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Newbie question...son was just diagnosed

Discussion in 'Parents of Children with Type 1' started by mistyz, Nov 23, 2011.

  1. mistyz

    mistyz Approved members

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    Hi there! I am new here. My son is 7 and was just diagnosed on the 17th. I am having a hard time, but I know this is new.

    My first question is how long is acceptable to wait between eating and getting his insulin shot? He is currently on 1 unit of humalog for 12 carbs. I am just wondering if it's okay if he eats dinner, waits a bit, has a treat and then his shot? Or is 30 minutes or so too long?

    I have a list of questions to ask the endo at our first "real" appointment on Monday, but thought I would post this one here as well to see what you all think and know. :)

    Thank you in advance!
     
  2. virgo39

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    I'm very sorry for your son's dx.

    My DD was dx'd two years ago, at about this time, and it can be quite overwhelming.

    I defer to those who are expert on MDI. But when we were on MDI, we tried to give DD her post-meal shot as soon as possible after the meal was over (because, ideally, as a general matter, you'd be giving the insulin before the meal so that it could better deal with the food as it is digesting).

    I think how long it's okay to wait may depend on how long the meal was and how long you mean by "a bit." I could see waiting five minutes or so, but I'm not sure I'd want to wait a lot longer than that, kwim, especially if the meal took half an hour or so. If you knew the carb count of the treat and were reasonably confident your son was going to eat all of it, you could simply add those carbs to his mealtime carbs, give him the shot right after dinner and let him have his treat later -- exactly how much later, I'm not sure, but I suspect at least 15-30 minutes or so.
     
  3. jbmom1b2g

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    I dose before she eats. She knows she needs to eat all her food so she tells me what she wants and I dose her for it.
     
  4. mommylovestosing

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    Wow! 12 to 1? That's a large ratio for a little one that age.

    Anyway - WELCOME! You will find a wealth of info here!

    Insulin takes about 1/2 an hour to work. So, the longer you wait to administer, the higher he will go before he comes back down. With our daughter, we give the insulin before she eats. Sometimes even as much as 1/2 hour before. This is something you will learn! You will come to understand how far in advance to give it based on beginning BG, activity level over the past 24 hours, the type of food, etc... The only foods we do NOT give ahead of time is pizza and fast food - for the fat content.

    I know this is a TON of info. There is a big learning curve here. Try not to be overwhelmed!!

    Jenn
     
  5. Becky Stevens mom

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    First of all, hello and welcome:cwds: I know this is hard for you and its frightening right now. I promise you that it will get better and easier and much more comfortable then it is right now. Since your son is newly diagnosed he is probably still needing quite a bit of insulin to keep his blood sugars within range. Soon he may go into honeymoon and that insulin to carb ratio will probably go up quite a bit. Its better if you can try to pre-bolus, meaning give insulin before he eats. If youre not sure how much he will eat you can try giving him part of the bolus before he eats and then maybe wait an hour after he's eaten and had a treat to give him more insulin.

    This being your first Thanksgiving with diabetes, try not to be too stressed about the blood sugars. He may be a bit high during the day but you can always give a little more insulin to bring him down again.
     
  6. akgiauque

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    When we started we gave the shot as soon as we could after a meal. We would get high numbers and a high A1C. This was a concern so our Endo suggested that we then went to giving a dose before and making a correction for additional carbs if we needed it. This was ok except getting a half unit in a syringe was tough for me. I did not like the variation. As we got to know how she ate we became more comfortable and began giving injections for the meal.
    My best advice is to listen to your Endo/ diabetic nurse they help folks through this process. I think it is about the parents as much as the kids in the beginning, I know our daughter handled it better than we did.
     
  7. mistyz

    mistyz Approved members

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    Thank you so much! It's so nice that this board is so active...it helps to read everything on here. I guess so far I am just used to giving him 3 doses, 1 after each meal and then his lantus at night. So to think of giving him an extra dose just for a treat seems "wrong" to me. But then I have not been around diabetes at all really, so I still have the no sugar mentality, even though that's not true.

    I know how much he loves pumpkin pie and so I'm worried about Thanksgiving. I dont' want to make him eat his pie right after dinner so that I can dose for it and then everyone else eats it later, you know? He will want another piece. *sigh*
    But it is okay, to just dose him after dinner. Let him eat dessert and then dose him again for that...?
     
  8. MomofSweetOne

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    We were taught to dose before the meal. They told us, though, that for 2-3 years olds, they recommend afterwards so that eating doesn't become a power-play that the child wins.

    Your son will feel better if he spikes less. We were told when possible to dose before the meal, the amount of minutes depends on the blood sugar level. It makes a huge difference, but we didn't do it on MDI.

    We do dose afterwards when viruses hit and appetites don't end up being as big as what she chooses. Otherwise we end up compensating with juice. :(
     
  9. emm142

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    If it's definitely only 30 mins after, I'd probably be inclined to give dinner and then bolus for both dinner and pie, and then let him eat the pie at 30 minutes later. There is normally enough of a spike after eating that he wouldn't drop low by waiting 30 minutes between being bolused for the pie and eating it.
     
  10. tiger7lady

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    If your son is tolerant of the shots then you can dose for food 20 times a day if you wanted (complete exaggeration but you get my point). If you are covering food there is no worry about getting too much insulin or what's called stacking insulin. So to answer your question, yes you can dose for the meal and then later when you guys go to do pie dose him just for the pie (no correction doses).
     
  11. vanessa22

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    So sorry about your son... My daughter was diagnosed 5 months ago yesterday and it is all new for me too.
    In my experience if her blood sugar is high I try and get it in either before or right away when she starts to eat. If she's normal or low I will do it right after. I think they told me in the hospital to not go past 15 mins as the rule but I have rarely even gone that long. It's hard when you don't know if they'll eat the whole meal but my daughter is really good about finishing what I give her.
     
  12. mistyz

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    Thank you. My son is very tolerant of the shots. He doesn't even flinch...pulls up his shirt and then jumps up to go about playing. So I think he would be fine with that. You know just mom guilt and constant worry. :/
     
  13. tiger7lady

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    That's how my son has always been too. He didn't care if he had to do multiple shots if it meant he got more food. LOL. :D
     
  14. wilf

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    This may sound like a silly question to you, but why not bolus before the meal? This is what most folks on Humalog do. Humalog takes longer to act than most foods will take to digest, so you run the risk of him developing big post-meal spikes in blood sugars if you wait until after the meal and dessert to bolus.
     
  15. caspi

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    First of all, welcome!:cwds: As others have said, bolus for the meal amd then bolus for the dessert when he eats it later. Just be careful not to give a correction with the dessert bolus - just bolus for the food only.

    I understand the no sugar mentality - I was always striving to find things low in sugar and/or carbs to avoid giving a shot, even though my son was fine getting them. In time this too, shall pass. ;)

    Have a wonderful Thanksgiving and remember that we're all here for you with any and all questions or concerns! :cwds:
     
  16. Heather(CA)

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    Welcome, my son was dx'd at 7 also...If it makes you feel any better, he is now 16. He plays sports year round and had a 4.0 GPA. It will get easier I promise. :)

    If you know what the treat will be, I would probably give the shot after he eats dinner but add the insulin for the treat into the shot :) Then don't forget to give it to him, set a timer or something and have him eat it within the 30 minutes mentioned. For a new dx'd I would rather do it this way than give an extra shot. JMO :)
     
  17. rutgers1

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    We used to give insulin after eating but quickly learned that it wasn't a good plan for Matt. Here is my reasoning why....When Matt is low, we give him carbs, which sends him climbing within minutes. Experimentation has shown that carbs hit him WAY faster than insulin. So, even if we give him insulin right before he eats, the carbs still win out initially.

    I think a lot of people see a number that is within range 3 hours later and assume that they gave the insulin at the right time. However, what they are often missing is the huge spike that occurred while the insulin wasn't active. In my experience, the only way to prevent that spike is to give the insulin early.
     
  18. NomadIvy

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    My daughter was diagnosed at 6, right before all the year-end get-togethers, not to mention birthday parties. It was a nightmare (in terms of carb-counting cause we were so new). But she quickly learned to withstand multiple injections for multiple treats. I always told her she could eat what she wanted (to a certain degree) as long as she covered it with insulin. Just glad she was a trooper with needles.
     
  19. Melissata

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    Exactly what most people often don't find out until the kids start using a CGM. Unless you have a picky eater, the way to go is to give the insulin before the meal. When we started giving insulin well before the meal, we saw an immediate reduction in A1c.
     
  20. Beach bum

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    First off, hello and welcome. Sorry you had to join. You will find great support here.
    To answer your questions.


    I guess so far I am just used to giving him 3 doses, 1 after each meal and then his lantus at night. So to think of giving him an extra dose just for a treat seems "wrong" to me. But then I have not been around diabetes at all really, so I still have the no sugar mentality, even though that's not true.

    It's ok to give extra shots, especially on special days. In the beginning, we tried to avoid extra shots until we really got into the routine of things, but learned to allow for flexibility. I think he's old enough to understand that if he wants to have a special treat with everyone else, then it's going to require a shot. As for learning about diabetes, it takes time, but before you know it, you will be well versed.


    I know how much he loves pumpkin pie and so I'm worried about Thanksgiving. I dont' want to make him eat his pie right after dinner so that I can dose for it and then everyone else eats it later, you know? He will want another piece. *sigh*
    But it is okay, to just dose him after dinner. Let him eat dessert and then dose him again for that...?


    Let him eat pie! When he wants, but as I said above, he needs to understand that sure, you can have it, but you need to give an extra shot. I think this actually is a great learning experience for all. It shows you that even with diabetes, life can pretty much be the same as before, but you have to be flexible and willing to compromise.

    So, dose for dinner as you always would (some do before, some do after, don't wait too long though insulin takes about 30 minutes to really start working), then have the pie whenever you feel like it and just dose again. And, if he wants another piece after you dosed, let him have it, just dose again.

    Best of luck.
     

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