think some of the sillier LCHF wrangles I’ve seen, and the ones most in need of the YDMV rule, have involved people failing to acknowledge this distinction. Psychologically as well as nutritionally it’s a much different disease for kids than adults, all the more so because parents are so intimately and inevitably involved.

2 Likes

This really depends on how it’s done. There’s a difference between not going to a party and going to a party but bringing one’s own food and keeping the focus on friends and fun rather than food. I grew up with food allergies and diabetes (at a time when diets were always restrictive) and I definitely participated in parties and the like even if I often didn’t participate in the food aspect. The same is true for me now as an adult.

I agree that dietary changes and/or restrictions are hard. I think this is the primary reason why things like low-carb diets aren’t more popular (although I do think they’re increasing in popularity). With time they get easier, but especially at the beginning, it’s a huge transition.

When I was diagnosed as a kid, I already had experience of dietary restrictions from living with food allergies. After I was diagnosed, I was of course (back then) on a very strict diet. But one day my mom got sick of me whining about the fact that I wanted cereal for breakfast like my brothers, and said, “Fine, eat whatever you want.” So I had a heaping bowl of cereal. Of course, insulin of that time (R and NPH) was completely ill-equipped to deal with such a load of carbohydrates, and when I tested at lunch I found my blood sugar at 30.5 mmol/L. The school got freaked out and called my mom. My mom got freaked out and called my doctor. I found the experience traumatizing enough that I still remember it today. It was a great way of letting me understand why I shouldn’t have cereal, that there was a reason behind it and it wasn’t just an arbitrary decision my mom was making to be mean. That was the last time I complained about eating cereal in the morning.

I understand a parents’ desire to not restrict their child’s diet. But there are lots of kids who DO grow up with dietary restrictions and don’t have any great fallout from the experience. Millions of kids live with food allergies, celiac disease, dietary restrictions due to ethical or religious beliefs… There are parents of kids with diabetes who choose a low-carb approach, and their kids are happy and healthy. So there are definitely ways of living with such restrictions so that life is not miserable and psychological problems aren’t created down the road.

3 Likes

Terry4 and others on a low carb diet – How do you determine what to take for a meal bolus?

I completely agree with you @Tim35. I recognize that YDMV, so while I’m lucky to have not experienced any complications up to this point, that may not be true for another person with diabetes.

With that being said… you only get to experience life once. Once! That’s it. That’s all we get! So I completely agree with the idea that kids should try their best to keep their blood sugar levels in range, and parents should try their best to keep their worries in check. Between the both of them, I genuinely (perhaps naively) believe that blood sugar levels will end up in a pretty good place overall.

Before I started on an automated insulin dosing system, I dosed for carbs, protein, and fat in my meal. This method is for an insulin pump. For the carbs I just calculated (or let the pump wizard calculate) the insulin dose using an insulin to carb ratio. I delivered that insulin all at once with an appropriate pre-bolus time. My pre-bolus time varied from 15-60 minutes.

I counted 50% of the protein grams and 10% of the fat grams and added them together. I call this number “equivalent carb grams.” I then divided that total by my insulin to carb ratio to get a dose quantity of insulin. Since protein and fat metabolically play out over a longer period, I use an extended pump bolus.

I would take the protein/fat bolus amount and deliver it at a rate of 1.2 units/hour (I arrived at this from personal experimentation, your diabetes may vary) for the time it takes to deliver the total extended dose. For example, if my protein/fat bolus was 4.8 units, I would extend this bolus for 4 hours (4.8 units/1.2 units per hour = 4 hours.)

If you have a pump, extended boluses dampen out post-meal variability and they’re relatively easy to get right with a little bit of experimentation.

If you’re not using a pump, I would suggest some testing with old fashioned Regular insulin, like Humulin R or Novolin R to simulate a pump extended bolus for the protein/fat part of your meal. This would be in addition to your basal insulin as well as a rapid acting analog insulin like Humalog.

I now use an automated insulin dosing system called Loop. I only deliver the carb bolus for meals and let the high and low temp basal rates cover for the protein and fat content of my meals.

I’m probably a bit undersized as a result of getting T1D at age 5. But it’s complicated in my case because I was a tiny kid at birth and through toddlerhood. Not ever underweight, but shorter than most kids. My predicted height would be about 165cm, based on my parental heights, but I’m only 152cm on a tall day😊. I have very average sized hands and feet for a woman, so maybe I’m supposed to be a bit taller.
But I wasn’t undernourished enough to delay puberty, in fact I hit puberty very early (8-9yo), and had finished my growth spurt by 12. This also doesn’t help with height achievement!
The very first meal plan I got after diagnosis was actually a struggle. I was 40lbs or about 18kg at diagnosis, and started on a carb plan of 50, 20, 50, 20, 50, 20. Huge amounts of food, far more than I’d eat now. I very quickly got fat. At my 2 months post diagnosis check up, I’d gained 10lbs, or 4.5kg. Now I’d never been particularly unwell or skinny at diagnosis, so I did not need that weight gain! I’d also not gained any height… My carbs were backed off, but still fairly high for a tiny kid, to 40/20 etc.
I’ve struggled with weight gain all my life, but I keep things more or less under control with vigorous exercise and very moderate carbs.
I went to birthday parties and so on as a kid, and had one wonderful experience. A very good friend’s mum had made sugar free jelly orange segments, but rather than making a huge fuss about it, she quietly told me that they were fine for me to eat, as they were diet jelly. I was not quite 6 at the time, and nearly cried with happiness. Most other parents made a huge fuss, even my own aunt and uncle. “Diabetic margarine” anyone? Seriously. :roll_eyes:
I was aware very early that most adults were completely clueless and I’d need to look out for myself.

I didn’t read every single response, but I do think YDMV is very much true. I don’t subscribe to a low carb diet, but I’m very consistent in what I eat and my carb counting is fairly accurate. I’m also an anxious person by nature, and I have extreme highs due to additional cortisol and leptin in my body due to stress. I am also a woman and for 1 week per month, my blood sugar runs higher and then lower than the other 3 weeks per month. I take taekwondo 3-4 times per week, it’s a highly intense workout. Depending on how much weights vs. cardio, my blood sugar will spike high or go low, I never know what the routine will be until I get to class, so I’m just winging it! I have two children, a husband, a dog and I work full-time. It’s hard to maintain a completely regimented schedule. I might not be able to eat until 2 p.m. one day or I might eat 3 hours apart because that’s just how my schedule worked. It’s not an excuse for poor management, but my diabetes does vary from day-to-day. I try hard to not be slightly annoyed at people with diabetes who are less than empathetic to the bodies and emotional well-being and life situations of others. We do vary, we shouldn’t use it as an excuse to give up, but seeing that variance is just part of the process helps us to not feel like a complete failure when unforseen circumstances keep us from hitting the goal.

2 Likes

It amazes me how a simple act of empathic kindness can be remembered for a lifetime! Thank you for your take on this issue.

I congratulate you on managing a full life and your diabetes, too!

I was coming back to add, I wear a 670G. I ate a half of a gyro for lunch today and counted carbs, bloused correctly while waiting for order to arrive. My blood sugar went up to around 170 and sat there for about an hour. Then around 2:30 pm, when it would normally come down and definitely dipped like it was going to, it spiked instead and climbed a mountain to 370 within 20 minutes. I got the low insulin volume alarm and something went haywire in there (Kinked tubing?Hormones? Spiked diet soda…probably not, but it wouldn’t be the first time? Who knows.) So from around 2:30 to 5:00, I took 6 units of insulin and drank a bottle of water and tried to not feel sick while it came down. I was 126 by dinner time. That’s just a freak thing, DTCV. :woman_shrugging: