Carb Counting

[Tom1982]

We’ve been carb counting now for a couple of weeks now. Using an Accu check meter and all going well. My question is (probably a daft one) is there a max amount of units of insulin we should be giving in a single dose? Our daughter is 4 and most of the Novorapid doses have been under 4 for her dinners and so on. If we decided to have a big dinner and the meter is showing a dose of 6 is there any problem giving her that?

 

[Inka]

There’s no max dose of insulin. People need what they need. Some people are on more than 100 units a day.

However, as your daughter is so young and so recently diagnosed, I’d just be watchful for hypos. Better to be slightly high than risk a hypo.

 

[Tom1982]

There’s no max dose of insulin. People need what they need. Some people are on more than 100 units a day.

However, as your daughter is so young and so recently diagnosed, I’d just be watchful for hypos. Better to be slightly high than risk a hypo.

So it wouldn’t be detrimental to give her a 6 or 7 if the dinner warranted it? The meter was given to us by the dietitian who had limited it to 4.5. Still not sure why.

 

[Inka]

In theory it would be ok @Tom1982 but I’d be anxious about giving a larger dose especially close to bedtime. I think if it was me, I’d up the carbs gradually to make sure her ratio worked rather than suddenly jump up a few units. That’s just me being ultra-cautious.

Also, more insulin/a larger amount of carbs can act slightly differently. So the pattern of blood sugars you see after might look a little different.

It would probably be fine but a bit of caution is best. You can always check with her DSN and get the go-ahead for the future.

 

[Inka]

I’m a smallish adult and have had Type 1 almost 30 years. 6 to 7 units tends to be my max dose for meals. Occasionally I’ll have more but I find that if I ate enough carbs to need, say, 12 units, my blood sugar would go a bit wonky - usually spiking high then hypo later, or annoyingly vice versa. The blood sugar profile isn’t so smooth. I get anxious having all that insulin sitting there releasing at an unpredictable rate, along with my digestion being different due to the increased carbs. I’ve found there’s a certain carb point above which things are harder to control. This point depends on the individual.

I don’t know what the equivalent amounts would be for a young child and always I’d be very careful of hypos. Yes, I know I’ve mentioned them repeatedly, but they can’t be mentioned enough, especially in the early days.

 

[Tom1982]

I’m a smallish adult and have had Type 1 almost 30 years. 6 to 7 units tends to be my max dose for meals. Occasionally I’ll have more but I find that if I ate enough carbs to need, say, 12 units, my blood sugar would go a bit wonky - usually spiking high then hypo later, or annoyingly vice versa. The blood sugar profile isn’t so smooth. I get anxious having all that insulin sitting there releasing at an unpredictable rate, along with my digestion being different due to the increased carbs. I’ve found there’s a certain carb point above which things are harder to control. This point depends on the individual.

I don’t know what the equivalent amounts would be for a young child and always I’d be very careful of hypos. Yes, I know I’ve mentioned them repeatedly, but they can’t be mentioned enough, especially in the early days.

Brilliant advice thank you. Little oaf is like an eating machine at the moment!!!

 

[Lily123]

There’s no max dose but watch out for hypos. Because of how much insulin I need when I had a big breakfast I needed 40 units - the pen only goes up to 30 😱.The reason the dietitian would have set a max dose on the machine is probably incase you accidentally put in the wrong amount

 

[Pumper_Sue]

So it wouldn’t be detrimental to give her a 6 or 7 if the dinner warranted it? The meter was given to us by the dietitian who had limited it to 4.5. Still not sure why.

Being such a little one I suspect it has a lot to do with lumps and bumps under the skin.
Not sure if I dare ask but how many carbs is your daughter having at meal times? I ask because I rarely go above 5 units for a meal 🙂

 

[Sally71]

If you’ve carb counted correctly and it says you need 6 units then you need 6 units, there’s no maximum amount. Be careful though, what are you going to do if you inject all that insulin and then your daughter decides she’s full up before she’s eaten all the carbs? You can’t take the insulin out again!

Maximum limits can be set on pumps and meters as a safety measure in case you accidentally enter a wrong amount (don’t want to be giving 15 units instead of 1.5 for example 😱). No reason why you can’t have a discussion with your medical team and increase the limit a little if it’s appropriate.

 

[Tom1982]

Being such a little one I suspect it has a lot to do with lumps and bumps under the skin.
Not sure if I dare ask but how many carbs is your daughter having at meal times? I ask because I rarely go above 5 units for a meal 🙂

Really???? I think she’s going to take after me (6ft 3 and 17 stone) she’s already head and shoulders above everyone in her class. Since she has been getting her insulin she’s a machine. Probably out eat me at the moment!!! I think the boss is managing to keep her meals between 40/50g of carbs but to be honest it ain’t easy.

 

[trophywench]

Well increase summat else instead of the carbs then! It is 100% true that the more easily eaten carby c**p we eat, the more we WANT to eat - it changes something in the brain - that TV doc, the twin did a Televised experiment screened last year which proved that. If she feels properly full, hopefully she'll know she's had enough.