Cooking for Diabetics

[SuzySushi]

This has been a very stressful week for our family.

My daughter has just been diagnosed with Type 1 (insulin dependent) diabetes. She'll be 9 years old next month.

My husband has Type 1 diabetes, so we knew there was always a risk, but his didn't develop until he was 38 years old. No one else in his or my family ever had it.

It's been a whirlwind of intense activity, learning experiences, and emotional ups and downs ever since. She was in the hospital for 2 days so they could do more tests and bring her blood sugar under control. We were sent home yesterday with 2 shopping bags of supplies and a 3/4" thick "bible" on diabetes management in children. Met with the dietician/diabetes educator, her school nurse & counselor, and even her school bus driver (in case she gets hypoglycemia while riding home).

I'm still a novice about how to test blood and mix & give insulin shots (she actually caught on faster than I did, but is scared of doing the needle pricks herself so needs someone to steady her hand).

I stopped at the supermarket to pick up sugar-free versions of sugary foods she likes -- like sugar-free pancake syrup, strawberry jam, yogurt -- and cracker and juice packs to use in school for low blood sugars.

It means a complete change in our lifestyles/eating patterns. Since my husband has had diabetes for so long, he can manage it himself and adjust his insulin intake meal-by-meal to compensate for what he eats. But she's initially been placed on an 1,800 calorie exchange plan (3 meals + 2 snacks) with 2 shots a day (before breakfast and before dinner), so if she doesn't eat the correct amount of carbs and protein at specified times, her blood sugars are likely to seesaw.

AAAAAAAAAAAAACK!!!!!!!!!!!!!!!

Sorry if this is TMI for some people! I'm not looking for sympathy, but if anyone has had similar experiences, please clue me in on what to expect and the easiest way to do things!!!! TIA

[KatieLoeb]

Suzy:

Both of my grandmothers had insulin dependent diabetes, so I'm somewhat familiar with the lifestyle/dietary changes your daughter and family are in for. The technology for testing, self-medication and treatment are so much more advanced now than when my grandmoms were still alive that it should be a *relatively* uncomplicated transition. Yes - it will be challenging, mostly for your daughter, however these days diabetics can lead an entirely normal life because everything is portable and easy to handle, and much less invasive and painful than it used to be. It'll be a nuisance for a short while and then will become so routine it shouldn't even take a second thought.

((((hugs)))) to you and your brave daughter. Remind her that there are plenty of folks in her shoes, some of whom are professional athletes, actors, politicians, etc. No reason this has to be a big issue, other than the usual precautions taken to keep things in check. My thoughts are with you and your family as you accustom yourselves to the new challenges ahead.

[Maison Rustique]

{{{HUGS}}} My grand-nephew is Type I. (He'll be 13 next month.) Yes, it's difficult with children, as they so want to be "normal" like their friends. Try your best to take advantage of all the classes they offer for you and your child. And try to have her go to as many diabetes-related activities with other kids as possible. Most areas have camps every summer and it's wonderful for the kids!

I'm sure she'll soon get over her fear of the needles and be doing her own testing and giving herself her own injections. As I recall, it didn't take my g-nephew long at all.

Once she reaches a certain stage, it becomes easier with food choices and she'll be able to east most everything (in moderation) as long as she counts her carbs and gives herself the appropriate amount of insulin.

The temptation is always there for kids to sneak forbidden foods, so it's best to try to allow them special treats as often as safely possible.

Keep reading and keep learning--and never give up hope that they will soon have a cure.

[anzu]

I also didn't develop Type 1 till adulthood (I was 24), so I can't say what it would be like to have to deal with it in childhood.

However, I have spent quite some time with others with type 1 who did have it from childhood on. From what they've said, two themes keep showing up.

1. A lot of them felt - rightly or (almost certainly) wrongly - that their parents stopped seeing them and their lives outside of diabetes. They would come home from school, and it wouldn't be questions about how their day had been, or how they felt, or were they tired, or what else had been going on in their lives, but instead only questions about their blood sugar: was it too low or high right now, had it gone too low or high during the day?, and other such questions relating only to the diabetes.

2. A lot of them also felt hard done by, basically feeling that they'd missed out on various things that their peers had enjoyed (like birthday parties with lots of cake and other 'sinful' things, for example). In adulthood, they could recognize that their parents had been doing what they thought was best, but that didn't get rid of the feeling that they'd missed out.

Of course, right now, how all of you are going to cope with diabetes will be in the forefront of your minds! But point number 1 is probably something to keep coming back to later when the situation has settled down somewhat and become more routine. I.e. how to make it clear that your love for your daughter and your interest in what's happening to her extends beyond the day-to-day coping with diabetes.

With point number 2, I think you really need to strive for the feeling that she's not going to miss out on things. I don't know how strict the professionals are that you've been talking with, but I've personally come across the whole gamut, ranging from 'Abstain from all joyful things: you are going to go blind or have even worse things happen to you if your blood sugar is not as perfect as possible as often as possible' to ' Occasional high blood sugar is sure not going to matter, and go ahead and have that piece of chocolate' (and sure enough, it was only the professionals who had diabetes themselves that advocated the occasional letting go ). So, I'd say an occasional 'letting go' (within reason, or course) is a good idea, and probably also the best way of ensuring that there will not be an out and out rebellion later on.

I'd disagree with Katie to the extent that she says ' it shouldn't even take a second thought'. In my experience, some things are always going to hurt, like checking one's blood sugar (though the pain of this truly does decrease with time), finding a new place on one's body that doesn't hurt to give a shot,(especially after you've been doing it a while and you find that you have been doing it for too long in certain specific areas) and so on. I feel that what should be emphasized is that, even it it hurts, that hurt doesn't last long, and is for an important reason.

Right at the beginning, various professionals told me that various things wouldn't hurt. They were lying, or wrong, or both, and I still resent them now, even though it was years ago and I was an adult at the time they told me this.

On top of that, there is always going to be a certain element of resentment and feeling deprived. Even if you are adjusting the insulin by yourself, there is always going to be a certain feeling (for me, at least) that it's not fair, that other people can just eat things without worrying about how much carbohydrate it contains, whereas you DO have to worry, and have to try to work it out. I think this is natural, and is probably going to be something you'll have to talk about (probably repeatedly) with your daughter.

I can see that, in these early stages, they want to have a fairly rigid regime of shots, meals, and snacks. I followed that type of regime for the first 8 years of my diabetes. In some ways, it does make things easier, there is less to have to worry about. However, I would qualify that and say that this probably easier only for people who are less accustomed to dealing with the carbohydrate content of food, the whole issue of giving shots, etc. This is not the case in your family, where you are accustomed to it.

I would suggest giving it a few months of seeing how it goes with this sort of rigid regime, and seeing how liveable you find it compared with the more intensive (and knowledge- driven) regime of your husband. At the end of that time, if you find the rigid regime less workable, don't be afraid to hassle the doctors so that it can be changed!

Brand names of insulin vary from place to place, so I won't use names. Instead: is the insulin to cover meal-times normal or ultra-fast acting (does it have to be given 20 minutes before the food is eaten, or immediately before eating?). If it is 'normal', this is much, much harder to deal with. There are so many situations where you can't know exactly how long it is until you will eat (eating in a restaurant is just one of these), and trying to guess that food will be ready in 20 minutes from 'now' is a major PITA. Try to have/get an ultra-fast acting insulin, it is unbelievable easier to work with.

How much is your daughter used to being pushy (not to mince words here) and standing up for herself?

I ask because, when I had to eat regular snacks between meals to ensure my blood sugar didn't fall, there always seemed to be someone around, or some type of situation, that would prevent my being able to eat when it was actually a medical necessity. You know, some person would be eyeing my food, for example, and saying: 'That look's good, can I have some?' when actually the quantity of food was measured out precisely, and it was essential that I should eat the full amount of what I had with me. Or I would be in a class which was going overtime, with the teacher ranting on and on, and all I could think was that I needed to be out of there and eating something, otherwise I would be in trouble.

If she's not used to being assertive, maybe you'll need to encourage her a little so that she can deal with difficult situations like these.

And (this is blindingly obvious, but worth repeating nonetheless) make sure that she ALWAYS has something sweet with her, for when/if her blood sugar falls. This includes times like 'I'll just be away from the house for 5 minutes, I won't be away for long enough for my blood sugar to drop'. After all, 5 minutes can easily turn into 15, and blood sugar can drop very quickly when you're on insulin.

I'd also agree with the issue of trying to find peers who have diabetes. There are groups, summer camps, and so on.

Again, this was in adulthood, but it was a great feeling for me to go out to a restaurant with a large group of people and have everyone there 'shooting up' together when the food came. One feels, essentially, like less of a freak! The feeling can only be stronger in childhood.

Best wishes for all of you.

[SuzySushi]

Thanks, Katie & Deb, for your moral support!!! {{{{Hugs}}}}

We missed the diabetes camp this summer, but at the end of this month, there's a back-to-school event for kids & their families which we're planning to attend. She's the only child in her school with diabetes, so we're hoping she can meet other kids in her age group there.

Luckily there are a lot more sugar-free options these days, and the medical community no longer banishes sugar as long as it's used in moderation, so there aren't any completely "forbidden foods."

[snowangel]

I have a close friend with a child with diabetes. I can remember well a couple of things she said to me.

She put a laminated sheet on a keychain on her daugther's backpack (or inside her backpack) with info. A lot of kids like Heidi (epilepsy in her case) have a med id bracelet; in Heidi's case, the tag is not worn on her wrist, but rather on her tennies in the first (bottom) set of holes.

The other piece of advice is that whenever she is going to be with a friend, make sure the parents/caregivers understand exactly what her needs are, which is why my friend went ahead and printed up some simple instructions and had them laminated.

Finally, it might be good for you to visit the classroom (perhaps accompanied by the school nurse) and talk to the classroom about the diabetes. One of the things I did this past fall when Heidi was mainstreamed was to go into the class. I talked a bit about her disability, but stressed to the class that even though she has Angelman Syndrome, she is more like the other kids than not. Talk to the teacher and see if this would be an OK thing to do. In Heidi's case, she is not able to speak for herself, but my friend said that her daughter was somewhat self conscious about talking about it and was relieved that her classmates knew what was up.

Finally, as you get together with other families, seek support from the other parents who have and are walking in your shoes.

[SuzySushi]

Thanks for your long and thoughtful response, Anzu. {{{{hugs}}}}

We're going to try to keep our daughter's life as normal as possible, and in fact are going to a (prescheduled) beach party/picnic this afternoon. She's more interested in the swimming than the eating, but we're making sure to bring along snacks she can eat. (Along with her test meter kit and glucose tablets.)

Luckily, our health care provider (Kaiser Permanente, if you're familiar with that HMO) is up-to-date on diabetes care and does believe that everything can be eaten in moderation. She's on the strict diet just for a couple of weeks/months until we can establish a blood sugar log to see how her body reacts to carbs/insulin at different times of the day & night and with different activities. They then intend to put her on a carb-counting diet so she has more flexibility in what she eats. Right now, she's taking a mixture of short-acting (NovoLog) and medium-acting (NPH) insulin, with adjustments to the short-acting insulin based on a sliding scale of blood sugar readings.

We got her a waistpack to carry her test meter in, along with sugar packets (in the pocket of the meter case itself) and glucose tablets. She can also use juice or candy for blood sugar lows, but we don't want her carrying around emergency foods that are so attractive to other kids that they'll try to "trade"!

I know it's impossible to completely do away with the "why me?" resentment, but hope that with a flexible diet plan, she won't feel that she's left out of other kids' activities. The current wisdom from our HMO and in the diabetes "bible" (which was developed by the University of Colorado) says to allow the children to have "extra" treats at special occasions like birthday parties and Halloween and adjust the insulin as needed. (In fact, the book says that kids may not even need the extra insulin because the excitement from the activities burns off more calories!)

I think she'll be pushy enough to stand up for herself to adults... she already announced in the supermarket that she's looking for the sugar-free version of such-and-such because she has diabetes. Good warning about the other kids who may want to sample her measured food! I'll have to discuss that "what if" situation with her.

My husband and daughter both say that the shots don't hurt! (Something that's very hard for me to believe!!!) The needles are so fine these days. But the finger-sticks do, and unfortunately need to be done 4X daily until they come out with a totally reliable non-invasive testing method...

May I PM you if I have other questions, etc.? I get the feeling some of the discussion may go way off base from what's supposed to be posted on the on the general forum!

Suzy

I also didn't develop Type 1 till adulthood (I was 24), so I can't say what it would be like to have to deal with it in childhood.

However, I have spent quite some time with others with type 1 who did have it from childhood on. From what they've said, two themes keep showing up.

1. A lot of them felt - rightly or (almost certainly) wrongly - that their parents stopped seeing them and their lives outside of diabetes. They would come home from school, and it wouldn't be questions about how their day had been, or how they felt, or were they tired, or what else had been going on in their lives, but instead only questions about their blood sugar:  was it too low or high right now, had it gone too low or high during the day?, and other such questions relating only to the diabetes.

2. A lot of them also felt hard done by, basically feeling that they'd missed out on various things that their peers had enjoyed (like birthday parties with lots of cake and other 'sinful' things, for example). In adulthood, they could recognize that their parents had been doing what they thought was best, but that didn't get rid of the feeling that they'd missed out.

Of course, right now, how all of you are going to cope with diabetes will be in the forefront of your minds! But point number 1 is probably something to keep coming back to later when the situation has settled down somewhat and become more routine. I.e. how to make it clear that your love for your daughter and your interest in what's happening to her extends beyond the  day-to-day coping with diabetes.

With point number 2, I think you really need to strive for the feeling that she's not going to miss out on things. I don't know how strict the professionals are that you've been talking with, but I've personally come across the whole gamut, ranging from 'Abstain from all joyful things: you are going to go blind or have even worse things happen to you if your blood sugar is not as perfect as possible as often as possible' to ' Occasional high blood sugar is sure not going to matter, and go ahead and have that piece of chocolate' (and sure enough, it was only  the professionals who had diabetes themselves that advocated the occasional letting go  ).  So, I'd say an occasional 'letting go' (within reason, or course) is a good idea, and probably also the best way of ensuring that there will not be an out and out rebellion later on.

I'd disagree with Katie to the extent that she says ' it shouldn't even take a second thought'. In my experience, some things are always going to hurt, like checking one's blood sugar (though the pain of this truly does decrease with time), finding a new place on one's body that doesn't hurt to give a shot,(especially after you've been doing it a while and you find that you have been doing it for too long in certain specific areas)  and so on. I feel that what should be emphasized is that, even it it hurts, that hurt doesn't last long, and is for an important reason.

Right at the beginning, various professionals told me that various things wouldn't hurt. They were lying, or wrong, or both, and I still resent them now, even though it was years ago and I was an adult at the time they told me this.

On top of that, there is always going to be a certain element of resentment and feeling deprived. Even if you are adjusting the insulin by yourself, there is always going to be a certain feeling (for me, at least) that it's not fair, that other people can just eat things without worrying about how much carbohydrate it contains, whereas you DO have to worry, and have to try to work it out. I think this is natural, and is probably going to be something you'll have to talk about (probably repeatedly) with your daughter.

I can see that, in these early stages, they want to have a fairly rigid regime of shots, meals, and snacks. I followed that type of regime for the first 8 years of my diabetes. In some ways, it does make things easier, there is less to have to worry about. However, I would qualify that and say that this probably easier only for people who are less accustomed to dealing with the carbohydrate content of food, the whole issue of giving shots, etc. This is not the case in your family, where you are accustomed to it.

I would suggest giving it a few months of seeing how it goes with this sort of rigid regime, and seeing how liveable you find it compared with the more intensive (and knowledge- driven) regime of your husband. At the end of that time, if you find the rigid regime less workable, don't be afraid to hassle the doctors so that it can be changed!

Brand names of insulin vary from place to place, so I won't use names. Instead: is the insulin to cover meal-times normal or ultra-fast acting (does it have to be given 20 minutes before the food is eaten, or immediately before eating?). If it is 'normal', this is much, much harder to deal with. There are so many situations where you can't know exactly how long it is until you will eat (eating in a restaurant is just one of these), and trying to guess that food will be ready in 20 minutes from 'now' is a major PITA. Try to have/get an ultra-fast acting insulin, it is unbelievable easier to work with.

How much is your daughter used to being pushy (not to mince words here) and standing up for herself?

I ask because, when I had to eat regular snacks between meals to ensure my blood sugar didn't fall, there always seemed to be someone around, or some type of situation, that would prevent my being able to eat when it was actually a medical necessity. You know, some person would be eyeing my food, for example, and saying: 'That look's good, can I have some?' when actually the  quantity of food was measured out precisely, and it was essential that I should eat the full amount of what I had with me. Or I would be in a class which was going overtime, with the teacher ranting on and on, and all I could think was that I needed to be out of there and eating something, otherwise I would be in trouble.

If she's not used to being assertive, maybe you'll need to encourage her a little so that she can deal with difficult situations like these.

And (this is blindingly obvious, but worth repeating nonetheless) make sure that she ALWAYS has something sweet with her, for when/if her blood sugar falls. This includes times like 'I'll just be away from the house for 5 minutes, I won't be away for long enough for my blood sugar to drop'.  After all, 5 minutes can easily turn into 15, and blood sugar can drop very quickly when you're on insulin.

I'd also agree with the issue of trying to find peers who have diabetes. There are groups, summer camps, and so on.

Again, this was in adulthood, but it was a great feeling for me to go out to a restaurant with a large group of people and have everyone there 'shooting up' together when the food came. One feels, essentially, like less of a freak! The feeling can only be stronger in childhood.

Best wishes for all of you.

←

[SuzySushi]

Thanks, Susan! Good tips! The laminated info sheet is a very good idea, which I'll be sure to adopt. We're ordering a MedicAlert bracelet, which Wendy wants to wear as an anklet. (In Hawaii we're more likley to wear flip-flops than sneakers, so the shoelace tag won't work... LOL!)

The nurse/educator offered to give a talk about diabetes to her classmates and teacher, and the school nurse is amenable to the idea, too. (We haven't spoken with her teacher yet... will do that Monday.) We'll also be putting a chart up in the classroom so the other kids can help watch out for symptoms of low blood sugar. And everyone will know where her glucose tablets are (in her waistpack) in case of emergency.

Yes, yes, there is SOOOOO much we can learn from other families, and not from books!

{{{{Hugs}}}}

I have a close friend with a child with diabetes. I can remember well a couple of things she said to me.

She put a laminated sheet on a keychain on her daugther's backpack (or inside her backpack) with info.  A lot of kids like Heidi (epilepsy in her case) have a med id bracelet; in Heidi's case, the tag is not worn on her wrist, but rather on her tennies in the first (bottom) set of holes.

The other piece of advice is that whenever she is going to be with a friend, make sure the parents/caregivers understand exactly what her needs are, which is why my friend went ahead and printed up some simple instructions and had them laminated.

Finally, it might be good for you to visit the classroom (perhaps accompanied by the school nurse) and talk to the classroom about the diabetes.  One of the things I did this past fall when Heidi was mainstreamed was to go into the class.  I talked a bit about her disability, but stressed to the class that even though she has Angelman Syndrome, she is more like the other kids than not.  Talk to the teacher and see if this would be an OK thing to do.  In Heidi's case, she is not able to speak for herself, but my friend said that her daughter was somewhat self conscious about talking about it and was relieved that her classmates knew what was up.

Finally, as you get together with other families, seek support from the other parents who have and are walking in your shoes.

←

[foodie52]

I met a child the other day who wears a monitor that actually supplies the insulin directly into her body when she pushes a button. She doesn't have to take shots. It appears that a very small tube is inserted into a port near her waist. The insulin is in an attached pouch: looks like a pager. She called her mom to ask how much she had to "inject". Her mom told her, the little girl pushed a button, and it was over.

I'm sorry I don't know more about this.

[ghostrider]

We have a lifelong friend who was diagnosed with Type I in her early teens. She has lived a full & varied life - married an Italian, lived in Rome for 5 years, etc. We are all now in our mid 50s & she is still doing well.

Last time we talked with her she had just learned about the monitor/dispenser described above & was eager to see if she could get one.

This is just to say that I think your daughter is going to do just fine.

[rlibkind]

I met a child the other day who wears a monitor that actually supplies the insulin directly into her body when she pushes a button. She doesn't have to take shots. It appears that a very small tube is inserted into a port near her waist. The insulin is in an attached pouch: looks like a pager. She called her mom to ask how much she had to "inject". Her mom told her, the little girl pushed a button, and it was over.  .  .  .

←

The device you describe is an insulin pump, which provides a steady "basal" flow of insulin and, as needed, a user-adjusted "bolus" for every meal. It is not a monito, which is a separate, palm-sized device. When if both of these functions successfully are combined into a single, practical, implantable device, you will have invented the artificial pancreas. Indeed, that is the subject of much research today. Researchers and medical device engineers are getting closer every day.

From Suzi's description of her care at Kaiser Permanente, it sounds like they know exactly what they're doing. The pump is something that may be very useful at some point in the future, but right now, they are wisely just trying to determine her basic rates/responses during the course of normal day-to-day life and activity; this way, her diabetic team and the family can develop a workable plan. In diabetes management, one size does not fit all.

Suzi, from what you've written here I have no doubt you, your daughter and husband will not merely cope with the situation, but thrive. Best wishes to all.

(And as an aside, when friends and relatives seem surprised at my testing my blood glucose four times a day, I simply respond: "Hey, it's a disease made to order for someone as detail-crazed as me.)

Edited August 14, 2005 by rlibkind (log)

[JSD]

A good friend of mine, in her mid 40s, has type 1 diabetes and also uses an insulin pump, which is covered by her insurance. She does check her blood sugar level, but she has a good knowledge of food, and knows from experience how much insulin she needs given what she's eaten. She has a very full life, is married, has 2 children, and works full time in the health field. She has more energy and accomplishes twice as much as most people I know.

[jgm]

My dearest friend has been a diabetic since childhood, and she says the answer is to keep it positive. The turnaround for her happened one day when she was whining to her grandmother about having diabetes, and the wise grandmother told her, "Actually, you're very lucky. Had you been born a hundred years ago, we wouldn't have known what to do for you, and you would have died." My friend says that everybody is watching their diet in one way or another these days, and she feels like she is in good company. Your daughter is also fortunate, in that she is learning how to keep herself healthy, early in life. She likely won't walk in the shoes of so many of us, who woke up at 40 or so and realized that time was passing awfully fast, and the scale was inching upward with each and every year... and our fitness levels were plummeting fast. Your daughter needs to understand that health is a choice, and a gift.

A cousin, recently diagnosed with diabetes as an adult, will have just one bite of his wife's dessert, and he says that's enough for him. I have a feeling that wouldn't work for everyone, but for those who could do it and not crave the rest of the dessert, it could be useful.

[pamjsa]

The device you describe is an insulin pump, which provides a steady "basal" flow of insulin and, as needed, a user-adjusted "bolus" for every meal.  But from Suzi's description of her care at Kaiser Permanente, it sounds like they know exactly what they're doing. The pump is something that may be very useful at some point in the future, but right now, they are wisely just trying to determine her basic rates/responses during the course of normal day-to-day life and activity; this way, her diabetic team and the family can develop a workable plan.

←

Suzi, a friend of my eight-year-old son's uses just such a device. My son thinks it's very cool and has said (more than once) that he wishes he could have one too. Should this become an option for your daughter, it certainly seems to be easy for Matt to use.

The school nurse did a presentation in my son's class at the beginning of last year, explaining to the kids what diabetes is and why Matt would be "poking himself all day," as my son describes it--nobody was afraid or worried or treated Matt like an outsider, as far as I can tell. In fact, he's one of the more popular kids in class. (My son is pretty much convinced that this is because of his diabetes and his cool medical devices. )

[KarenS]

My sister has had diabetes since she was six. Both my brother and I learned how to give a shot, "just in case"- and we never have had to! My sister is now 47- and has been giving herself shots for 41 years. I am well aware the need for regular scheduled meals and snacks. I live in Hawaii too- teach her to stay away from the two scoops rice- macaroni salad kind of plates. Tell her also that Halle Berry has diabetes. Once she learns to manage it (with your help) it will not be too difficult.

[SuzySushi]

Whooh!!! What a lot of moral support and great advice!!! Thanks, everyone!!!

Follow up: We went to the beach party/picnic yesterday with no problems. My daughter ate lunch beforehand (because it would have been too long to wait), and had her afternoon snack there. We alerted the two other families, so they brought along diet soft drinks and no sugary desserts. My daughter was too busy having fun swimming and playing with the other kids to pay much attention to food, anyway.

We made her chew 2 glucose tablets before going in the water, and a friend's older-teenage daughter was with her all the time. She began feeling a little shaky from hypoglycemia just as we were pulling into our driveway (I guess all that activity really did burn off the carbs!), so she had another glucose tablet before going upstairs. When we tested her blood sugar 10 minutes later, it was 114, so that had been the right thing to do.

That experience also taught me that I'll need to have some suitable foods she can eat "ready to go." If we're running late coming home, she can't wait half an hour for me to cook dinner -- I don't want to waste her carb/calorie allowances on emergency snacks. That means maybe I'll cook up extras of foods she likes and portion them into bags in the freezer, which I can pull out and reheat quickly in the microwave, or give her for a brown-bag lunch that can defrost in her backpack.

Child-friendly lunch ideas needed: 2 carb exchanges + 2 protein exchanges + 1 fruit exchange! (1 carb exchange is about 15 grams carbs, 1 protein exchange is 1 ounce protein) TIA!

[Chris Amirault]

SuzySushi, my thoughts are with you and your family as you make these adjustments. Two quick thoughts:

Packing up appealing, ready-to-go, long-lasting foods in freezer-type ziplock bags and stowing them everywhere -- cars, houses, backpacks, purses, beach bags, all over the place -- will help to reduce your stress. Just knowing that there are caches of appropriate food available will probably help.

In addition, I'd like to make the suggestion that you write up a page or two of information about your daughter's condition, her diet, and so on, make a set of dated copies, and hand them over to the principal, teachers, and anyone else who works with her at school at a meeting you call when the year starts. I run a preschool and kindergarten, and I can tell you that many people have preconceived notions about conditions like diabetes that aren't going to be helpful; if you take the lead, you'll head off those preconceptions and give people the accurate, particular information they need to serve your child.

[KatieLoeb]

Whooh!!! What a lot of moral support and great advice!!! Thanks, everyone!!!

Follow up: We went to the beach party/picnic yesterday with no problems. My daughter ate lunch beforehand (because it would have been too long to wait), and had her afternoon snack there. We alerted the two other families, so they brought along diet soft drinks and no sugary desserts. My daughter was too busy having fun swimming and playing with the other kids to pay much attention to food, anyway.

We made her chew 2 glucose tablets before going in the water, and a friend's older-teenage daughter was with her all the time. She began feeling a little shaky from hypoglycemia just as we were pulling into our driveway (I guess all that activity really did burn off the carbs!), so she had another glucose tablet before going upstairs. When we tested her blood sugar 10 minutes later, it was 114, so that had been the right thing to do.

That experience also taught me that I'll need to have some suitable foods she can eat "ready to go." If we're running late coming home, she can't wait half an hour for me to cook dinner -- I don't want to waste her carb/calorie allowances on emergency snacks. That means maybe I'll cook up extras of foods she likes and portion them into bags in the freezer, which I can pull out and reheat quickly in the microwave, or give her for a brown-bag lunch that can defrost in her backpack.

Child-friendly lunch ideas needed: 2 carb exchanges + 2 protein exchanges + 1 fruit exchange! (1 carb exchange is about 15 grams carbs, 1 protein exchange is 1 ounce protein) TIA!

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Glad the adjustment is going smoothly thusfar.

Is all natural peanut butter without added sugar a good protein on whole grain bread?? There are certainly plenty of no-sugar added preserves that could make a PB&J if that's something your daughter likes already. I personally never liked grape jelly but I still love peanut butter and raspberry or strawberry preserves.

How about having some pre-cooked chicken breasts or one of those rotisseried chickens in the fridge at all times for some fast grab-n-go protein?

[SuzySushi]

Thanks, Chris! Good suggestions, particularly about writing up the information. We have a poster on hypoglycemia that I'e been giving out, but I should also add something about what times she's expected to eat and what foods and snacks she can have. (So many things to remember to do.... )

SuzySushi, my thoughts are with you and your family as you make these adjustments. Two quick thoughts:

Packing up appealing, ready-to-go, long-lasting foods in freezer-type ziplock bags and stowing them everywhere -- cars, houses, backpacks, purses, beach bags, all over the place -- will help to reduce your stress. Just knowing that there are caches of appropriate food available will probably help.

In addition, I'd like to make the suggestion that you write up a page or two of information about your daughter's condition, her diet, and so on, make a set of dated copies, and hand them over to the principal, teachers, and anyone else who works with her at school at a meeting you call when the year starts. I run a preschool and kindergarten, and I can tell you that many people have preconceived notions about conditions like diabetes that aren't going to be helpful; if you take the lead, you'll head off those preconceptions and give people the accurate, particular information they need to serve your child.

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[SuzySushi]

Is all natural peanut butter without added sugar a good protein on whole grain bread??  There are certainly plenty of no-sugar added preserves that could make a PB&J if that's something your daughter likes already.  I personally never liked grape jelly but I still love peanut butter and raspberry or strawberry preserves.

How about having some pre-cooked chicken breasts or one of those rotisseried chickens in the fridge at all times for some fast grab-n-go protein?

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PB&J is a "natural" for kids. Pre-cooked chicken breasts are a good idea. My daughter also likes string cheese so I should make sure to keep some of that around. And maybe peel & section oranges a few at a time and pack them into individual plastic bags or cups so they're ready-to-go as well.

[robyn]

I don't know anything about diabetes. What I do know is that Type 1 diabetes (formerly known as juvenile diabetes) is a very serious disease.

I have read 2 very interesting medical articles recently. The first is a front page article in today's New York Times (Sunday). Free painless registration is required. It's about how people spend endless hours trying to learn about serious diseases (frequently on the internet) and wind up with a lot of information they don't understand - can't assimilate. Plus - a lot of the "advice" they get is worthless. I seriously recommend reading that article tonight.

The second is an article from the December 6 issue of the New Yorker about the "bell curve" in medical practice. Even if you think your doctors are ok - the point of the article is that most practitioners are average - and only a few are best. Doesn't make much of a difference in most cases - but it can with serious diseases (the disease profiled in the article was cystic fibrosis - another disease of children - where the life expectancy of children in the best places was years - perhaps decades longer - than the life expectancy of children in good - but average places). I would be glad to send you a copy if you PM me with your address since it doesn't seem to be available on line. Robyn

[kitwilliams]

I can't emphasize enough how fabulous the insulin pump is. I've had Type I for twenty-five years now and have had a pump for the last twelve years. Just got the latest edition from MiniMed/Medtronic, called the Paradigm. Each pump has better functions than the last and this one is absolutely terrific. It has a companion glucose meter which "talks" to the pump: when you test your blood sugar, the meter sends a signal to the pump and your blood glucose level shows up on the screen of the pump. You then tell it how many grams of carbs you're about to eat and the pump calculates how much insulin you need to cover it. That's the simple version of what it does...

I will write more later, but it would be so great to see both Suzi's daughter and husband starting on and learning the pump together. You have no idea how it frees up your life. It works on regular insulin alone, no long-acting, which eliminates the peaking of insulin at certain times and the need to eat at those times. With regular insulin, you can even skip meals (not good for kids to know about but convenient for adults most certainly!).

Must log off now, but if anyone wants to speak to me further about this, I'm always happy to share pump information. It makes life with this disease much more normal.

[FabulousFoodBabe]

Oh, man. That stinks. I'm so sorry this happened to her. Those insulin pumps are amazing; a friend of ours' daughter has had Juvenile Diabetes since she was three (she's in high school now), and once she got her pump, her life changed. Lots of athletes compete with a pump attached -- a woman on the LPGA tour has had one for years.

I had gestational diabetes through two pregnancies, was on a strict diet, and tested five times a day, minimum. I had the bonus of this being for the babies so I didn't feel deprived. The habits I learned have stayed with me (and the babies are now teens). I've noticed that most of the newly-touted diet plans advocate five or six smallish meals a day, discuss "glycemic index" and recommend more lean protein than the diets of years past. This is what diabetics do all the time, and it's probably a healthier way for all of us to eat and live.

I know, too, that child on the brink of adolescence who needs sustained medical treatment, can be difficult and a little scary. They are changing so fast at this age physically and emotionally, and it's almost a full-time job to keep up with what they are doing, the doctors, and all that. And, of course, trying to be sure the kiddo lives a normal life. My heart goes out to all of you.

-Fabs

Edited August 15, 2005 by FabulousFoodBabe (log)

[Hiroyuki]

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

[Hiroyuki]

You can get more information about the water from here:

http://www.enagic.co.jp/english/indexm.cgi

I am in no way affiliated with this company, but my brother is. He says he wants to be a distributor for the company.