A Good Day

So yesterday we had a good day.  Had our quarterly appointment yesterday in San Antonio and my lil man did awesome.  I expected the same question as usual, "How do you think his A1c is doing?"  And as usual I hope for the best.  She told us his A1c went from 7.9 to 7.4!  I mean, that is great right?  Fixing to be three years since his diagnosis and we're still learning.  Sometimes I feel as though we don't do enough.  But you just have to start every day anew.  This coming Thursday he will turn 4.  Unbelieveable how time flies.  Oh and I did ask about his carb restrictions, we were told that they didn't want him to gain weight.  O.o  His weight is perfect, right on target really.  He can't help if he's short, he has two short parents.  :)  Anyway, we had a few places to run errands for my mom where he got his Easter gift early from BuildABear, from his nana of course.  I just wanted to share.  I feel like it's a small victory in a way.  I always hate going to these appointments, always worried if I'm doing good with my child.  Nervewracking really.  But I feel good for him.  A small, tiny bit of good.  Thanks for letting me gush.  :)

What your doctor is saying about restricting carbs is EXTREMELY unusual.  Can you get a second opionion?  Can you meet with a dietician?  

A normal 4-year-old is going to gain weight.  Most kids kind of chub up before having a growth spurt.  A diabetic should be able to eat the same number of carbs as any other healthy person.  The only time that would not be appropriate is if the child was obese.  

Hi Jennifer,

That is great news!!!  You are doing a great job.  I can't believe your little guy has been diabetic since he is 1 years old (same as my dad).  That must have been quite a challenge.

Be proud as your son is doing great and has a very good A1C for a child.  

I also must say that I have not heard of an endocrinologist restricting a child's carbohydrate intake.  Actually, when I first became diabetic and wanted to lose weight so I cut down on carbs and calories, I ended up in the emergency with ketones.  The emergency room physician asked me if anything had changed recently to explain the ketones since my sugars were okay and I told him I was on a diet.  He  told me regardless, a diabetic needs a minimum amount of carbs per day or you can develop ketones.  I was also told this when I developed a stomach disorder and was unable to eat much and although my sugars were perfect I had ketones from lack of carbs/nutrients.

I agree with Jenna that maybe a second opinion is worth your while if that is possible.

My son is 11 and has been a diabetic for almost 3 years.  He  is in the 90th percentile for height and weight and since he has followed on this continuum the doctors are happy.  He has no restrictions on carbohydrates per say although we do follow a scale for his insulin and he does have a set amount per meal but we can adjust this and give him an extra unit or two if needed.

We are looking to get him on an insulin pump like myself where technically he can eat as much carbs as he likes at that point.  

Of course, you do not want a child with diabetes (or anyone for that matter) to have a weight issue and insulin is a growth hormone so it can make you can weight, your son is quite young to be restricted of carbs.

Good luck with everything and keep up the GREAT job!!!


Total agree with Jodi. People get ketones when dieting. Diabetic or not. It's just not healthy for a diabetic.  I would check him often since he's not eating much.

I'm brand new to this group, but I agree with what everyone else said about carb restrictions. I have a just-turned-3-year-old, and I can't imagine limiting her to 40 carbs per meal. Some days she eats less than that per meal, but most days she needs more. She's tall and lean and growing like a weed and I would guess she eats between 45 and 60 carbs for her average lunch and dinner. When we were on shots, our CDE trained us to use an insulin ratio, so if she was getting 1 unit for every 30 carbs, then we would give her 1.5 units if we thought she was going to eat 45 carbs (obviously this is just an example, I have no idea what your kid's ratio would be). I would definitely push back on your endo or get a second opinion. You know better than the doctor how much your poor little fellow needs to eat, especially if he's consistently telling you he's hungry!

And way to go on the A1C!!! That's absolutely phenomenal for a 4 year old.

Great news!  We used to be concerned or stressed about about appointments but I got to a place where I decided to see these as a trip to visit the person who "has our back".  Our endo understands the challenges and is very positive and helps us stay on track.  It was a mind shift for me but we try to get one nugget of new info at each appointment!  Maybe you can look for the good news!

When you say 40 carbs per meal is that a drink included?

We would like a second opinion or at least I would but the one we go to is THE person to go to for children in our area.(We live in a small town so we have to go to San Antonio - that's where he was life flighted to when he was diagnosed.)

This is how they want us to dose him...

1 unit for 15 carbs

2 units for 30 carbs

1/2 unit extra if tested over 240

1 extra unit if tested over 300

No more than 40 carbs per meal including the drink, and 15 carbs for a snack.

His numbers are still random even though we do our best to "fix" them.  Hardly ever in the so called "normal" range.  If he stays below 200 I'm happy.  We watch the carb amounts, how much sugar is in products, what ingredients are in them...at times I don't know if I am doing enough or too much.  We have yet to figure out this "cross carb" thing...

My son isn't overweight at all.  He's a growing boy but my poor kiddo is gonna be short, we know that.  I tried looking at the graphs for the percentiles but I can't figure those things out.  His dad is 5'7" and I'm 5'1".  I just wish this was simple and not so stinkin complicated.  I feel like I am so far behind in being informed.  I try to research what I can ... just doesn't feel like enough.

Thanks everyone - time for little ones bottle!  Wee!  P.S.  Diabetes sucks!  <3

Omg does the doctor not want him to drink milk? I'm sorry, but I find this very disturbing. With the carb ratio I would think he would have many lows. My son is 30 g per 1 unit and 40g per 1 unit at dinner and bedtime snack. I feel for him. I can totally understand why he wants to eat between meal. Poor kid :(

Is your endo in a group practice? If not, have you investigated the group practices at the SA medical school's teaching hospital? You could either ask to start going to another doctor within the practice, or just switch practices if your insurance will let you.

Another great resource is the clinic's diabetes educator. If you have any concerns between appointments, they are a great resource to talk to about needing to change treatment plans between the every-3-month office visit.

Also, is your kiddo on Lantus or other long-acting insulin? I know sometimes the very littlest T1s don't go straight on long-acting at diagnosis, but at 3 years post-dx it might give you some flexibility to increase the daily carb load.

Good luck! We've definitely been in situations where we had to push back HARD against our medical team, but it's important to follow those mommy instincts and at least raise the question when something doesn't seem right.

That is good.  When we went to our appointment in October my sons was 7.9 after being in the 9's but I knew that that 7.9 was only a result of him having a whole month of lows the first month back to school.  Then when we went back in January it was back up which I had expected it to be.  He was dx 3 years ago and just went on the pump in Dec. so I am hoping we figure out his bolus and basal right so his A1C will go down.  Glad to hear your son is doing good.  And I've learned in the 3 years that all we can do is take one day at a time.  Because just when I think things are good he is high and then when we least expect he is low so you just never know.