Looking for help with carb intake

[joshuasgranny]

I am new here, and my grandson (I am his primary care-giver and I also home school him) was diagnosed in January as a Type 1 Diabetic. Joshua is 7 years old.

Joshua takes Novalog three times a day, and Lantus at night. The doctor is still making adjustments to his dosages, but right now he takes one unit of Novalog for every 12 grams of carbohydrates, and 2 units of Lantus at night.

His doctor wants him to eat 72-84 grams of carbohydrates per meal. This is really proving very difficult for us. Because of my husband's heart problems, we have always eaten a heart-healthy diet. We eat very little meat, and only fresh fruits and vegetables. We do not eat pasta, potatoes, or bread. We have never eaten pasta, potatoes, or bread, even before the heart problems. We simply don't like them. I have tried to get Joshua to eat them, but he won't. He doesn't like them in any way, form, or fashion with the exception of Kraft Velveeta Shells and Cheese macaroni. We have also never eaten desserts, candy, or anything sweet. We do not like sweet things, so we have never made or offered such things to our children.

Our foods contained no carbohydrates, with the exception of the fresh fruit that we eat several times daily. His doctor was amazed. I always planned my meals a month at a time, and therefore I was able to show him past and current family menus. No carbohydrates to speak of.

That is the problem. I am having the worst time coming up with so many grams of carbohydrates. I am looking for any help or suggestions. We don't have a local dietician (we are rural) so we don't get to see one very often, but the last time we did, she wasn't of much help. She suggested a lot of things, which I tried, but Joshua refused to eat them. And, as I have found out, fixing him something he is not likely to eat creates a bigger headache because then I have to scramble around to come up with something to take the place of what he is not eating. I sure appreciate any help or advice, and I am interested in knowing if anyone else has this problem, or am I the only one?? LOL. It seems as if we are not the "typical" eaters.

[BrendaK]

That's a hefty amount of carbs for a 7 year old. If your grandson is on a sliding scale like you said, it is not necessary for him to eat this many carbs. Do you know why the doctor recommended this? Is he severely underweight or something?

My son eats between 20-70 grams of carbs a meal, it really varies, and we adjust his insulin accordingly.

Does his meal plan allow for snacks? I'm thinking maybe the doctor sees on the growth charts that he needs about 240 grams of carbs/day and he just divided it into 3 meals. My son probably eats roughly around that, but he has 3 meals AND 3 snacks a day. There's no way he could cram that much food down at each meal, especially breakfast.

Ask these question to your grandsons doctor. And good for you for searching for answers!

[joshuasgranny]

Believe it or not, he also is supposed to eat snacks three times a day, which he does. He gets a mid-morning snack, an afternoon snack, and a before-bedtime snack. The snacks aren't too bad to come up with, as he always wants fruit, but the meals are something else. Although he has always had a good appetite, what he really prefers is vegetables. He has a difficult time eating those high-carb meals! (Or, at least, they are high-carb to us!) I knew nothing about diabetes, but I just followed what the doctor and the dietician recommended. Joshua is not underweight, he is very tall for his age (his dad is 6'7") and he weighs about 80 but because he is so tall, he doesn't look it. When he was in the hospital, he had lost about 30 pounds because his blood sugar I guess had been high for such a long time (we didn't know it, of course) and he had something called Diabetic Kenotesis or something like that. Once he got treated though, it didn't take him long to gain his weight back.

I will ask the doctor about the meals and see if maybe we can cut back (hopefully way back) on those carbs. She wants him to have 6 units of insulin at every meal, which works out (depending on the meal as he has different dosages per meal) to 72-90 grams of carbohydrates! Of course, we can adjust his insulin, but she wanted him to stay between 5 and 7 units per meal. I don't understand it.

Thanks for your reply. I appreciate it.

Susan

[Ali]

If he takes insulin before each time he eats the Dr. should explain how to adjust his insulin amount based on his carbs he is planning on eating. He could eat only 10 carbs or 50 carbs and you can adjust his insulin to match the meal. Tell your Dr. the problem and insist he/she finds a routine and explains it to you, or gives you a chart or a book, that explains it and that works for you. Call and insist on seeing the Dr. or his nurse right away-no need to wait. Ali By the way fruit juice is an easy way to add lots of carbs, or two slices of whole wheat good quality bread will be 35 to 40 grams of carbs, milk is 14 grams per cup (make it chocolate milk and it hits 20 to 30 grams of carbs), raisins are high in carbs (label lists the carbs, but a few handfulls and you are up to 20 or 40 grams, one large peanut buter cookie is 35 to 40.

[Ali]

More healthy high carb ideas. Fruit cobblers with real sugar, muffins are high high high in carbs, corn bread high and easy to snack on and healthy, bananas, rice, noodles, tapioca pudding, bread pudding, bagels, graham crackers, potatoes all kinds, cereals all kind, pumpkin bread, banana bread, pound cake, angel food cake. these are all pretty healthy but dense in carbs. Canned beans or cooked beans. good luck. Ali

[joshuasgranny]

Thank you, Ali! I appreciate all of your help and ideas.

Susan

[Gwyn]

Hi Susan,

Changing your diet is always hard! Eating that many carbs at every meal would be difficult for anybody who is used to a diet of mostly fruits and vegetables!

Talking to your dr about moving back toward your usual way of eating would probably be a good idea, but remember that growing boys do need their energy foods.

Some foods that your grandson might like that are relatively higher in carbs could be pears, grapes, most dried fruit (my daughter likes dried apricots), oatmeal, quinoa, rice, lentils, and black or kidney beans. Hummus (a dip made from chick peas) is also a good sandwhich spread or vegetable dip that he might enjoy.

Best of luck!

[deborahg]

Initially when diagnosed a lot of children need to regain the weight they have lost and sometimes doctors feel this is best achieved by making sure they eat lots of food. Most kids have a few weeks with a big appetite when they start on insulin and then things settle back to normal. The weight goes back on. As a children's dietician - I generally work with parents to slot diabetes in to their lifestyle rather than their life revolving around insulin. Look at your family meals and snacks. What does the child like and work out how much carbs are in it. Meals rich in fruit and vegetables tend to have some carbohydrate and by choosing the carb denser varieties and sources alside of adding pulses and grains means it is possible to increase carb intake - but unless a child is extremely active it is not necessary to consume large amounts at all meals. As a rule the recommendation is 50% of the recommended kcal intake should come from carbs. i.e. if the kcal requirement is 1500kcal/day then 750kcals should be from carbs. To work out grams of carbs devide by 4 ie. 188g/day. In reality this doesn't fit everyone. With a sliding insulin scale - you can adjust the dose based on what they are eating (especially those on the fast acting insulins). If you are finding you are using juices etc to make up the carbs for a meal you are getting in to a situation where you are feeding the insulin. My advice is to normally reduce the insulin dose. The trick with diabetes is to work out 1. how much carb you need to have to live, do what you want to do and for kids grow 2. exercise (lowers the blood sugar) and finally 3. the amount of insulin needed to maintain a good level of control. Insulin only comes in to the equation after the other two have been sorted. As for the rest of the diet choose heart healthy fats and lean sources of protein or alternatives.

Get back on to your dietician and doctor - explain your problems and ask for help. It's what we are trained to do. It a big learning curve with a new diagnosis. I use thes forms to make myself a better caregiver. We don't always get the advice right for you the first time. If you cann't get to see you dietician - email/talk over the phone. Good luck.

[joshuasgranny]

Thank you so much for this very informative reply. We were, as you say, feeding the insulin. We now eat "normally" and his insulin is given accordingly. This means that sometimes he may only require 3 units, sometimes 5 or 6. But, we have noticed no difference in his blood sugar, which means that we were indeed feeding the insulin and he is doing just as well eating "normally". He is also much happier with his meals, as he can eat his fruits and fresh vegetables and we are not worrying about whether he has a certain amount of carbs.

Again, thank you so much for your post. I appreciate it.

Susan