# 30g carb supper and no insulin - yes or no?



## Amanda102 (Apr 28, 2012)

Hi all, since my daughter was diagnosed she was told to have supper of about 30g starchy carbohydrate about an hour before bed and to do no additional insulin injection.  This seemed to work fine for a long time, but now she has started to have really high readings in the morning (16 ish).  I did recently query with the nurse whether she should still be having this supper and she advised it, saying she felt it was a long time to go without food from tea to breakfast.  It just doesn't make sense to me now.  If she is hungry she could still have supper and inject so that's not really an issue.  I think I will reduce to 10g tonight and see how she goes (I must admit I have a fear of her going hypo during the night so I am a bit anxious to disregard what the nurse said!).  Does anyone else give their child a 'free' supper? Any views or advice gratefully received!


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## MeanMom (Apr 28, 2012)

Hi 

Never ceases to amaze me the different advice given by different Health care professionals  

We were told a snack no larger than 15 carbs at bedtime without insulin (so milk and a cookie as this was Pre Dx supper too). If your daughter needs more carbs than this to keep levels up during the night then something is wrong with the amount of insulin she is having IMO (ie she is having too much)
If she is so hungry as to need such a big snack I would suggest she needs more food for her evening meal. 
We like K to go to bed on slightly higher numbers than day time - any lower than a reading of 6 and she has another biscuit.
Those numbers you give are too high as waking levels (IMO) on regular basis - if it was us I would be giving a smaller snack at supper and if still a problem
 increase long acting insulin. 

You will need to be prepared to test during the night (if you feel the need). 

Good Luck


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## Pumper_Sue (Apr 28, 2012)

Hi Amanda,
if your daughters basal is set correctly she will not go hypo if she has no supper.
Any carbs eaten whilst on a pump have to be bolused for unless correcting a hypo or perhaps  when exercise is sprung on her with little warning so not having time to reduce bolus.

Do you have the book pumping insulin by John Walsh? (Amazon) If not the best investment you will ever make


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## MeanMom (Apr 28, 2012)

Sorry missed that you were pumping - so I'm sure Sue's advice is correct.

Think we were both saying 'No' to 30g carbs without insulin!


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## Hanmillmum (Apr 28, 2012)

Hi Amanda, what regime is your daughter on ?

Just seen she is pumping! (pay attention me!)

My daughter has her supper of a drink of milk at 6.30pm (very early) as bed is around 7pm, it is 10g carbs, we don't bolus but cover for it with her tea-time bolus being a bit higher. (if that makes sense) Her nights are so long at this age but the carbs need covering or she would be high all night (and 12 hrs running high is too much) If it were me I would try a lower carb supper or if you know  your basals are correct you could cover with the bolus. 30g free seems such a large amount not to cover.

Best of luck with those numbers


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## Amanda102 (Apr 28, 2012)

Pumper_Sue said:


> Hi Amanda,
> if your daughters basal is set correctly she will not go hypo if she has no supper.
> Any carbs eaten whilst on a pump have to be bolused for unless correcting a hypo or perhaps  when exercise is sprung on her with little warning so not having time to reduce bolus.
> 
> Do you have the book pumping insulin by John Walsh? (Amazon) If not the best investment you will ever make



Thank you!  I have been onto Amazon tonight and ordered the book - it certainly gets great reviews.  She was 13 when she checked her levels this evening so she did not do a correction and went without any supper (she didn't want any - I wasn't starving her!).  I will just see what she is in the morning and go from there.  I think we may have a bit of adjusting to do to her basal levels over the next few days.  

It seems to just be one hiccough after another!


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## Amanda102 (Apr 28, 2012)

Thanks everyone.  I think I am going to have to see how things go over the next few evenings/mornings!  I agree that 30g seems a lot....


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## trophywench (Apr 28, 2012)

Oooh dear Amanda, best both of you get used to hiccoughs, mate.

3 months ago my insulin needs plummeted dramatically, hypo city.  reduced everything and got some stability for about 4 weeks, since then off we go again back in the direction we just came from.

I don't think anyone could possibly say I've got honeymoon period woes, teenage or menopausal woes or anything else that actually has a name, woes.

It just happens ......


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## Adrienne (Apr 29, 2012)

Hiya

When we were on mixed insulins and MDI then yes my daughter had to have a bedtime snack but no more than 15 cho.

On a pump though there is no need for any free snacks in theory.  Not convinced your DSN actually knows how pumps are supposed to work, really odd.

If the basal rates are ok then in theory no food is needed at all.  In theory you can go all day and all night with no food and the basal will keep you ticking along.

If your DSN thinks that all children need a bedtime snack because its a long time to go then she is still thinking along the lines of MDI or mixed insulins. 

Do you night test at all?


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## Amanda102 (Apr 29, 2012)

Adrienne said:


> Hiya
> 
> When we were on mixed insulins and MDI then yes my daughter had to have a bedtime snack but no more than 15 cho.
> 
> ...



Hi Adrienne. Thanks for that.  My daughter was on MDIs initially and the night snack seemed fine.  Interesting what you say about the pump - makes sense.  My nurse has been excellent in may ways, but I am beginning to realise that she is not always necessarily right!!

I have night tested periodically when there has been a particular issue.  I think I will stop or reduce the snack and test at 0300 for a few nights to see how she goes.  I was told that 0300 is the best time to test as that is when she will likely go hypo if it is going to happen.

This morning she was 5.8 at breakfast with no snack, but she was 13 about an hour before bed.  It's so difficult!!  Fortunately my daughter is a star and I marvel a how well she copes most of the time.


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## Amanda102 (Apr 29, 2012)

trophywench said:


> Oooh dear Amanda, best both of you get used to hiccoughs, mate.
> 
> 3 months ago my insulin needs plummeted dramatically, hypo city.  reduced everything and got some stability for about 4 weeks, since then off we go again back in the direction we just came from.
> 
> ...



Do you know - I find that hugely reassuring!  My daughter is really good at managing her diabetes and wants good BMs all the time, but  I need her to realise that sometimes it will go awry for no apparent reason and it is not her fault.  I tell her that good management is about how she deals with the unexpected results, not necessarily having good results all the time!

Sometimes it is hard being positive and reassuring to her while inside I am panicking!!

I am so glad I found this forum - it has already helped me (and indirectly my daughter) more than I could have imagined.


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