Well spoken, Mpatton... I think you are doing fine and asking questions IS the right thing to do if you are unsure about something
[quote user="Kim"]
[quote user="mpatton"]
We are still on syringes for insulin so I am still not 100% comfortable with how you dose for a larger meal and dessert later on. Do you dose for dessert when you do it for dinner even if they are having dessert about an hour later?
[/quote]
Hi mpatton,
I'm not sure anyone addressed this specific question you had. The timing of insulin would typically be within a few minutes of eating the food you've dosed for - otherwise she may drop too low before the food can take effect. So, this would mean two seperate injections in this scenario.
I hope you'll stick with us. There's a lot to learn, and this can be a great place to get the kinds of information you won't find many other places. We're full of supportive, compassionate people here at Juvenation - promise! :)
Happy Thanksgiving, and I hope you'll let us know how the insulin strategy works out!
Kim
[/quote]
i DID answer that question..but it got over shadowed by Jill's post. my reply is literally stuck between her post and mpatton's post telling her to bugger off =(
[quote user="Batts"]
[quote user="Kim"]
[quote user="mpatton"]
We are still on syringes for insulin so I am still not 100% comfortable with how you dose for a larger meal and dessert later on. Do you dose for dessert when you do it for dinner even if they are having dessert about an hour later?
[/quote]
Hi mpatton,
I'm not sure anyone addressed this specific question you had. The timing of insulin would typically be within a few minutes of eating the food you've dosed for - otherwise she may drop too low before the food can take effect. So, this would mean two seperate injections in this scenario.
I hope you'll stick with us. There's a lot to learn, and this can be a great place to get the kinds of information you won't find many other places. We're full of supportive, compassionate people here at Juvenation - promise! :)
Happy Thanksgiving, and I hope you'll let us know how the insulin strategy works out!
Kim
[/quote]
i DID answer that question..but it got over shadowed by Jill's post. my reply is literally stuck between her post and mpatton's post telling her to bugger off =(
[/quote]Oh, sure enough! Now she has two repsonses to consider. :) Sorry I missed that, Batts.
haha not your fault, i think everyone did :)
Ah, I remember my first Thanksgiving with D - it was only 3 years ago and I remember feeling really daunted by it since you don't have all the experience that you'll later have after living with it for awhile. I agree that it's probably better to dose for dinner and dessert separately, for a couple reasons. First, you don't really know how long the timing between the two will be and you don't want to be bound to eat dessert right away if you end up wanting to wait. Second, your daughter may decide she wants to eat more or less dessert than previously planned, depending on how full she is from the meal - and so the amount of insulin you give will be dependent on that. It does suck to have to take an extra shot, but I think if you explain it to her beforehand and she knows to expect it, hopefully she'll be ok with it.
My strategy for that first Thanksgiving was to try to control the carbs I ate without going too crazy. So I chose maybe only 2 of the carby foods that I wanted with dinner (mashed potatoes and stuffing) and took smaller portions than I otherwise would have so that it totalled somewhere around 50 or 60 grams of carb. I loaded up on other stuff that didn't have carbs like turkey, salad, and veggies and didn't even bother with cranberry sauce (it takes just a tablespoon to pack a big, carby punch and I just decided it wasn't worth it.) As for dessert, again I try to choose just one or two desserts that I really want and leave the rest and take a portion that equals about 30-40g of carb. Also, I ate dessert a couple hours later, so that it was almost like another meal. Whether you decide to go full carb or lower carb on your recipes, this is the plan I tried to stick with. Pumpkin pie is usually pretty lower-carb than most other desserts in general. You can cut a satisfying slice of a regular pie for usually somewhere around 30g - which really just makes it kind of a heavier snack! ;)
Once you get more practice with control and how your body responds to lots of carbs and lots of insulin, you'll be able to play with it more and have days that you really just let her indulge and dose for it. But I TOTALLY understand why you'd want to try to limit it just a little when you've only been doing this for 3 months. I'll be keeping a tighter reign on what I eat this Thanksgiving also, since I'm 7 months pregnant and really striving for super-tight glucose control. I'm planning on following the plan that I stuck to that first Thanksgiving. Good luck and Happy Thanksgiving!
Oh wow, clearly I owe you an apology. Trust that what is written oftem does not always come across as it's intended to be heard. I was not trying to offend in the least, and certainly not judge your ability to raise a diabetic child :-(
It's only been three months for you to absorb this new reality. You are still in the midst of a very emotional time. Truth be told I'm almost 2 years in and I still cry at the drop of a pin and constantly ask "why her". By no means to I claim to be an expert (far from it)
My only point was that it really doesn't matter how many carbs your daughter eats, as long as you have an established carb to insulin ratio. Obviously, which I didn't know, you're still in the inbetween phase (honeymooning maybe? I don't know) where you are still working on finding this out. Your best method is to stick to your specific carb goals. One thing I have a very hard time dealing with, and get very defensive over,(as my post came across) is people asking my daughter if she can "have" certain things or whether or not she should have "seconds". And things like only offering her sugar free chocolate. I hope you understand what I'm saying.
For anyone else who misinterpreted my post (be it me or the reader) I sincerely apologize. This forum has been nothing but a wealth of knowedge and a sea of support.
Happy Thanksgiving
aw, see? everyone kissed and made up! now let's all hold hands and say something nice about juvenation :D
i love the happy, warm, fuzzy feeling i get from the DOC.
kind of like this ridiculously fuzzy baby bunny
[quote user="mpatton"]
The flourless chocolate cake recipe I found on the d life website is not low carb but its much lower than other desserts - it has 15 carbs per serving. I was trying to make the low carb pumpkin pie just to have it and see how it is. I wasn't going to advertise to anyone that it was low carb and see if anyone noticed a difference.
We are still on syringes for insulin so I am still not 100% comfortable with how you dose for a larger meal and dessert later on. Do you dose for dessert when you do it for dinner even if they are having dessert about an hour later?
[/quote]
Pen or Syringes if Ri is going to eat it all at once I give her one injection if not I wait. Or I will even split it up into two injections if I dont think she will really be able to eat it all at once. I often give her dessert to her with her meal and just give her less food. I know how much she can and will eat tho so I am rarely off on that. If for some reason she cant finish I give her juice or something to make up the carb difference.
[quote user="mpatton"]
In the spirit of kindness, I am attempting to not take offense to the tone of your post.
Every doctor prescribes different methods for maintenance of this lovely disease. As my daughter was diagnosed only 3 months ago, I am sure our practitioners have advised different approaches to the holidays. My daughter has averaged 45 - 60 carbs a meal for the last three months and I am still LEARNING on how to handle higher numbers. We have not had a reason to vary our routine very often so this is all new to us. I posted my forum as this is our first thanksgiving and was looking for some advice on carb counts and recipes, and SUPPORT, which I have received from the other members of this forum. I was not looking for reproach to the "mother of a diabetic child" and do not appreciate your judgment. This is why I hesitated to join this forum to begin with and will rethink posting in the future. Have a lovely holiday and be thankful not judgmental.
[/quote]
Is she on NPH and a fast acting? They had Ri on that at first and honestly it sucked. I hated a fixed carb diet where she could this many carbs and got this much insulin for it and it had to be at this time of day ect..
This is my first Thanksgiving with diabetes to, I'm going to look at my plate tonight and not know where to start counting. But I'm sure we'll do just fine.
Good luck with everything!
Today is also Sarah's first Thanksgiving since diagnosis and she can't wait for dinner tonight! I'll have to do some guessing - as I have no idea how many carbs are in the stuffing my mother in law makes, for example. But we'll probably figure it out close enough. We usually eat Thanksgiving dinner pretty early, so at least we have a lot of evening left to deal with any weirdness after.
One thing I've learned is that doctors around the country/world and different healthcare organizations seem to have very different strategies and give different messages to parents. That's one reason I love juvenation, because I've learned different ways of doing things that I'd never heard of before! Ours basically told us from the get go that Sarah should be allowed to eat exactly as she ate before, with those few exceptions like soda (which she never did anyway) and not too much fruit (which we discovered on our own after she had a super mega spike resulting from 1/2 banana!). The doctors said that their studies have shown that kids who don't "miss out" end up doing better in controlling their diabetes in the long-run because the kids don't have as much of a reason to resent diabetes as those who aren't able to enjoy what others do.
That said, three months in you're still in major learning mode. I bet if I go back and look at my own posts from May/June, I'll sound completely overwhelmed! But try not to worry too much. You'll be with your daughter all evening, so any spikes or lows you will be able to deal with. :-)
Question for everyone... is there any reason why a person on MDI couldn't do a "combo bolus" for a meal such as Thanksgiving? I am SO thankful Sarah is on the pump today, but it seems like - for example - if I was estimating she needed 8 units, I could give her 3-4 before the meal, and 3-4 an hour later. Wouldn't that have the same effect as the pump's combo bolus and possibly reduce the possibility of a major spike after such a fatty meal?
[quote user="Michelle"]
... is there any reason why a person on MDI couldn't do a "combo bolus" for a meal such as Thanksgiving? I am SO thankful Sarah is on the pump today, but it seems like - for example - if I was estimating she needed 8 units, I could give her 3-4 before the meal, and 3-4 an hour later. Wouldn't that have the same effect as the pump's combo bolus and possibly reduce the possibility of a major spike after such a fatty meal?
[/quote]Hi Michelle, the combo/square wave bolus is not actually two separate doses delivered at different times, as your question seems to point to. It is, rather, an "up-front" dose, as in the 3-4 units in your example, then, depending on what you've set as a time frame, the remainder of the bolus is delivered in small increments over that time. Again, back to your example, the remaing 4-5 units would be spread over an hour's time. If you were to be using MDI for this option, you would actually give an injection of less than half a unit every three minutes! The combo bolus is great for either high-fat foods or, as in the case of most Thanksgiving dinners, a meal that will take a long time to get through. I hope this explanation helps a bit! Happy Thanksgiving to you as well as to all you other Americans on Juvenation! I, as a Canadian, celebrated Thanksgiving last month!
I hope those of you having your first d-giving had a successful one. This was my 21st, and I was still pretty up and down :o) I did a lot of guessing. My swings weren't too crazy (nothing over 200 mg/dL), but it gives me room to do better next year!
:o)