| Hi Sweetlife,
A couple of ideas ... I think in this whole scenario we all have to be realistic about the fact that this is a growing child, going to a school where diabetes care may or may not be very easy to accomplish.
FIRST. 11:30 to 8:30 is a long time for a kid to go without food, so she's going to need her afternoon snack(s) and probably something fairly substantial. Super-low carb is probably not going to be a great option at this stage in her life.
SECOND. Routinely testing 2 hours after meals may or may not be practical at school (or affordable for the poster). Adding another injection for snack may or may not be practical. Also you have to find the balance between optimum testing and not overburdening the child to the point where in a few years when she's managing this on her own she burns out and starts neglecting her care. That's something for Sweetlife to consider and discuss with your daughter and her teacher. (It would still be well worth a frequent testing schedule for a week or so, just to get a clearer picture of her pattern.) The temporary workaround would be to test her when she gets home and give a correction injection if necessary then, so that she's back into normal range by dinnertime.
THIRD. At 11, you are probably already running into the first changes of puberty, and that's going to affect her BG in weird and wonderful ways. So while it's important to identify these trouble areas and keep things as stable as possible, you may still run into random, apparently inexplicable highs. Testing often enough that you can catch and correct these is going to be important in the next few years.
I wanted to add too, that you can often calculate carbs reasonably well by the cup as well by weight. When we're making curries, stews, baking, etc., we track how much carbs in the total and then try to divide into equal portions.
For example, a cup of cooked lentils is 24 carbs. A cup of cooked rice, 45 carbs, a cup of white flour, 90 carbs. I keep a poster on the cupboard door of frequently used ingredients and their carb counts so it's easy to do a quick calculation. And for dishes that we make a lot, we eventually find an estimate "per serving" that seems to work for my son.
One thing to consider. My son loves Indian food and it's full of healthy ingredients, but we do fairly often see a late BG spike with it that we normally only see with high-fat food. That doesn't really explain what's going on with your daughter if lunch is similar to dinner, but you might watch the post-lunch pattern for a few days to see if she
a) goes high and stays high (ie needs more insulin at lunch) or
b) has pretty good BGs until late in the afternoon, and THEN goes high (in which case more insulin at lunch might risk making her go low). If you're seeing a late BG spike, then an additional insulin dose at snack time or after school would be the way to go.
Good luck -- I hope you find a way to get that pre-dinner number back where you want it!
__________________
Holly
Mom to Aaron, 17, Type 1 Sept. 05
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