Eating late

[fencesitter]

Hello all
My son William (14) is a month into his new life as a weekly boarder at music school, and having a great time 🙂 He's also doing well on the whole with the MDI. But ...
On Tuesday nights they all send out for a pizza and a couple of times he has joined in and managed OK. However, last Tuesday things went a bit pear shaped. He did what he thought was the correct bolus and woke up the next morning with a bg of 18 😱 feeling really rough. He didn't have any ketones and managed to get the sugars down to sensible levels by the end of the day. He didn't have an infection or anything.
William's now trying to decide what to do next time this situation crops up. He wants to do the same as his friends, but he doesn't want to risk feeling lousy again. He doesn't know if the morning high was due to underestimating the carbs in his pizza, or overestimating and having a hypo in the night, although he thinks he'd have woken if he'd gone v.low. Usually when he has pizza, he splits his dose which works pretty well, but if they eat late he can't really do that as he has to go to bed.
I've suggested that he chooses something else if he's eating late, like chicken wings, or only eats one or two slices instead of the whole thing! I also think it's unwise to stuff food just before going to bed ... 'Matron' might have a view on it too - she was worried by this episode.
William has asked me to post this thread as he's interested in what other people would do in the same situation, and whether you eat late at night.
Sorry that was so long ... looking forward to your replies.

 

[Northerner]

I must admit that I have always avoided eating late, for the reasons you state - I don't like going to bed with active bolus in me. Also, pizza is pretty notorious for being difficult to predict - it can be slow, due to the fat content, but not necessarily so. It's possible that he gave an adequate bolus, but that this had become exhausted whilst the pizza was still digesting, hence waking high. I guess the only solutions are setting an alarm for a split bolus, getting a pump (!) or not having a potentially long-digesting meal too soon before bed.

I can understand that he doesn't want to feel different from his friends, but his diabetes does need to be a consideration when food choices are being made. If, for example, he was coeliac or had an allergy he'd have to choose an alternative, and it may be better to become comfortable with this now rather than establishing a habit of eating unsuitable food. (I'm really sorry if that sounds a bit harsh, I don't intend it to 🙂)

 

[Robster65]

Hi Willsmum.

Agree with Northerner. I've never eaten late by choice and pizza is really hard to deal with. Varying amounts of base, fats, carb and protein which is impossible to predict.

Can also see the importance of joining in with the group. I wouldn't imagine he'd want to be an outsider in that situation.

I hope he finds a solution.🙂

Rob

 

[Copepod]

If it's not too often, then fitting in with friends is probably more important than occasional higher than target blood glucose levels.
However, it's probably still possible to split dose a bit, even if there's only 30 mins between doses, before and after eating.

 

[Northerner]

If it's not too often, then fitting in with friends is probably more important than occasional higher than target blood glucose levels.
However, it's probably still possible to split dose a bit, even if there's only 30 mins between doses, before and after eating.

It's a weekly event though (which I would consider quite often) and my main concern would be going to bed with active bolus, and probably more so with a split bolus. But then, I'm 52 and realise life is very different when you are 14! 🙂

 

[Pumper_Sue]

Hi, the problem with Pizza is the high fat content which slows everything down then bang up goes the blood sugars after the carbs hit the bloodstream.
Most people have to do a split dose for pizza.
The only thing he can do is is try a split dose on the understanding he sets an alarm and tests at 2 AM to see what his blood sugars are like. Or
Matron can earn her wages and check him

Safest option though as you have already said is to choose something else when eating so late, and save the pizza for a different time of day.
It sounds to me as if your son has his head screwed on firmly in the right place.
As he is doing so well with his carb counting and looking after himself, would a pump be an option for him, with perhaps a CGM option thus it will alarm if he goes to low when indulging in late night scoffs with his friends?

 

[fencesitter]

Hi again. William has just read all these posts and says he found your ideas very useful. He thinks for the time being he's going to join in the late night eats but go for something less carby/fatty.
(Agree that a pump might be the way to go, but he's not keen at the moment. His consultant is quite pro - William has lymphoedema in his legs as well, which restricts the number of injection sites and means even more vulnerable feet. W says he might think about it but not yet!)
Thanks again everyone 🙂