Cooking for Diabetics

[SuzySushi]

Sorry to hear that, SuzySushi.  This thread is quite timely for me; I learned only a few days ago that my brother (47) had developed diabetes.  Now he turns to electrolyzed reduced water.  He says he drinks two liters of this special water a day.

http://homepage3.nifty.com/hydrogen-richwa...0ofdiseases.htm

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So sorry to hear about your brother! I'll read up more about the water.

[Milagai]

Hi Suzysushi: very sorry to hear about your daughter,

but it's heartening that others on the site have posted

encouraging stories of their experiences managing this condition.

In case you don't already know, chana dal, a popular Indian legume,

is supposed to have an extremely low glycemic index and

is excellent as part of a diet intended to manage diabetes, and

if your family likes Indian food, here is a link with a lot of

information and recipes:

http://www.mendosa.com/chanadal.html

Milagai

[anzu]

A couple more tips:

if making things like cake, it is immeasurably easier to calculate the carb content per serving if you bake small cup cakes (or use mini-muffin tins) rather than whole cakes that then have to be sliced. When eating them, they also give the illusion of more food. (i.e. wow, I had three whole cup cakes vs all I had was one piddly little slice of this big luscious cake.)

If freezing any for later use, mark clearly how much carb there is per cup-cake. I, at least, forget amazing quickly how much each thing contained.

The same rule for labelling goes for anything else which contains carbohydrates and is to be proportioned out for use at some later date. I can't begin to count the times I've made something, and have not kept a good enough record...

Also, if following something from a cookbook which does not have the carb content given for the recipe, but contains carbs nonetheless, work out the total carb content of the recipe on the basis of weight of ingredients and using all those fiddly charts that I'm sure you've been given. Then (this is the important bit), write that total carb amount next to your recipe. Saves having to work it out all over again next time around. Personally, I always forget to do this, after having painstakingly calculated it.

If your daughter is then going to eat, say, one quarter of the total amount, it's easy to calculate one quarter of the total carbohydrate amount.

In addition, this practice of figuring out the quantity of carbs for the total dish can be quite useful even when following a recipe where they do give carbs or exchanges per serving, as sometimes the servings are absolutely minuscule (one twenty-fourth of a cheesecake, anyone?), but this is not always immediately apparent on reading the recipe.

A lot of the things I deal with give the carb. content relative to weight only for the dry weight of foods like rice and pasta. This is really unhelpful when you are cooking several serving's worth of that food.

Maybe you have been given other information that does give you the cooked weight for one portion/exchange, but if not:

work out the cooked weight for one portion/exchange-worth of foods that you eat a lot of in your house, such as rice, pasta, noodles, cooked potatoes, and such like, and keep a list of it handy in the kitchen.

And, if you don't already have them, buy scales. Preferably the digital kind that you can easily reset.

I think the scales are probably the most-used item in my kitchen. Measuring things in cups-worth is less helpful than weighing it (compare filling cooked pasta into a cup to see how much you have versus putting a plate on the scales, hitting the dial so that it sets to zero, then serving the pasta directly onto the plate, and you'll see what I mean).

Scales also help a lot in trying to figure out things like, for example, how much carbohydrate fruits contain. It's all very well to be told that an apple, for example, is one exchange, but then that really doesn't hold true when you have teensy tiny apples, or humungously large ones. Having scales makes your life so much easier.

Given that your husband has type 1 already, all this is probably teaching your grandmother to suck eggs. Hope it's of some use.

[SuzySushi]

Hi Suzysushi:  very sorry to hear about your daughter,

but it's heartening that others on the site have posted

encouraging stories of their experiences managing this condition.

In case you don't already know, chana dal, a popular Indian legume,

is supposed to have an extremely low glycemic index and

is excellent as part of a diet intended to manage diabetes, and

if your family likes Indian food, here is a link with a lot of

information and recipes:

http://www.mendosa.com/chanadal.html

Milagai

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Interesting!! I've bookmarked the website to read later. I'll make sure to pick up some chana dal next time I'm at the Indian market (or if our local health food store carries it). It's fascinating to find out how people in other countries manage the disease -- sometimes in ways quite different from the old American easy fix of eiliminating sugar.

[SuzySushi]

And, if you don't already have them, buy scales. Preferably the digital kind that you can easily reset.

I think the scales are probably the most-used item in my kitchen. Measuring things in cups-worth is less helpful than weighing it (compare filling cooked pasta into a cup to see how much you have versus putting a plate on the scales, hitting the dial so that it sets to zero, then serving the pasta directly onto the plate, and you'll see what I mean).

Scales also help a lot in trying to figure out things like, for example, how much carbohydrate fruits contain. It's all very well to be told that an apple, for example, is one exchange, but then that really doesn't hold true when you have teensy tiny apples, or humungously large ones. Having scales makes your life so much easier.

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Thanks, Anzu! We already have a small kitchen scale, but a larger digital one is a good idea, now that I'll be weighing and calculating a lot more. And placing the plate on the scale and resetting it to zero is a brilliant idea! All this time, I've been weighing foods in the scale's "scoop," having to transfer them onto the plate (and still have them visually resemble something edible). Dumb, dumb, dumb!!!

BTW, I can't thank you enough for your tip the other day about not asking first off "How were your blood sugars?" I've vowed to keep my daughter's life as *normal* as possible!

[tejon]

I would also highly reccomend cookbook/recipe software to make keeping track of carbs/protein/fat simpler. I usually recommend Lving Cookbook, but MasterCook tallies up nutritional information much more easily. Nice to be able to enter in what you just put into a salad, or the ingredients of a sandwich, and get nutrition data for that spur of the moment recipe. Also very handy for figuring out counts for recipes in cookbooks or online that don't give nutritional information.

[Sony]

As a student working towards an RD, I just came back from working at a diabetes camp where the majority of the children are Type 1 diabetics. I am so glad that you have found about about your daugther's condition before any long-term side effects of extended hyperglycemia set in! (which unfortunately was the case for some of the children I saw this summer...)

As others mentioned before, making this a part of her life and not her entire life is a great idea. It sounds like you're working to understand her needs both medically and emotionally! Here is some feedback that I have based on what campers and their veteran parents told me and what I found for myself during the internship. Of course, Wendy, your family and your doctor will know the best about medical decisions given that you know the best about your own situation and capabilities....so please just consider what's below:

1. Most children initally go on insulin shots before the pump for at least 6 months. This is usually to establish a consistent pattern of blood glucose management. Though the pump will probably allow for more flexbility in the future, hang in there with management via basline insulin and shot boluses.

2. Concerning lows: Glad you have already seen how physical activity can affect glucose management!

Hard candy is convenient to keep around, but difficult to administer if swallowing difficulty comes with the hypoglycemic episode. Plus, it usually takes about 5 hard candies to treat a hypoglycemic episode. Not bad to keep on hand, but juice box or glucose tabs may be better options if available. Also, at the camp we usually gave crackers after re-checking blood sugar 10 minutes later to prevent a rebound low (juice, etc can shoot up blood sugar, but it can dip again on the lower side without the crackers)

Though expensive, glucose gel may be a good option to keep on hand. If (heaven forbid) Wendy gets to a point where she can't swallow due to hypoglycemia, the gel can be placed in her cheek pocket so that it can be absorbed without her actually swallowing.

Not sure if this was recommended before, but checking FSBS (finger stick blood sugar) in the middle of the night is a good idea since this is typically the longest time going without food. If you find her having lots of hypoglycemia overnight, a bedtime snack that combines carbs with protein and/or fiber will help carbs to release in a more regulated way during the night. Examples? Fruit with yogurt or cottage cheese, sandwich with meat or peanut butter on whole-grain bread, oatmeal or whole-grain cold cereal with milk, hard-boiled egg with whole-grain toast.

4. Concerning highs: I'm more in the moderation camp. Having a meal plan initially is good to establish a norm of how Wendy's BS fluxes through the day. However, the flexibility will kick in soon enough. As mentioned before, high BS would probably be a short term nuisance (thirst, having to pee) but is a real danger if it lasts for extended periods of time. The other danger is that an attitude of invincibility may set in because the "acute" effects of hyperglycemia are not as severe as those of hypoglycemia.

All that said, I would hate for a child to miss out on birthday cake, ice cream with freinds, etc because of a manageable condition. The key is to make sure it's managed, that's all.

5. Sugar free products are great, but please remember that they may still contain carbs. After all, sugar-free cake is still made with flour. Sugar free pudding is still made with milk. Sorry if I'm stating the obvious . It's just that after working in a hospital with long-term diabetics, I was surprised by how many patients thought "sugar free" translated to "free" foods.

It is amazing how much you all will know in a short period of time. Label-reading skills for grams of carbs will become a norm (and has become the norm for so many, even non-diabetics!) And of course you know your daughter much better than I do, but chances are she will show the same resiliency that I saw in so many other children at camp. I was so impressed and humbled by the knowledge and wise perspectives of the children and their parents. I see that same spirit in your posts, and I wish you the best.

[SuzySushi]

Sony, thanks for your advice and insight! We just came back from about a 2-hour session with our diabetes educator, in which she discussed the results of the tests done in the hospital, which confirmed that Wendy is Type 1 :-(( , reviewed Wendy's blood sugars for the past week, and modified her insulin dosages to adjust for a "low" she seems to get shortly before lunch each day, and a "high" reading she's been having before dinner.

To get technical, this means less fast-acting insulin in the morning, plus a third shot of just 2 units in the afternoon -- BUT that will allow her to eat a more substantial afternoon snack since she's been coming home from school hungry. We also got an insulin pen for the afternoon shots and to carry if we might be out at dinnertime. We're to check back by phone with the diabetes educator by Monday at the latest (sooner if there are any problems -- she's available 24/7 by pager!) to fine-tune it further.

And we have an appointment with a dietitian at the beginning of September, to discuss a carb-counting diet. On the advice of the diabetes educator, we just picked up a copy of an amazing book, The Diabetes Carbohydrate and Fat Gram Guide: Quick, Easy Meal Planning Using Carbohydrate and Fat Gram Counts. It gives nutritional breakouts (calories, carbs, fat/saturated fat, protein, cholesterol, sodium, fiber, and servings/exchanges) for thousands of foods, from generic ingredients to brand-name prepared foods, fast foods in restaurants, and ethnic foods (ever wonder about the nutritional content in raw walrus meat or nopales?). That'll make carb-counting a lot easier.

The crackers following glucose tablets is also what our diabetes management plan recommends. As for glucose gel, it recommends a tube of CakeMate decorating gel (not frosting) -- less expensive, more compact ("which would you rather carry around"), and it does exactly the same thing! The supermarkets around here must be wondering why there's suddenly been a run on the white CakeMate! LOL!

Her blood sugar has actually been okay during the night -- pretty near perfect at bedtime and slightly elevated in the morning. Her bedtime snack has been milk or yogurt plus a starchy carb, and we may discuss adding a little protein, too.

I'm curious to hear what else the kids learned at diabetes camp. We *just* missed this year's session here. Maybe next year!

[anzu]

Milagai's suggestion about the inclusion of channa dal is a good one, but I think it important to elaborate a little before you start cooking and serving it.

Caveat first: I know only the results of eating particular foods on my own body. Other people may react differently to the same foods. Most people I know are Indian and eat beans or lentils every day, or are non-Indian, and don't eat beans or lentils at all. Unlike me, they don't fluctuate between eating a lot of it occasionally and other periods where I might consume none. Therefore, I've never been able to compare with others and see if they actually have the same experience.

Firstly:

all beans and lentils have an extremely strong impact on blood sugar, not just channa dal. Chickpeas (garbanzos) and soy beans both have the lowest amount of carbs out of all the various bean and lentil varieties (soy beans being extremely low indeed). So, if you are trying for some reason to get a lot of food for a small(er) amount of carbs, these are the two to go for (or to be avoided if you want to get a lot of carbs without having to eat too many beans).

Secondly:

the impact that eating beans or lentils have on my blood sugar is quite radical. If over half of the carb component of the meal comes from these sources, I have to reduce the amount of insulin I'm taking for that meal, otherwise it is absolutely guaranteed that I will have low blood sugar later. If not reducing the insulin dose, I wil eat extra food.

Thirdly:

I find this blood-sugar lowering effect to be cumulative. That is, by the time I have eaten meals with beans or lentils for 2 meals a day for about 3 consecutive days, I have to reduce my entire insulin dose: not just that for the meals, but for the time in between as well. Low blood sugar at night can get to be a real problem during that period.

This is not an observation from just a one-off event. We go back to India for 4-6 weeks at a time each year and, while there, I tend to eat far more dals and beans than I do at other times. This is a consistent pattern that I've noticed over several years.

Now, as observed in the caveat above, it may be just me. But the effect certainly goes beyond what I'd expect based only on the glycemic index of the beans (eating a lot of other foods with an equally low glycemic index does not produce the same reaction). I do recall reading that beans contain a particular type of gum (??? forgotten all the details) that is known to have this effect.

This possible effect is something to bear in mind, I feel, if you are going to be eating more beans or lentils. If making something like pea and ham soup, for example, and serving it as the main carb source in a meal, you might do well to serve it with bread as well, and to be sure to check your daughter's blood sugar 2 hours after the meal.

If it were only a very small component of the meal - such as a small helping of bean salad, say - I don't think you should need to be concerned.

And now a request from my side: does the ethnic part of your book include the carb content of Chinese sausages by any chance?

In Germany, they have no legal requirement to put the nutritional info on food packaging, and so - to my great frustration - they don't (even for brands that are present in the US, and where the label is otherwise identical, the nutritional info. part is left off here).

And the books available here that give nutritional info don't include Chinese sausages, nor is the information anywhere online that I could find.

But the sausages clearly do contain plenty of sugar - as my overly high blood sugar will attest to every time I've ever eaten them. I'd LOVE to know what the amount is.

If not in the book, is it on the package labelling of the sausages in the Chinese grocery store, and could you take a look for me the next time you're in the vicinity?

Thanks in advance!

[SuzySushi]

Milagai's suggestion about the inclusion of channa dal is a good one, but I think it important to elaborate a little before you start cooking and serving it

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Verrry interesting!!! I wonder if any reputable diabetes researchers in the West have done any studies about the impact of beans on diabetes management, and if the results can be quantified. That's something to check into further in my *free* time.

And now a request from my side: does the ethnic part of your book include the carb content of Chinese sausages by any chance?

... the sausages clearly do contain plenty of sugar - as my overly high blood sugar will attest to every time I've ever eaten them. I'd LOVE to know what the amount is.

If not in the book, is it on the package labelling of the sausages in the Chinese grocery store, and could you take a look for me the next time you're in the vicinity?

Thanks in advance!

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No problem! According to the book, 1 ounce of "Chinese sausage" (generic - no brand listed) contains 100 Calories, 2g Carb, 8g Fat (3g Sat. Fat), 6g Protein, and 246mg sodium; it's classified as 1 high-fat meat exchange. I'll check my supermarket next shopping trip to see how this lines up with the nutrition panels on the packaged brands.

[rlibkind]

Verrry interesting!!! I wonder if any reputable diabetes researchers in the West have done any studies about the impact of beans on diabetes management, and if the results can be quantified. That's something to check into further in my *free* time.

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Beans are a tremendously useful food if you have diabetes. It's pretty well established that the carbohydrates found in beans/legumes do not have the same impact on blood glucose as most other carbohydrate-laden foods. Obviously, each person is different, but assuming you're not eating baked beans with lots of added sugars, beans and legumes simply don't raise b.g. levels to the extent that potatoes or bread or white rice do.

Some thoughts on using beans:

Make them from dry beans. Although canned beans are fine, they tend to have a bit more salt and be mushy. Cooking your own beans is easy. Make a lot, then freeze them in portion-sized containers with the cooking liquid. Garbanzos (chick peas) work particularly well.

For a snack, roast chick peas coated in a little olive oil, salt, pepper and garlic. Or make them spicier with some cayenne or other chile pepper concoction. Roast in a single layer in 400-F oven, shaking pan occasionally, until nicely browned and crisp. Let them cool, then pack in an airtight container. (Alas, this is a particularly good snack with beer, which is not a recommended quaff from a diabetic perspective, though an occasional indulgence -- but not for a nine-year-old!)

Chicken parts of your choice (preferably on the bone, but skin can be removed) braised with Indian spices and herbs to your taste, onions, then rice and chick peas. Yum. Can be frozen into portios and reheated.

Wow! I'm out of beans. Gotta make some more!

[tejon]

Wanted to add that chana dal has a significantly different glycemic profile than other lentils and beans - it's more similar to soy beans and garbanzo beans. So keep that in mind.

[SuzySushi]

For a snack, roast chick peas coated in a little olive oil, salt, pepper and garlic. Or make them spicier with some cayenne or other chile pepper concoction. Roast in a single layer in 400-F oven, shaking pan occasionally, until nicely browned and crisp. Let them cool, then pack in an airtight container.

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We have lots of dried chick peas in the house as "emergency food." I sometimes cook them for hummus and stews. Do I roast them just dried, or soak them first?

[squids]

Sony, thanks for your advice and insight! We just came back from about a 2-hour session with our diabetes educator, in which she discussed the results of the tests done in the hospital, which confirmed that Wendy is Type 1 :-(( , reviewed Wendy's blood sugars for the past week, and modified her insulin dosages to adjust for a "low" she seems to get shortly before lunch each day, and a "high" reading she's been having before dinner.

To get technical, this means less fast-acting insulin in the morning, plus a third shot of just 2 units in the afternoon -- BUT that will allow her to eat a more substantial afternoon snack since she's been coming home from school hungry. We also got an insulin pen for the afternoon shots and to carry if we might be out at dinnertime. We're to check back by phone with the diabetes educator by Monday at the latest (sooner if there are any problems -- she's available 24/7 by pager!) to fine-tune it further.

And we have an appointment with a dietitian at the beginning of September, to discuss a carb-counting diet. On the advice of the diabetes educator, we just picked up a copy of an amazing book, The Diabetes Carbohydrate and Fat Gram Guide: Quick, Easy Meal Planning Using Carbohydrate and Fat Gram Counts. It gives nutritional breakouts (calories, carbs, fat/saturated fat, protein, cholesterol, sodium, fiber, and servings/exchanges) for thousands of foods, from generic ingredients to brand-name prepared foods, fast foods in restaurants, and ethnic foods (ever wonder about the nutritional content in raw walrus meat or nopales?). That'll make carb-counting a lot easier.

The crackers following glucose tablets is also what our diabetes management plan recommends. As for glucose gel, it recommends a tube of CakeMate decorating gel (not frosting) -- less expensive, more compact ("which would you rather carry around"), and it does exactly the same thing! The supermarkets around here must be wondering why there's suddenly been a run on the white CakeMate! LOL!

Her blood sugar has actually been okay during the night -- pretty near perfect at bedtime and slightly elevated in the morning. Her bedtime snack has been milk or yogurt plus a starchy carb, and we may discuss adding a little protein, too.

I'm curious to hear what else the kids learned at diabetes camp. We *just* missed this year's session here. Maybe next year!

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I just found this thread and was reading through, wondering if anyone else had heard about that book--it is amazing; a bible that I carry with me where ever I go. Good for you for finding out about it! I have had type I diabetes for 34+ yrs, diagnosed at age 9. My how things have changed since then! My first comment is how quickly you have come up to speed on all the information that is out there...it sounds like you've got a good start. And yes, even though you've already been exposed to diabetes, it is very different for a child and for a female. I myself have just gone to the insulin pump about 5 months ago, and highly recommend it, when the time is right. This book was recommended by a Nurse Educator who was giving a class on carb counting with the pump. I also recommend that you let your daughter do as much as possible on her own to become self-sufficient--by going to camp so early, it was an easy transition for me to become very self-sufficient at such a young age. But even though you just missed the camp this year, attending next year will still be an aid in her learning.

Two other items I am surprised that no one has mentioned. One is the fact that fat has an effect on blood sugar levels, just as carbs do. This is something I only learned about, and could only really "see" the effect of, when I went on the pump. How one's body reacts to different foods becomes very clear when on the pump. For instance, I could almost never eat beans, as they would raise my blood sugar greatly! (I can't tell you how my body will react to them now, as I have since become allergic to legumes. ) One of the reasons I mention about the fat is that when sugar is removed from food, almost always you'll find the fat content is sky-high. Growing up, I would much rather have eaten a small scoop of "regular" ice cream, vs. the ishy tasting sugar-free version that had 3 times the amount of fat. And although sugar-free items taste better these days then they used to, they still are not the real mccoy to me. Sometimes it's better to forego the roll with dinner, to have the cookie as dessert. One word of caution in trying to work out the diet/insulin ratios, however, and this has become clear with the proponents of the diets like Atkins and South Beach....too much insulin WILL throw the body off track. The combination of insulins and peaks and valleys, which it sounds like you've already experienced, makes it very difficult to actually "see" the real reason a blood sugar is rising or falling. While I am still trying to work out the formula of what my body does when I eat higher fat foods, I can't tell you how much being on the pump clarifies what is happening. The down side is that you have to do more blood tests, to see exactly what is happening with the sugars. As far as the testing being painful, I recommend trying different testing devices out. While they all look like they'd be the same, I actually found that it hurt me more to use the one that came with my OneTouch meter than to do it manually. I now use the Accuchek softclix, and while I used to test 4-6 times a day, in the beginning of going on the pump I was testing as many as 10 times a day to get an accurate picture of what was happening. Two, is that exercise can have an effect on blood sugars as long as 72 hours after the actual exercise has happened. Important to keep in mind during this topsy-turvy time of newly diagnosed diabetes.

I also highly recommend the camp experience, and getting in touch with the local JFRF and ADA. (do they have chapters where you are in Hawaii? If not, you can access them online) I spent many summers as a child, and then as a counselor, at a camp for diabetics. In fact, I went to camp a few weeks after I was diagnosed, so I had the benefit of learning the basics in a setting where others were doing the same. The point was made earlier how everyone nowadays is watching their diets and what they eat, and I think that is a very good point. And the resources that you have at your fingertips, well, the fact that you are so far along in your knowledge says quite a bit. Sorry to be so verbose...but I'll end by saying that it sounds like you're laying good ground work already for your daughter to have all the tools to manage her diabetes as successfully as possible. Best of luck to you...

Terri

[SuzySushi]

I just found this thread and was reading through, wondering if anyone else had heard about that book--it is amazing; a bible that I carry with me where ever I go. Good for you for finding out about it! I have had type I diabetes for 34+ yrs, diagnosed at age 9. My how things have changed since then! My first comment is how quickly you have come up to speed on all the information that is out there...it sounds like you've got a good start. And yes, even though you've already been exposed to diabetes, it is very different for a child and for a female. I myself have just gone to the insulin pump about 5 months ago, and highly recommend it, when the time is right. This book was recommended by a Nurse Educator who was giving a class on carb counting with the pump. I also recommend that you let your daughter do as much as possible on her own to become self-sufficient--by going to camp so early, it was an easy transition for me to become very self-sufficient at such a young age. But even though you just missed the camp this year, attending next year will still be an aid in her learning.

Two other items I am surprised that no one has mentioned. One is the fact that fat has an effect on blood sugar levels, just as carbs do. This is something I only learned about, and could only really "see" the effect of, when I went on the pump. How one's body reacts to different foods becomes very clear when on the pump. For instance, I could almost never eat beans, as they would raise my blood sugar greatly! (I can't tell you how my body will react to them now, as I have since become allergic to legumes.  ) One of the reasons I mention about the fat is that when sugar is removed from food, almost always you'll find the fat content is sky-high. Growing up, I would much rather have eaten a small scoop of "regular" ice cream, vs. the ishy tasting sugar-free version that had 3 times the amount of fat. And although sugar-free items taste better these days then they used to, they still are not the real mccoy to me. Sometimes it's better to forego the roll with dinner, to have the cookie as dessert. One word of caution in trying to work out the diet/insulin ratios, however, and this has become clear with the proponents of the diets like Atkins and South Beach....too much insulin WILL throw the body off track. The combination of insulins and peaks and valleys, which it sounds like you've already experienced, makes it very difficult to actually "see" the real reason a blood sugar is rising or falling. While I am still trying to work out the formula of what my body does when I eat higher fat foods, I can't tell you how much being on the pump clarifies what is happening. The down side is that you have to do more blood tests, to see exactly what is happening with the sugars. As far as the testing being painful, I recommend trying different testing devices out. While they all look like they'd be the same, I actually found that it hurt me more to use the one that came with my OneTouch meter than to do it manually. I now use the Accuchek softclix, and while I used to test 4-6 times a day, in the beginning of going on the pump I was testing as many as 10 times a day to get an accurate picture of what was happening. Two, is that exercise can have an effect on blood sugars as long as 72 hours after the actual exercise has happened. Important to keep in mind during this topsy-turvy time of newly diagnosed diabetes.

I also highly recommend the camp experience, and getting in touch with the local JFRF and ADA. (do they have chapters where you are in Hawaii? If not, you can access them online) I spent many summers as a child, and then as a counselor, at a camp for diabetics. In fact, I went to camp a few weeks after I was diagnosed, so I had the benefit of learning the basics in a setting where others were doing the same. The point was made earlier how everyone nowadays is watching their diets and what they eat, and I think that is a very good point. And the resources that you have at your fingertips, well, the fact that you are so far along in your knowledge says quite a bit. Sorry to be so verbose...but I'll end by saying that it sounds like you're laying good ground work already for your daughter to have all the tools to manage her diabetes as successfully as possible. Best of luck to you...

Terri

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Hey, Terri, this is my baby we're talking about!!! I'm a voracious reader, and if it concerns her health, I'm gonna read everything I can get my hands on. I'm also not shy about talking about health problems and asking for advice! The squeaky wheel, and all that...

No one else has gone into the relationship between fat and blood sugars yet... probably because her exchange diet is so restrictive anyway. I'm sure the dietician will discuss it, and if he doesn't bring it up, I will!

I'll look into the Accuchek Softclix. She's using a OneTouch meter and the lancet pen that came with it. My husband uses the same kind and hasn't complained about it, but he's not a child with sensitive fingers.

The ADA has a support group here for parents of children with diabetes. We're planning to attend their back-to-school event next week so we can meet some parents and Wendy can meet some kids in her situation. She's currently the only child in her school wih diabetes.

[anzu]

Gonna cover several different things here.

First, thanks for the info on Chinese sausage. Mine seem to have way more sugar than that , but it is a starting point.

The roasted chickpeas have to be cooked first before baking. I've tried this a couple of times, and always taken them out of the oven too soon, meaning they were not dry and crisp enough. You have to watch out for the amount of these that you eat when you're diabetic. Since they are dried out again, a very small quantity has a lot of carbohydrate. Easy to eat more than you realize.

Incidentally, the same can be done with mung beans (whole ones, boiled till just soft, then treated the same way). I was first given these in a private home in China.

Not just fat, but the quantity of meat eaten also makes a difference to blood sugar. In fact, basically everything you eat will affect blood sugar. The time they take to affect blood sugar take longer than with carbohydrates. I used to have the times written down somewhere, and can't find them (can't find anything since I last moved house, even though it's been almost a year now). I do know you can find the information on the web, though it might take a bit of searching. For what help it's worth, fat takes longer than protein.

But it does boil down to things like: eating a much larger amount than usual of greasy food, or of protein, may well cause one's blood sugar to behave unexpectedly at unexpected times - major upward spikes in blood sugar, for example, several hours after eating a lot of protein. And many people on insulin can't cope with the particular combination of carbohydrate and high fat that you get in pizza, for example (you can read more about this on the internet using the keywords "pizza effect" and "diabetes"). You can end up with high blood sugar for up to 8 hours later.

I have an insulin pump, and have tried playing around with varying the timing of the insulin so as to be able to eat pizza. No matter how I did it, my blood sugar skyrocketed. This is one of the few foods I have now given up on completely as not compatible with diabetes and insulin.

Other foods that are particularly fatty might be similarly problematic. (I am talking REALLY fatty here, though). The few times I had breaded deep-fried camembert, for example, it always turned out to be a bad idea later...

Different subject entirely:

with the blood glucose meter, are your test strips are the kind that come individually in a foil packet, which then has to be ripped open and put into the meter? (this is the kind I used for years).

If so, a big plug instead for Accu-chek Compact. You get 17 test strips in a type of drum which you just put as is into the meter, then all you have to do is press a button, and the strip is ready for testing. It's way easier to deal with than anything I've used before. Basically it allows you to easily test your blood sugar one-handed, or while standing up, or in a jolting bus, or wherever. Far, far easier.

Don't know if its far more expensive over there than the regular test strips and meter. German health insurance companies are far more generous with this kind of thing than US companies.

[squids]

Not just fat, but the quantity of meat eaten also makes a difference to blood sugar. In fact, basically everything you eat will affect blood sugar.  The time they take to affect blood sugar take longer than with carbohydrates. I used to have the times written down somewhere, and can't find them (can't find anything since I last moved house, even though it's been almost a year now). I do know you can find the information on the web, though it might take a bit of searching. For what help it's worth, fat takes longer than protein.

But it does boil down to things like: eating a much larger amount than usual of greasy food, or of protein, may well cause one's blood sugar to behave unexpectedly at unexpected times - major upward spikes in blood sugar, for example, several hours after eating a lot of protein. And many people on insulin can't cope with the particular combination of carbohydrate and high fat that you get in pizza, for example (you can read more about this on the internet using the keywords "pizza effect" and "diabetes"). You can end up with high blood sugar for up to 8 hours later.

Very true---I didn't mention the protein, since that is usually much easier to recognize and count when calcualting the diabetic diet. i.e.,1oz= 1 meat exchange. When I was learning about diet and exhanges, it was even before the emphasis on the different types of meats (high fat, low fat-----do low fat meats really exist?) While foods will react differently in different people, I have heard that pizza is a very common one that is difficult to manage. Chinese food is another type of food that was emphasized during my pump learning process to be difficult, but not impossible, to manage. Both of those things are not in my diet anyway, due to other food allergies, so I can't really comment. As far as "high-fat" foods, the obvious ones are easy, such as potato chips, Hot Dogs, chinese or any other kind of sausage, microwave popcorn, etc. (Deep fried camembert, heh? sounds delish ) I myself have spikes just when I eat any type of cheese, which is unfortunate, since it is such an easy-protein-rich snack.

anzu, if you ever locate that info about times, I'd love to see it! I've recently moved myself so I completely understand I've also never spoken to anyone whose used the Accucheck compact, but it sounds like it might be very convenient, especially for a young child. I tried to change to an Accuchek a year or so ago, since my insurance company is in cahoots with them and will pay more $ for the strips. But for me, I found my readings were more accurate with the Onetouch and the longer memory served my purposes better, so the cost savings did not add up for me.

The ADA has a support group here for parents of children with diabetes. We're planning to attend their back-to-school event next week so we can meet some parents and Wendy can meet some kids in her situation. She's currently the only child in her school wih diabetes.

ADA's POD group was instrumental in teaching the schools in my area way back when, on how to deal with diabetes, so it is good to hear you've got a chapter nearby.

(I can't seem to get the quotes to work right, sorry! It is difficult typing with a cat who decides to take over one's lap at the most inopportune moments!)

[SuzySushi]

Not just fat, but the quantity of meat eaten also makes a difference to blood sugar. In fact, basically everything you eat will affect blood sugar.    The time they take to affect blood sugar take longer than with carbohydrates. I used to have the times written down somewhere, and can't find them (can't find anything since I last moved house, even though it's been almost a year now). I do know you can find the information on the web, though it might take a bit of searching. For what help it's worth, fat takes longer than protein.

But it does boil down to things like: eating a much larger amount than usual of greasy food, or of protein, may well cause one's blood sugar to behave unexpectedly at unexpected times - major upward spikes in blood sugar, for example, several hours after eating a lot of protein. And many people on insulin can't cope with the particular combination of carbohydrate and high fat that you get in pizza, for example (you can read more about this on the internet using the keywords "pizza effect" and "diabetes"). You can end up with high blood sugar for up to 8 hours later.

←

In a way, maybe we're lucky then that Wendy is such a picky eater! That, combined with her currently restrictive diet, means that she's not going wild trying a lot of different foods and we'll be able to more easily discover the relationship between the carb-protein-fat components and her blood sugars. She eats the same breakfast every day, for instance, and goes through stages of wanting the same dinner for days in a row! (I'd get bored, but she doesn't!)

Re: pizza, interestingly enough, the manual the hospital gave us, which was developed by the diabetes center at the U. Colorado (one of three pediatric centers in the USA, apparently), suggests pizza as a bedtime meal/snack for sleepovers. It says that the kids get so excited at sleepovers (which I can attest to, by my sister calling them "wakeovers"!) that they need the extra fat & protein to keep their blood sugars from dropping during the night!

Different subject entirely:

with the blood glucose meter, are your test strips are the kind that come individually in a foil packet, which then has to be ripped open and put into the meter? (this is the kind I used for years).

If so, a big plug instead for Accu-chek Compact. You get 17 test strips in a type of drum which you just put as is into the meter, then all you have to do is press a button, and the strip is ready for testing. It's way easier to deal with than anything I've used before. Basically it allows you to easily test your blood sugar one-handed, or while standing up, or in a jolting bus, or wherever. Far, far easier.

Don't know if its far more expensive over there than the regular test strips and meter. German health insurance companies are far more generous with this kind of thing than US companies.

←

I suspect we're locked into the OneTouch glucometer. That's what our HMO gave us, and those are the test strips they supply (the test strips are very expensive, as I'm sure you know -- list price for OneTouch is $35 for 50 strips, and we go through at least 5 strips a day, but pay only a $15 co-payment for a 1-month's supply, which goes down to $10 if we order 3 months at a time). Also, the meter itself can be downloaded right into the diabetes educator's computer to provide her with a record of the log.

The test strips come packed in plastic canisters, 25 to a canister, about the size of a roll of film. A canister fits right into the meter case, though we do need to remove each strip individually. These are glossy plastic about 1" long x less than 1/4" wide. They literally require only one drop of blood, and we get a reading in 5 seconds! I remember the old paper strips that used to seep purple dye over everything they touched, so this is a great improvement!

Suzy

[MomOfLittleFoodies]

I don't know much about type 1 diabetes, but if the school is making accomdations for your daughter, get them in writing in the form of a section 504 plan or an IHP. That way if the plan of accomdations breaks down, you can go back, show them the document and say "but you said you'd make these accomodations."

My 8 year old has life-threatening food allergies, and we don't have either, and it's come back to haunt us repeatedly.

[SuzySushi]

I don't know much about type 1 diabetes, but if the school is making accomdations for your daughter, get them in writing in the form of a section 504 plan or an IHP. That way if the plan of accomdations breaks down, you can go back, show them the document and say "but you said you'd make these accomodations."

My 8 year old has life-threatening food allergies, and we don't have either, and it's come back to haunt us repeatedly.

←

Yup, they're doing an IHP. (That's what the public health nurse met with me for.)

Sorry to hear about your child's food allergies {{{{{{{hugs}}}}}}}.

Suzy

[Alberts]

This thread is fascinating and full of heartfelt responses. Sometimes, I think that our site (e-gullet) is full of what I would call "tertiary" topics, and I am glad to see the real world discussed and the benefit of communicating with others through life's joys and pains. It also shows how food is related to life in all its circumstances.

A few of things:

As a phyician and the husband of a type 1 diabetic, I just wanted to be sure it was clear that type 1 and type 2 diabetes are two entirely different diseases, the first usually has its onset earlier in life and involves distruction of the pancreatic cells that make insulin, the second involves resistance to insulin. The body is making it just fine.

Regarding the insulin pump, this is really a revolution for kids. When the time is right to do it, go for it! It is inserted every three or so days, and saves 6-7 (or more) shots per day. It gives a child control, it gives parents comfort, and it helps with blood sugars.

The critical element for me as the spouse of a diabetic, is not so much concern for high sugars (yes they are important and can be critical), but making sure that anyone in the environment of my wife (or your child) recognizes a low sugar and responds to it immediately with juice, glucose tabs, or sugar under the tongue. Be certain there is a medic alert bracelet (they are quite fashionable these days) with specific instructions on not just the condition but what do do.

I would never advocate sugar substitutes. I am still convinced we don't know enough about them. I do understand that for kids, the need to have some kind of snack (and veges get boring fast) is powerful, however.

Finally, everyone push for research and (sorry to get political), but I'm talking STEM CELL RESEARCH. This is one of the first diseases that will be cured by this. If the immune response can be blocked and stem cells can create new pancreatic (beta) cells, we are in business.

Sorry to offend anyone, it was not intended.

Best regards

[SuzySushi]

Thanks, Alberts!!

Eveyone has such great things to say about the pump. We will definitely check into it when the time is right.

I may have said this before in this thread, but we're lucky that Hawaii is one of the states that's pro-active about diabetes and diabetes education. It is automatic that she gets an IHP in school. A public health nurse is going over to her school to train the teachers and staff on what to do in an emergency; 30 people have signed up already!!! Her teacher taught her classmates about diabetes and about the warning signs for low blood sugar even before a diabetes educator came in!

I agree with you 1,000% about stem cell research. I personally feel we're this close to a cure for diabetes, and it'll be one of those "Eureka!" moments like discovering the spiral form for DNA.

Suzy

[eatmorepesto]

We are having a party and one of our guests has Type 1 diabetes. I want to make a dessert that she can have. I thought I'd get two kinds of sorbet - one sugarless, if possible, but then I wanted to have a little cookie with it. Do you have any suggestions? I wanted to make mexican wedding cookies, but was unsure of how to substitute for powdered sugar. Any ideas would be appreciated.

[SuzySushi]

We are having a party and one of our guests has Type 1 diabetes.  I want to make a dessert that she can have.  I thought I'd get two kinds of sorbet - one sugarless, if possible, but then I wanted to have a little cookie with it.  Do you have any suggestions?  I wanted to make mexican wedding cookies, but was unsure of how to substitute for powdered sugar.  Any ideas would be appreciated.

←

I haven't tried sugar-free cookie-baking yet as most of the recipes I've seen are not the kind of cookies my daughter likes. In cookies and cakes, sugar contributes texture and browning as well as sweetness, therefore, most sugar substitutes can't be used on a one-to-one basis. Also, the flour in cookies is a carbohydrate, so must be calculated in a diet plan.

Rather than tinkering with your cookie recipe to try to make it sugar-free, I think you should go for a tried-and-true recipe from Splenda (www.splenda.com) or Equal (www.equal.com). Also, some excellent sugar-free cookies are available commercially.

[anzu]

Expanding on what Suzy has said, I would not try too many substitutions. Many of them taste fairly foul. On top of this, some artificial sweeteners can have a laxative effect, particularly on the sensitive.

With type 1 there is usually a certain freedom of diet: you can take an amount of insulin to correspond with the amount of carbs being consumed. This means that the most helpful thing you can do is inform your guest about the foods you are serving before the meal starts. That way, the guest can decide accordingly how much insulin is required for the meal (and, if more comfortable that way, ask to have smaller or larger portions of part of the meal).

The worst thing you can do is to not inform the guest about the entire menu, or to have food which has carbohydrate 'suprises'.

In the first case, I've had a well-meaning relative serve 'sugar-free' muffins after a meal, when I had been told beforehand there would be no dessert. As Suzy has said, 'sugar-free' does not mean carb free, so this meant having to take yet another injection of insulin or else hurt the person's feelings. I really wished I'd been told beforehand what the full menu contained, it would have spared me considerable stress.

In the second case, I know someone who ate a dessert at someone's place thinking it contained sugar, and who had given themselves insulin accordingly. She discovered only afterwards that it had actually been reduced sugar and reduced carb, by which time her blood sugar was already falling to dangerously low levels. The intention had been good, but the failure to inform her was really not a good thing.

In your case, if serving a sugar-free sorbet, do let your guest know in advance that it's sugar-free!