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Total Number of carbs per day

Discussion in 'Parents of Children with Type 1' started by jules12, Jul 17, 2010.

  1. jules12

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    Has your endo ever told you to be sure you child has a certain amount of carbs each day? This is summer and the kids are on a more relaxed schedule so sometimes they sleep in and have two meals that day and the endo wasn't very happy about it. Just wanted if you have ever been told that? They said he should have a minimum of 120 carbs per day. Typically, he has more than that because he is around 40 for breakfast and 40-60 for lunch and then the same for dinner.
     
  2. emm142

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    I went through a period of not eating much, only about 50g carbs per day. I did end up with ketones most of the time, but it wasn't a big deal. I don't think starvation ketones are particularly dangerous. I'd say if he has energy and his weight is fine, it doesn't matter too much.

    The majority of the time nowadays I'm at 150ish carbs per day, sometimes up to 200, and on a rare day with pizza or chinese food, up to 250.
     
  3. jules12

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    That is what I thought - it was just because it is summer - during the school year - he has more than 120 most days... no ketones all summer...I just thought it was odd they focused in on this. I know our A1C went up but we switch gears every year from Mom handling most things to Dad handling things while he is off for two months in the summer. He is a bit more relaxed than me :rolleyes:.
     
  4. Mistync991

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    i think we were told under 250 but more than 180 ..45-60 for each meal and then up to 3 15c snacks..when she was first dx anyways...when i went to my nutritionist she told me to keep under 180..but im trying to loose weight and she really wanted me to count calories not carbs for this reason but i told her i was already counting carbs so she finally just said under 180 lol
     
  5. Lisa P.

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    Was this advice regarding diabetes or general diet?

    A lot of folks have set opinions on diet, we're a weird country regarding food and I'm convinced if you put 10 Americans in a room and had them write down what they thought a healthy meal was no two papers would in any way match. Doctors and nurses and nutritionists aren't immune to this and I think sometimes they use whatever standard they find healthy (e.g. a vegetarian doctor thinks you need lots of grains, an Atkins fan thinks a lower end carb diet is great) to advise their patients.

    I'd ask whether this is specifically related to diabetes management (in which case I'd ask what their reasoning was) or if they were giving general pediatric advise. If it's general pediatric advise (my suspicion) I'd check in with your pediatrician or your gut instead of your endo's office for that. :)
     
  6. Mimi

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    We had target carb amounts for each meal when dd was first dx'd and on NPH. Keeping to those targets soon became difficult as she was either more hungry or less hungry than the required carb amount. :rolleyes:

    We have a much more relaxed schedule in the summer as well, with a later breakfast and not so much a 'lunch' more of an afternoon graze and then a regular dinner. As long as my kids are growing, making wise choices (which I can control by buying the appropriate food) then I don't worry about how much they take in. I try to let them eat when they are hungry not for other reasons - bored, tired, upset, sad etc. They know when they are hungry.

    If you are happy with what/when your child is eating and the food is being covered appropriately with insulin, then I wouldn't worry about it.
     
  7. Kaylas mom

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    When Kayla was first dx it was 75 for each meal and 2- 15 carb snacks a day.. so total would have been 255ish. The dietician said that was a good number for a 14 year old Now.. I don't know she takes on avg 12 to 14 U of humalog a day so she must be eating around 240 to 280 carbs a day.
     
  8. jules12

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    We have hit a bit of a snag with summer this year. My dh has finally had a light bulb moment - it has been a long time coming (three years) for him to realize that he cant be so laid back about the D care.

    Our A1c went up some but I wasn't as worried about it because I knew exactly why - I think the endo was trying to find anything and everything they could to point out as to why this happened.....I know why it happened because my DH didn't understand that being in the 200's was not OK. During the school year, we have much better control but once DH is in control during the summer.....well things just go crazy. They even questioned his TDD which is 10 units and we are three years into D mgmt. When I pointed out we have doubled TDD over the last year, they backed off.

    The good news is last week, after DH finally got it (a little), the crazy swings, and high numbers were greatly reduced this past week!!!
     
  9. joshuasgranny

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    We had such a struggle with this when Joshua was first diagnosed. To begin with, we are night people. Everyone has always worked night shifts and therefore our schedules are completely opposite of most people's life schedules. Joshua is homeschooled, so going to school doesn't come into the picture.

    We eat very little carbs. That is mostly just because we don't like most of the foods that have carbohydrates. We don't eat bread, we don't eat potatoes, etc. We do eat healthy- we grow our own food and eat only what we grow. But, our diet is simply meat and vegetables. We have never eaten sweets, because none of us care for sweet stuff.

    When Joshua was diagnosed, his doctors wanted him to eat 60 carbs a meal. We simply couldn't do it. There was no way we could come up with that many carbs in one meal, without introducing a lot of what we would call "junk food".

    His doctors also had him "scheduled" for breakfast at 8 a.m., lunch at noon, etc. Totally different than our lifestyle. Talk about chaos! We had this horrible disease to cope with, and everyone's life was being turned inside-out to top it all off.

    Finally, several people on here told me that we were fitting our life to diabetes, and not diabetes into our life. In other words, we were "working" backwards.

    I told his doctors this was our life and Joshua's life, and this was the way we lived. We would adapt his diabetes into it. They were very agreeable (since their way was really creating chaos and wasn't working out at all).

    We all sleep until about noon. We have brunch, then we have supper about 6:30 p.m. and a snack around midnight. Joshua eats very healthy foods, and he eats a lot, but all in all, he averages about 20 carbs a meal.

    Joshua is doing great. He is healthy, growing normally, etc. Your lifestyle may differ greatly from ours, most people's does, but the real thing to keep in mind is that a diabetic is much happier and ultimately much healthier when they are living life "normally" and not trying to shape their life around their diabetes. I feel this is especially important with a child- a child deserves to be a child and not suddenly be shifted into the grownup world of worries, etc. Childhood should be carefree and happy (or at least as much as possible).

    Susan
     
  10. BrokenPancreas

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    Does he have ketones from the lack of carbs?
    Thanks
     
  11. simom

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    We also find ourselves eating more fresh veggies in the summer, which tends to be inherently lower carb.

    We try to get some good whole grains and fruits (or full-sugar treats - DQ anyone? - haha) in to keep up healthy growth - but if there are no ketones and kids are growing, I would not worry at all.

    We haven't been told that a specific number of carbs (or a limit) is a goal.
     
  12. lauraqofu

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    I would be really worried about a low carb lifestyle for kids in general, not just kids with diabetes. The only form of fuel the brain uses is glucose, so in kids with developing brains, not getting enough carbs can affect brain development. Your endo may be have been concerned about that...also, while ketones aren't necessarily incredibly harmful to your body, they are very damaging to fetal brain development, so in no way should a pregnant woman ever allow ketones. Obviously, this isn't an issue for your son, but brain development is....
     
  13. bajama

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    Low Carb and Brain Development

    Hi Laura,

    I live a low-carb lifestyle, and my family mostly does by default, including 3 kids. I've read quite a bit about low-carb and ketones, and have never come across anything about brain damage.

    Do you have any sources for this information?

    When my type 1 son eats low carb, we find his blood sugar much easier to control. We've never even thought to check him for ketones unless his bg was high. I don't know if I'd worry about it.

    - Not just for Laura - I think this is a really important discussion. Do they need 120 grams of carbs per day? I've always thought this was nutritional nonsense. Our bodies make glucose through gluconeogenesis. Our brains can use ketones for energy, as well as glucose. Since carbohydrate affects our kids' blood sugar more than anything else, this is something we really should know more about.

    Take care,
    Jan
     
  14. tbcarrick

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    We never had our Endo tell us how many carbs per day.Where we go,we have a
    nutritionist.We see her everytime.She has helped us alot.Brandon is 280 per day.
    He is also 14,138LBS,and 6' tall.This is alot of food.I questioned this,and she told me that since he is still growing he needs a certain amount to keep him healthy.
    She gave us all kinds of info on how she determines what would be appropriate for him.I hope this helps.
     
  15. zakksmom

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    My 16 yr old son consumes 200-400 carbs a day.. I think we are going to have to get 2nd jobs just to feed this kid!!!
     
  16. Lucky 868

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    When my son was diagnosed, the nutritionist told use he could eat no more than 5 carb points per meal. That's 75 grams - for a 16 yo boy, 6'1" tall, weighed 119 at diagnosis (but quickly went back up to his usual 134 lbs.). That's a starvation diet for a kid that age!! We spent the entire night stressing about how he was going to ever stay full. We were also given a 3 meals a day, 3 snacks, eating meals at least 3 hrs. apart (tricky between breakfast and lunch). The next day the endo saw us and said "no way can he live on that few carbs. He's still growing and needs some meat on those bones." We started off with the "eat however much/whatever you want and give Humalog for the carbs" plan. Were told that was a "more advanced plan" that what patients usually start with (anyone know what that really means, by the way?).
     
  17. joshuasgranny

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    No. The only time he ever has ketones is sometimes when he is sick. I wasn't aware that not having enough carbs could cause ketones.. that is new information to me.

    Susan
     
  18. lauraqofu

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    A million years ago, before I was derailed by Fibro and Grave's and Lupus, I was studying to be an RN. One of our required classes was Nutrition, which was taught by a Registered Dietician, an amazing woman who had a PhD, and was actually a peer reviewer of many text books on nutrition. It was such an eye-opening experience.

    First of all...Registered Dieticians are actually the only people with the education to advise you about diet. Doctors, even our amazing endos, aren't required to take so much as a single class on nutrition. Nutritionists, even licensed ones are often as clueless as we are because they don't have the training that a Registered Dietician does.

    We discussed at length the Atkins diet and other low carb diets. I was particularly surprised at the information about ketones and fetal brain development because my OB said nothing about it to me when I was producing ketones during my pregnancy with Cass because of the constant nausea and vomiting I experienced in my first two trimesters, I actually lost weight and was producing ketones, and while I was hospitalized for the ketones, and put on IV nutrition, no one told me the risks to the baby.

    And yes, we make our own glucose in the process of gluconeogenesis, of course, ketones are the byproduct of gluconeogenesis. And while ketones are a necessary part of the glucose/insulin chain reaction, too many ketones can have a negative affect. I think in the average low carb diet, ketones aren't necessarily a problem...but it's not optimal for humans to restrict carbohydrate intake, of course, the flip side of that is that it's also not optimal to have an excess of low nutrient content carbs, either. When I talk about carbs, I mean things like whole grains and fruits and veggies, I don't mean white rice and white bread...And I didn't say anything about brain damage, but rather not having proper fuel for brain development. However, ketones can have a negative effect on fetal brain development, but currently the research isn't as extensive as it could be....sort of like the effects of alcohol on fetal development. We know there's a safety thresh hold, we just don't know where it is...

    I'm sure that limiting carb intake does provide better control of blood glucose numbers, so it's a question of weighing the need to control blood sugars, and making sure your child's developing body is getting all the nutrients it needs.

    I would really hate to tell anyone what to do with their kid, mostly because I know how obnoxious that is. I'll go ahead and put the link to the Nutrition textbook we used, but I really think the best thing to do is talk to a Registered Dietitian. Nutrition is such a complex science, it's amazing what our bodies do with what we eat, and how we turn a salad into energy is just astounding.

    I will say this about low carb diets...I've always felt that a diet that discourages anyone from eating fruits or vegetables is just ridiculous. The best diet is a varied one, with plenty of lean protein, whole grains and fresh fruits and veggies...IMHO

    Anyway, here's the link for the text book...they have a pretty great website, too....
    http://www.amazon.com/Understanding-Nutrition-Eleanor-Noss-Whitney/dp/0495116866

    Here's the companion website...
    http://www.wadsworth.com/cgi-wadswo...ipline_number=18&product_isbn_issn=0534622267
     
  19. NomadIvy

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    Weird. ~K was 6 years, 4 mos. at diagnosis. We were told the same thing. And she's a tiny one (roughly 30th percentile on the "norm chart").
     
  20. Lisa P.

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    I tend to the Michael Pollan school, which I read as it being a bad thing overall in a society (no reference to the PP above about a very good dietician she trusted) for us to turn our food decisions over to nutritional experts.

    His take is, if I remember correctly, eat food, not too much, mostly plants. And never eat anything your grandmother wouldn't recognize as food.

    I have found that when we get all the cr@p out of the way, when it's simply not an option to eat food made in factories instead of kitchens, kids will eat what their bodies need to eat. If you let the animal instinct develop without interference, kids eating what they are hungry for will not get them in trouble.

    Some days, years, months, seasons, a kid may need lots of protein; others, carbs. If good, real food is available and the kid can choose, he'll be all right. Even for our diabetic kids, who feel themselves what their bodies do with food, while we're always just guessing from the outside.
     

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