Help for my granddaughter

My grandbaby was diagnosed in December with type 1 Diabetes. The diabetes advocate here said not to change her eating habits. I think maybe she thought the child had good eating habits to begin with. This little one is 2 years old and is fed candy and sweets all the time. I have done my due diligence in learning about how to feed her. I am concerned about what my son calls “free foods.” The give my granddaughter yogurt throughout the day, yogurt for kids… the kind with a ton of sugar. What I have read says that plain yogurt is a free food, not the flavored kind. Am I missing something here? K’s glucose level is all over, this morning it was 540 after having a frosted cereal for breakfast. Help!

Wow… so sorry. I am a stepson that has had simular issues. I have went to Diabetes seminars, gotten pamphlets and tons of info from other parents and consultants on diabetes. I have been told yea let have to no… from what I have taken out of all advise is they need to learn proper good eating habits and curb on the sweets ( cut back) you can’t cut out but to have a longer healthy life they need to learn and then also not cheat and do proper carb counting with insulin. We are over the 9 month time with a 13 yr old and our problem is mom has put her in a bubble … no excersise no proper eatting, whatever whenever and insulin all the time… I do feel for you but do reach out to the upcoming summits/mentor families/the doctors and even social workers thru hospitals. Joining these sites will give many options… Best of luck!!!

The girl ought to be put on an insulin pump, but even if she isn’t her parents must count carbs to know how much insulin to give her. There are some basic techniques the parents can get off the web. A pediatrics endocrinologist would be the best doctor for her, and he could arrange to get her on a proper diet. The girl should not be allowed to have sweets except on rare occasions. Then as she assumes more responsibility for her care, she will have the discipline to eat right.

That diabetes advocate was probably acting irresponsibly to say that, but you might want to find out if she/he actually said it and what the context was. Hopefully you can get through to your son. A small child does not know what is going on within her and is unable to understand, much less explain, the feelings of high and low glucose levels in her little body. As she gets older she will be able to assume more control of her own diabetes maintenance.

My son was diagnosed at 9 years old so I can’t relate to having to deal with this with a child as young as 2. So sorry! I don’t know your son but there is a lot of guilt associated with this diagnosis. He may not have been honest with the advocate giving her the impression that the baby ate good food so how else would she know to change anything. With that said if a food has carbs it isn’t “free”. There is the honeymoon phase which can allow for some carb intake without a shot but it’s usually not a lot. Essentially she can’t keep eating yogurt all day with no insulin especially if it’s within a short period of time. Frosted cereals a re high in carbs. I would imagine her carb ratio would require a shot for that. Sugar free jello has zero carbs. That would definitely be a good alternative if they want to give her a treat. It’s tough. My son is 15 now. We do let him splurge but he has to balance it out. He’s very active and burns a lot of calories so he can afford to splurge. Not everyday. Good luck trying to figure things out.

I forgot to mention, I was barely five when I got diabetes. My parents took me completely off sweets except my birthday, and it was a small amount. There was a whole lot less knowledge about T1 Diabetes in 1957, but now we know that carb counting is crucial to good control of sugar levels in the blood. And a pump makes that job a lot easier. Besides maintaining a “basal” (base) rate, it can give boluses (a pulse of insulin a lot like the pancreas’ Islet cells do when they are told there is glucose in the blood that needs to be taken into the cells, and it puts out insulin in response. Also, excess glucose carried into cells, or unable to be processed for use in exercise or growing new cells, shows up as weight gain. An overweight diabetic child is not a well-managed diabetic child. If your little grandchild does not learn good habits while it she is young, she will carry the bad habits into adulthood. And females are known to have a lot harder time avoiding the bad complications, like blindness, kidney failure, neuropathy, and premature death, that are caused by diabetes. That is what the child is facing, and with parents like she appears to have, there may well not be grandchildren to enjoy in their later on nor a daughter. That is how serious this disease is.

I fear for your granddaughter’s health and safety. First of all, when her blood sugar is high, she probably feels really bad. Her body has no fuel, because she doesn’t have enough insulin to allow her to use her food for fuel. So she is tired and has no energy. If her parents don’t help her change her diet, she will have horrible experiences, like going to the ER with ketoacidosis: high blood sugar, throwing up, very sick, and they will put insulin in her veins along with fluids because she will be horribly dehydrated. Perhaps her parents are overwhelmed with the diagnosis, which is common. They need help figuring out how to keep their daughter healthy for life. Nobody is perfect, and sometimes we overindulge, or get burned out, but we can’t take too many breaks from our routine, or our health will suffer. It is not fun. I am 58 years old, and I have had type 1 diabetes for 46 years. I am still relatively healthy, and I have given up sugars for the most part. It took a while, but the cravings stopped about a week after I gave up sugar, and now I eat just a little bit of sweets, like a cupcake for my birthday. Bottom line: if her parents want to see her grow up healthy, they should start learning how to take care of her. Perhaps they can take the opportunity to improve the entire family’s eating and exercise habits.

Hi,

First of all, I’m sorry you’re having to deal with this. Handling a new diagnosis is stressful and frustrating for everyone involved. To echo others, I would encourage you to talk frankly with your son about what the diabetes advocate actually said. It sounds like it would be beneficial to have another visit to specifically ask what the best option is for your granddaughter’s healthcare.

I do want to point out, though, that her diet does not need to drastically change because of her diagnosis. What DOES need to happen is carb counting and insulin delivery, whether via injections or a pump. That is something you can also discuss with her healthcare provider. She can eat yogurt and cereal in moderation (just like any other child) as long as she is being given the appropriate dose of insulin for the amount of carbs in her food. If the diabetes educator and/or her primary doctor are unable to assist you and your son in determining her insulin to carb ratio, or provide resources for learning how to carb count and dose, I would strongly suggest that you find a new healthcare team. The diagnosis is difficult to get used to, but this is a manageable disease. She can lead a happy and healthy life like other kids as long as she sticks to the right diabetes management plan.

I’m not a parent, but I have had Type 1 for 32 years and was diagnosed as a teenager. First off, this is an incredibly complicated disease, and it will take time and a lot of patience to learn the ropes. Even now I still learn new things all the time!

She is too early in her diagnosis for an insulin pump, so put that on the back burner for now. Type 1’s experience what is called a “honeymoon period” (not sure where that name came from cuz it’s no honeymoon), where their insulin requirements may be lower and more erratic for the first few months to a year or so. Then once the remaining beta cells die off, her insulin requirements will go up but they will stabilize for the most part, and at that point a pump can be considered and they are great!

There are very few “free” foods. Examples include meat, cheese, eggs, diet sodas, and sugar-free gelatin. Even plain yogurt still has carbohydrate in the form of lactose (milk sugar), so it needs to be counted. It doesn’t really matter if it’s sugar, starch, pasta, fruit, whatever. Carbs are pretty much carbs. This is a tough concept to grasp, because everyone has it in their minds that diabetics can’t have sugar, but the reality is that it’s all carbs in the end, and it all needs to be managed, counted, and tracked.

The first thing to do is to get a referral from the endocrinologist to a registered dietician. They will teach you and the child’s parents about how to count carbohydrates and how to administer insulin accordingly using insulin-to-carb ratios. For example, if they determine that a good starting ratio is 1:15, and she eats 22g of carb, she should be given 1.5 units of insulin. Then you can log her blood glucose numbers and tweak the ratios as needed from there. The ratios may differ by time of day, since many of us are insulin-resistant in the morning due to hormone production. The dietician can help you with all that, as well as meeting with a Certified Diabetes Educator, who are specialized RN’s that work with Type 1’s on all kinds of things.

Please check in here with whatever questions you may have along the way. I’m glad she has you around to get involved, although obviously it will be important for the parents to be on board since they will mostly be responsible for her care.

I am so sorry that your grand baby has to suffer through this. I wish no child has to endure through this dreaded condition. It is natural that your son is still learning the ropes of managing your angel’s condition. It is especially difficult to manage 2 Year old.
Having blood sugar at 540 is too high and dangerous. Any food with high carbohydrate content is going to raise the blood sugar very high. While I would look at everything in its context, it is imperative to maintain a blood sugar range recommended by your endocrinologist. Please be religious to make the quarterly visit to your doctor and review the A1C with him/her.

I’m so sorry for you and your granddaughter. The diabetes advocate was both right and wrong. I was diagnosed over 20 years ago, when I was 6. Back then my diet did need to change dramatically because the insulins available only worked if you followed a rigid schedule. With the newer insulins, type one diabetics have a lot more freedom and choice when it comes to what, when, and how much we eat. The catch is that we need to carb count and still take insulin on a regular basis. And sticking to a strict schedule and diet, especially right after diagnosis, will make treatment much easier. I still (roughly) follow the diet that was set for me when I was 6 because I know it works for me. I think you’ve gotten a lot of good advice so far, but I disagree with Davyboy regarding the pump and agree wholeheartedly with Moneypenny and Angivan. Your granddaughter doesn’t need an insulin pump. She needs insulin. Period. I’ve been on multiple daily injections (MDI) my whole life and manage my diabetes just fine. As your granddaughter gets older she’ll figure out what works for her. A pediatric endocrinologist, nutritionist, and/or certified diabetes educator can help. It might be a pump, but it might be MDI. All that matters is that she monitor her blood sugar routinely, carb count, and take the appropriate amounts of insulin. How she accomplishes that is entirely up to her (or her caretakers - parents, you, doctors - while she’s so young).

I just have a couple things to add that I think might help. If you and your son need help with carb counting (because Angivan is right - even most “free” foods have a small amount of carbs), I recommend using CalorieKing (http://www.calorieking.com). They publish a book that lists carbs, calories, and fat content for almost any food you can think of. I used it all the time when I was learning to carb count. I’d also suggest that you ask your son if you can tag along to the next doctor’s appointment. My grandparents came to several of my early appointments with my endocrinologist so that they would know how to care for me when I came to visit.

As a grandmother I am sure you feel at a complete loss. If you push too hard you may cause problems in the family. Be gentle. Maybe print out all these posts and help educate your son and daughter-in-law. I applaud you for wanting to help. The education for this disease is ongoing.
My baby girl was diagnosed back in August 2015, 2 weeks after her 7th birthday. Her father and I are divorced with equal parenting time. We were absolutely devastated. I don’t know what we would do without our Diabetes Educator/Registered Dietitian, Katie.
We log 4 times a day the following: glucose levels, carbs eaten, and number of insulin units given at each meal and bedtime. We report all this information to her every week. Changes are made accordingly. Carb ratio, correction factor, units of her slow acting insulin. Some CR and CF are different for each meal. Katie has been instrumental in “educating” us. Those sweets are okay to eat if insulin is given, in moderation. And it would be even better to have them with a meal that consists of protein, fiber, fat, and other complex carbs.

It was so overwhelming in the beginning. It is just our new normal today. It’s not going away, it just has to be managed the best way we know how. However, I promise you, it does get easier. We were just approved for Lillie’s pump. We are so excited to learn a new way of managing T1D.
The most important thing we have taught Lillie and you can teach your grandbaby as she gets older, is to make good eating choices. I teach my non diabetic children the same thing. Of course in the beginning we controlled it all. Rarely did she have sweets. Over time we have lightened up. We all love sweets at times and I don’t want her to grow up feeling different than her friends or to resent this disease. We can’t protect and control our babies forever, but we can do everything in our power to teach them a much healthier lifestyle. I do give her the choice, 1/2 c. ice cream for dessert (16 carbs) or 4 Oreo cookies? (28 carbs) She will stop and think whether her glucose levels have been running high that day. Nine times out of ten, she makes the better choice. And there are many times, she will say, “I had candy because of my low today, so no more junk for me!” I’ve also tried teaching her that the choices aren’t about today’s health, but over her lifetime.
I wish your darling grandbaby good health and happiness. I’m happy she has YOU!

Thank you all for sharing with me. I try to keep my little one’s meals balanced, she and her parents live with me. Unfortunately I only have control over dinner periodically. I have tried to talk to my son but he says his hands are tied as my daughter in law is the primary caregiver. I will continue to encourage my son to find a registered dietitian and to get more education for the wee one’s sake.