Discussion in 'Parents of Children with Type 1' started by mom2ejca, Sep 19, 2010.
We requested to be graduated from that pretty quickly. Within the first 3 months I think.
At dx we were given the choice of either NPH/Reg or Lantus/Novalog. With the NPH they would have put us on a fixed meal plan (which never would have worked for us). We chose Lantus for the flexibility even though it meant more injections. It has worked out well for us.
Sorry to say but we were diagnosed in the UK and they didn't even KNOW what she could eat for the first day. The nurses on duty said "oh - perhaps macaroni cheese". There was no carb counting - it wasn't even suggested - they just let children eat, gave them their "usual dose" and then corrected if that didn't work. When I said I wanted to count carbohydrate because that was the one variable we could control they said "well, that is quite old fashioned, but if it is what you want to do" and they humoured me! It still beggars belief that they could be sending people home with children with diabetes who don't even know how to carb count and alter their insulin to suit! Perhaps they have changed in the past few years - but I looked online - and same old faces!
East Tn here. I hated that meal plan!! Really...you want my (then) 3 year old to eat an exact number of carbs, exactly when she's supposed to?? The endo was very old-school. Thankfully we went on the pump quickly. He wasn't happy about it, but we insisted. I think he still wanted us to stick with the meal plan. We switched to a larger med endo group in Knoxville very quickly.
We were given a mixed message at the hospital just 3.5 months ago. The dietician showed us the exchange plan and gave us guidelines similar to those you posted. But at the same time the nurses counted carbs with us on a ratio that I can't remember now.
We basically counted carbs from the get-go. At times I wish we could knew carb exchanges better... mostly for potlucks or eating out. I can never get the visual portion (thumb=ounce, palm = cup) straight. But I think it's a tool I'd like to have in our back pocket.
Ds is on novalog and lantus and has been since day 1.
Lia was put on Regular and NPH.
Breakfast 45-60 grams
AM Snack 15 grams
Lunch 45-60 grams
PM Snack 15 grams
Dinner 45-60 grams
Bedtime snack if needed, anywhere between 15 and 45 grams depending on blood sugar.
We were to check only three times a day. Before breakfast, dinner and bedtime.
It was a hot mess with a high strung five year old attending before school care and kindergarten in a school district with no nurses.
We were put on a Lantus / Regular regimen with set carbs for meals and a sliding scale for corrections.
We were not even given a sliding scale for corrections. We had to call in to the on-call ER dr. to find out how much to give her when she was high. Which she was ALL the time in the beginning. Really frustrated with the level of care knowing what I know now.
I'll bet we are .
We have that same conversation on a regular basis .
I think it is a reflection of the time. In 2002 it wasn't offered. I've seen so many advances just in eight years and choices of regimen-- right up front are one of those advances.
No. We were taught from the get-go how to adjust insulin dose, to look for patterns, to compute corrections (no sliding scale here), etc. It was nerve-wracking at the beginning so we would usually call the emergency pager. But we would be asked - "What would YOU do?" They told us that since we live with this we would be the experts on how our daughter reacts to/responds to different food, to the insulin, to exercise, etc. I am glad we were taught that way.
yes and it was insane for a 20 month old cause he didn't eat that many carbs and I think the smallest meal was lunch at 30 carbs, rest at 45. He ate a lot of crap to feed the insulin. We were at TX childrens in Houston at diagnosis. We didn't get a I:C ratio till we moved to Oregon and thank God we did!
The Children's Hospital where our DS ended up. (We were on vacation on the east coast) sent us home on Lantus/Novolog and a meal plan of 60 carbs/meal with 15-20cb snacks mid-morning afternoon and bedtime. The snacks were uncovered and they had us dosing his Novolog using a sliding scale to correct.
When we got back to Illinois we continued the same thing with the endo we found here at home. We'd call numbers in every thursday and his endo would adjust the scale and lantus dose accordingly. We were making some adjustments already based on carb:insulin ratios and a correction factor that our CDE talked to us about off the record. The endo really wanted to keep this regimen in place for awhile.
When I asked him about switching to simply carb:insulin ratios and correction factors he was reluctant at first. He indicated that he understood that it gave the parents and kids more flexibilty, but he also felt that it sometimes made it harder to help young kids learn good eating habits and that sometimes his newly diagnosed kids gained a little more weight than he would like.
He qualified it by saying that it really depended on the family and child and if they could keep a decent handle on their management he didn't have a problem with it. We stayed with the meal plans and didn't really have a problem with it and neither did our DS. We adjusted meals that were more when we ate out or he wanted a little more carb, but still used the sliding scales for almost 9 months till he got his pump.
We're pumping now (since June) and we still do 60 cb meals alot out of habit. Alot of his favorites are low carb so we don't see him hungry and if he wants something else we just cover it. The pump is great. I don't have a problem with his care before the pump because his CDE was always available and we had contact whenever we needed it. Our kid is pretty regimented in everything he does, so the meal plan didn't really bother him. He really didn't like shots either, so if we did do something different we always worked it into his meal and adjusted his Novolog accordingly. He wouldn't ask for anything in between if it meant another shot, even if it was a hot fudge sunday. He really likes his pump!
I ditto this, our D team said the same exact thing...kid first, D second. Believe, Vince was sooo happy to hear that he could once again have a donut!
My son left the hospital on 70/30 diluted insulin in 1997. (I did the dilution.) He was forced to eat a certain amount and we searched high and low for food a 3 year old would eat. He stayed on a set eating plan even when the insulin went to NPH/Regular, NPH/Humalog until he was set free when he went on Lantus/Humalog in 2001.
No one in this family eats that crap we ate for years -- nutri grain bars, tater tots, cheese sticks, fish sticks. We now eat normally.
Alex was on a set plan like this at dx. He was on nph and humalog. The really interesting part was he was 15 yrs old and his carb amounts were the same as your 6 yo was....but Alex only got 60 gms of carbs at lunch!!! And the nutritionist made a big point of saying that they were giving him a lot of carbs b/c he was a teen! But he was fine with the amount....I do know he ate lots of free foods in between meals but the carb amounts at the meals seemed fine for him.
Oh, and this was only 5 yrs ago....and we weren't given instructions on how to correct for highs either. Maybe at sometime during that first year we started doing that but I don't remember doing that until he got on the pump.
Connor was put on Lantus/Novolog at dx. For the first 3 weeks they wanted us to do a set amount of carbs at each meal. I can't even remember the number of carbs they wanted him to have.
My husband had been T1 for over 17 years when Connor was dx'ed so we came home and did things our way from about the 3rd day on. When we went back to the endo 3 weeks later for our training on carb ratios we had already been doing it with Connor for over 2 weeks. Luckily, our endo has always praised us for our knowledge and ability to figure things out on our own and did not fuss at us for figuring it out on our own. By 4 months after dx Connor was on a pump and we've never looked back.
Yes, NPH and fixed meals. It didn't work well at all.
Premixed Humalog+NPH (25/75%) twice a day and strict meal plan. It was a disaster. Unfortunatley it is a rule here - all the children are put on the premixed insulin.
Strangely, on the day of diagnosis, Jordan went to the doctor (for what I thought was going to be a urinary tract infection) immediately after school for a UA. Well, when the diagnosis came a few hours later after leaving because we were waiting on the results, then we were called back immediately because they were so alarmed by the high sugar. We then were sent an hour to Indy to Riley Children's Hospital. So, he hadn't eaten anything since lunch at school, and we didn't know a lot about diabetes at that time, so when we arrived to be a direct admit thru the ER @ Riley, both starving - I walked down to the McDonalds they have inside Riley and got him a 3 piece Chicken Tender meal. We took it with us to his room, and they were so nice explaining everything to us. They told him they wanted him to lead as normal life as possible, being a teenager is hard enough so eat what you want and make sure to count appropriate carbs.
So, his first meal post dx was not only carb filled with deep fried tenders and a large french fry - It was one of his favorite meals too!
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