# Confused about carbs



## ScottishThistle (Aug 24, 2017)

Hi all, my daughter was diagnosed with type 1 two months ago and we are doing well considering but I need advice about non-carb meals. She is 8 so is still growing but she eats a very healthy diet and sometimes we find she is having no carbs, such as salmon with salad for lunch. I do not inject any bosul at these times and when the doctor at the diabetic clinic heard this he told me not to do it. Apparently, she needs insulin injecting anyway  - so there was me thinking the insulin is to deal with carbs but now confused if in fact the carbs need to be given to deal with the insulin! It is not very often when she has a no carb meal, she has basal twice a day and bosul with each meal so I don't understand why he freaked out at me!


----------



## Kaylz (Aug 24, 2017)

Sometimes if carbs aren't eaten the protein in the food raises levels too, at a much slower rate though, did the doctor say why?


----------



## ScottishThistle (Aug 24, 2017)

Kaylz said:


> Sometimes if carbs aren't eaten the protein in the food raises levels too, at a much slower rate though, did the doctor say why?


Hi, thank you for your reply, the doctor just said that she needs insulin so I must not give her a carb free meal.


----------



## Sally71 (Aug 24, 2017)

I don't agree, if my daughter eats a no-carb meal we don't give a bolus, and that works fine for us.  You calculate the meal bolus based on carbs and if there aren't any carbs then how do you calculate the bolus?  It's true that protein can raise blood sugar but I've never been given any calculation to work out a bolus for this, and I don't think it raises it very much or very quickly.
Yes your daughter needs insulin, but she's got her basal/long acting insulin working all the time, and that should be enough if she isn't eating carbs. 
Are you carb counting and changing the dose as necessary? If so then you are doing exactly the right thing by giving her no insulin for no carbs. If you are still on fixed doses then it might be worth asking the doctor about carb counting and asking him why your daughter shouldn't miss a dose of insulin if she doesn't want to eat carbs.  As long as she has taken her basal insulin then missing the occasional meal dose doesn't hurt if no carbs are involved.


----------



## HOBIE (Aug 24, 2017)

ScottishThistle said:


> Hi all, my daughter was diagnosed with type 1 two months ago and we are doing well considering but I need advice about non-carb meals. She is 8 so is still growing but she eats a very healthy diet and sometimes we find she is having no carbs, such as salmon with salad for lunch. I do not inject any bosul at these times and when the doctor at the diabetic clinic heard this he told me not to do it. Apparently, she needs insulin injecting anyway  - so there was me thinking the insulin is to deal with carbs but now confused if in fact the carbs need to be given to deal with the insulin! It is not very often when she has a no carb meal, she has basal twice a day and bosul with each meal so I don't understand why he freaked out at me!


Hello & welcome. I have been T1 from the age of 3. I could eat no-carb seafood for England. A few NHS staff are not as good as they think they are Good luck


----------



## Ditto (Aug 25, 2017)

Hello and welcome to the forum ScotsThistle. I am in awe of parents who look after younger ones with D. I don't think I could do it. In fact I know I couldn't so kudos.


----------



## Ash (Aug 25, 2017)

ScottishThistle said:


> Hi all, my daughter was diagnosed with type 1 two months ago and we are doing well considering but I need advice about non-carb meals. She is 8 so is still growing but she eats a very healthy diet and sometimes we find she is having no carbs, such as salmon with salad for lunch. I do not inject any bosul at these times and when the doctor at the diabetic clinic heard this he told me not to do it. Apparently, she needs insulin injecting anyway  - so there was me thinking the insulin is to deal with carbs but now confused if in fact the carbs need to be given to deal with the insulin! It is not very often when she has a no carb meal, she has basal twice a day and bosul with each meal so I don't understand why he freaked out at me!


Hi if my daughter has a none carb meal she always checks her BM first and gives bolus if a correction dose is needed, but if her BM is within normal range she does not inject.


----------



## ScottishThistle (Sep 4, 2017)

Sally71 said:


> I don't agree, if my daughter eats a no-carb meal we don't give a bolus, and that works fine for us.  You calculate the meal bolus based on carbs and if there aren't any carbs then how do you calculate the bolus?  It's true that protein can raise blood sugar but I've never been given any calculation to work out a bolus for this, and I don't think it raises it very much or very quickly.
> Yes your daughter needs insulin, but she's got her basal/long acting insulin working all the time, and that should be enough if she isn't eating carbs.
> Are you carb counting and changing the dose as necessary? If so then you are doing exactly the right thing by giving her no insulin for no carbs. If you are still on fixed doses then it might be worth asking the doctor about carb counting and asking him why your daughter shouldn't miss a dose of insulin if she doesn't want to eat carbs.  As long as she has taken her basal insulin then missing the occasional meal dose doesn't hurt if no carbs are involved.


Hi, thank you for your reply, sorry for the delay in getting back to you, I have just returned to work and having to try and fit shifts in between her injections! I agree with you completely, I am carb counting and at the moment she has normal blood sugars most of the time. The doctors at the clinic can be quite bullish, they do not agree that she should have a non carb meal and told me I have to give her 200g a day (which I would find difficult to do because she has a very healthy diet). I am quickly learning that I can manage her diabetes without their interference. The last visit I came home in tears because one of the doctors accused me of not taking blood tests for a whole 24 hours, was in my face demanding an explanation which I couldn't give because I am always testing her, I then noticed the doctor was reading the meter wrong!


----------



## ScottishThistle (Sep 4, 2017)

HOBIE said:


> Hello & welcome. I have been T1 from the age of 3. I could eat no-carb seafood for England. A few NHS staff are not as good as they think they are Good luck


Hi, thank you for the welcome, I am getting conflicting information from different doctors so I will agree with you, the staff are not as good, in fact I have found this site to be much more beneficial.


----------



## HOBIE (Sep 4, 2017)

ScottishThistle said:


> Hi, thank you for the welcome, I am getting conflicting information from different doctors so I will agree with you, the staff are not as good, in fact I have found this site to be much more beneficial.


I have a mate of mine who WAS T2. But now off beer, food with lots of carbs. & now walks the legs off his poor dog. He shakes his head at some of the advice he get off some nurses. Now off all meds for his T2. He is strong willed but still smokes  You learn every day & good luck


----------



## ScottishThistle (Sep 5, 2017)

HOBIE said:


> I have a mate of mine who WAS T2. But now off beer, food with lots of carbs. & now walks the legs off his poor dog. He shakes his head at some of the advice he get off some nurses. Now off all meds for his T2. He is strong willed but still smokes  You learn every day & good luck


Thank you Hobie, there is so much to learn and it has been a huge shock for us, can I ask you something - one doctor told me that I do not need to worry about hypos in the night because my daughters liver would react and yet another doctor told me I should be testing through the night to make sure she is not hypoing, what is your experience please x


----------



## Sally71 (Sep 5, 2017)

I'd like to answer that too if I may! I was also told not to worry about night time hypos because they will probably wake my daughter up.  WRONG - since having the Libre I have discovered that my daughter can quite easily be low for 2-3 hours and she just carries on sleeping soundly!  Hypos can also happen unexpectedly, no matter how hard you try to adjust basal accurately, allow for exercise during the day and so on.  So after a lot of trial and error I have settled on doing just one test somewhere between midnight and 2am, if she's ok then then I can leave her alone for the rest of the night.  It may be different for you, but I have found out that if my daughter is going to drop low she will do it during the early part of the night, it is extremely rare for her to go low later on. So one test around midnight works for us.


----------



## ScottishThistle (Sep 5, 2017)

Sally71 said:


> I'd like to answer that too if I may! I was also told not to worry about night time hypos because they will probably wake my daughter up.  WRONG - since having the Libre I have discovered that my daughter can quite easily be low for 2-3 hours and she just carries on sleeping soundly!  Hypos can also happen unexpectedly, no matter how hard you try to adjust basal accurately, allow for exercise during the day and so on.  So after a lot of trial and error I have settled on doing just one test somewhere between midnight and 2am, if she's ok then then I can leave her alone for the rest of the night.  It may be different for you, but I have found out that if my daughter is going to drop low she will do it during the early part of the night, it is extremely rare for her to go low later on. So one test around midnight works for us.


Thank you Sally, I was also told that my daughter would wake up! It is such a worry for us but your suggestion of a test is a good idea, as all of this is quite new I wake up in the morning and the first thing I do is check she is still alive! Sounds silly probably but doing a test in the early hours would help, thank you again.


----------



## pottersusan (Sep 5, 2017)

ScottishThistle said:


> Hi, thank you for the welcome, I am getting conflicting information from different doctors so I will agree with you, the staff are not as good, in fact I have found this site to be much more beneficial.


Hi 
Welcome.
In my experience this forum is far more knowledgeable and practical than all the medics I've met put together. there are lots of parents on here who will give you good advice.


----------



## HOBIE (Sep 21, 2017)

Sally71 said:


> I'd like to answer that too if I may! I was also told not to worry about night time hypos because they will probably wake my daughter up.  WRONG - since having the Libre I have discovered that my daughter can quite easily be low for 2-3 hours and she just carries on sleeping soundly!  Hypos can also happen unexpectedly, no matter how hard you try to adjust basal accurately, allow for exercise during the day and so on.  So after a lot of trial and error I have settled on doing just one test somewhere between midnight and 2am, if she's ok then then I can leave her alone for the rest of the night.  It may be different for you, but I have found out that if my daughter is going to drop low she will do it during the early part of the night, it is extremely rare for her to go low later on. So one test around midnight works for us.


The Libre is so good to learn is it not Sally? During the night its great for others to konw what your bg is.


----------



## trophywench (Sep 21, 2017)

Your own instinct on these things is actually far better than the doctors you've seen.

There is a book written precisely for people like you  called 'Type 1 diabetes in babies, children and adolescents' by Ragnar Hanas (though it applies equally to people who are 50 or younger or older.  It is written in English not medicalese.  We always recommend it to the newly diagnosed whatever age they are, and it talks absolute sense and explains why too - which is not only helpful - it could also be very useful if you ever need to 'defend' why you did something 'they' told you not to.

Yes we absolutely DO need to have insulin on board every minute of every day - but that's precisely why they invented MDI using two types of insulin in the first place, and Dose Adjustment for Normal Eating (DAFNE) - you can miss meals entirely if you want to - but of course I would absolutely NOT suggest that for a growing child.

For interest - I wasn't diagnosed with D till I was 22 so I've had it 45 years - but so far, I've never needed any insulin for protein.  And if I say that all starchy carbs are as boring as hell and I couldn't possibly eat them without both protein and fruit and veg (well except chocolate cake LOL) - I do eat protein as often as possible so I do think I should know whether it affects me or not.


----------

