[betty6333]

my 6 year old is a picky eater. his dr said that he can eat after he get his injection and that we have to make sure he eats all he got the shot for obvoiusly... well some foods it will take an hr for him to finish b/c he pokes at it and talks ect.... but sugar like candy corn he can inhale in 5 seconds flat. my question is this.... yesterday i gave him his insulin for 1-30 ratio.... 60 carbs 2 units ( i weigh everything on the gram scale) he ate all of the candy corn in less than 5 minutes....out of curiosity i checked him 35 minutes later and he was 130 (preshot) before and the meter was HI... 35 minutes after eating. then 1hr 10 minutes later he was 470 and three hrs after he was 116..... that seems like a dangerous curve to me. How long do you guys wait after taking you insulin to eat..... so you don't have a wild ride like this. i don't want to wait too long so he goes low and i don't want him being that high... even though the dr says feed him when he wants to eat just give him insuiln... and do you think it is safe for that kind of curve?

[UpNorth]

For me it depends a bit on what i'm eating... If it's fast carbs like candy, then i might inject about 15-20 minutes before i eat it if my sugar level is normal and i don't notice a tendancy to be dropping. But generally, i inject while eating, or when i have finished eating, especially when i'm eating out and can't be sure the food will arrive fast...

What insulin is your son on?

[UpNorth]

Another thing i do when i eat sweet things, is to eat it quite slowly so not all the glucose enters my bloodstream at the same time like a sugarbomb. I guess his curve would have been less dramatic if he had eaten those candycorns in a 10-20 minute period instead of having them all in just 5 minutes. It does take a while for carbs to break down into glucose in your stomach...

[betty6333]

novolog and lantus

[UpNorth]

Okay, then it could be a good idea to inject and then wait for maybe 10-15 minutes if bloodsugar is good at that time, and the carbs are fast. Novolog/Novorapid kicks in pretty fast, but some kinds of sugar kicks in even faster.

[Eddy]

Originally Posted by betty6333

my 6 year old is a picky eater. his dr said that he can eat after he get his injection and that we have to make sure he eats all he got the shot for

I'm no medical pro, but my take: No, it's not safe to go that high. IIUC, the blood thickens above 500 mg/dL, and going high also causes osmotic imbalances.

The timing depends on food. Sometimes I shoot first; sometimes I eat first. Sometimes I use one insulin; other times I mix three. Yes, I'm insane -- but the point I'm making is that there's no "one size fits all", not even within a specific person.

I applaud your curiosity. You determined that the insulin had begun working before the 70-minute mark; candy corn had done its magic within half an hour. For more precise information, you'll have to keep him in range. Next time, consider 15g of candy corn and 45g of something slower-digesting.

I hope this thread develops more. I'm trying to think what would be best for a six-year old. My tactics of "avoid certain foods", "time things precisely", and "mix up to three different insulins" probably wouldn't work so well... but at least some intake moderation and timing are advisable.

Something I've not yet gotten around to, but which interests me greatly: Dilution. Do not attempt any of the following without thorough understanding. Realize that discussion of large doses is for much weaker insulin concentrations; injecting a large dose of the standard stuff would likely prove fatal.

NovoNordisk makes a sterile diluent for Novolog. If you were to dilute using a 10:1 ratio, you then would need 20U of the resulting U-10 for 60g of CHO. Give him 4U of the dilute insulin (equivalent to 0.4U of the strong stuff), and 12g of candy corn. Observe the BG response with said smaller, more-controlled parameters.

Perhaps I need to look into this further. It seems that information on dilution is scarce. If you can find an authoritative source, talk with them. Otherwise, I'd feel much rather that I be the "guinea pig" than a six-year old.

Is pumping an option? One feature of pumping is the so-called "super bolus". It whacks in a large bolus right now for the impending sugar hit, then suspends the basal "long enough" to balance things.

There's really no way to sugar coat things, so to speak: Good control will require good understanding of various foods, and matching eating/insulin habits accordingly. Some foods release glucose smoothly over four or five hours. Others nail me in as little as 15-20 minutes.

[xMenace]

Insulin pump - Wikipedia, the free encyclopedia

[Real4]

Originally Posted by betty6333

but sugar like candy corn he can inhale in 5 seconds flat.

I know it is said that a diabetic can eat anything with proper management of carb counts and insulin dose, but clearly with your child that is NOT possible. Stop the candy, if you can not control how it is eaten for the good of your child.

[soso]

Perhaps if he got the candy portion after he had finished the good stuff,you might kill 2 birds with one stone, so to speak.. I can appreciate how hard it must be for you to get it right with a youngster.. it's hard enough at my age! (53)

[Eddy]

Originally Posted by Real4

I know it is said that a diabetic can eat anything with proper management of carb counts and insulin dose, but clearly with your child that is NOT possible. Stop the candy, if you can not control how it is eaten for the good of your child.

I'd argue that it is possible with proper management... but whether proper management is possible/feasible is another story.

To that end... I question whether "going cold turkey" will work. I find that I no longer crave the sweets that I used to, unless something is imbalanced. Will that work for a six-year old? Or would it be more realistic to have limited treat intake, and only after good food?

I don't know. I'll defer to those with [diabetic] children regarding what tactic works best psychologically. I don't know whether a six-year old understands coma/death, or whether such would even be advisable to mention.

[betty6333]

i have started a timer plan. on dinners he can eat right away, start w/ the veggies and protien end with the carbs... it works ok..... but with snacks he is getting his insulin and then we set the timer (just like we do for toy sharing with his brothers) for 25 minutes, that way a 60 carb load doesn't kill his little brain. he is ok with this... he just doesn't like delayed gratification.... but really who does?
thanks guys...

[Alice]

I'm a "picky eater" also. Often I take my meal bolus after I am through eating...making sure I've had all I wish to eat. Although I can certainly "plan" a meal and the amount of carbs the reality is that those carbs change for various reasons.

It's ok to take the bolus immediately after eating. The recommended instructions are 15 minutes prior to just after...so that may help.

The candy is more of a "nutritional" factor than a carb obstacle. Children just aren't eating enough healthy foods and fall back on those sweets. I'd keep them for dessert or lows...but make sure your child is not told "diabetics can't eat sugar". This is a dangerous myth to children...and adults alike and causes guilt in all forms throughout life...unnessarily.

But the education of eating sugar needs to be taught.

[solox316]

Originally Posted by soso

Perhaps if he got the candy portion after he had finished the good stuff,you might kill 2 birds with one stone, so to speak..

If eating the candy after the meal, with proteins, fat, and complex carbs, the candy may not absorb quite so quickly.

With a picky eater, you may consider giving half the carb bolus prior to eating as well as any correction insulin, then the remaining bolus after determining how much food was actually eaten. Darn, I just realized you said Lantus and Novolog... well... consider a pump

60g of candy in one quick sitting will mess any of us up, a super quick spike.

[Eddy]

Originally Posted by solox316

60g of candy in one quick sitting will mess any of us up, a super quick spike.

True enough. If I had 60g hit before the insulin started, that would be about a 140-150 mg/dL spike for me... and I weigh about 180 pounds.