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Sensible Chocolate Advice?

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Tina63

Well-Known Member
Relationship to Diabetes
Parent of person with diabetes
We have already as a family received 2 big tins of chocolates this Christmas. I know we all say there are these misconceptions that people with diabetes can NEVER eat chocolate again, but how would you all deal with this? I really had hoped people would have more sense that to buy chocolates for us this year, but it seems not. (Sorry if I sound ungrateful but it will just add another problem to the list).

My son loves chocolate, and I understand the whole thing of him eating them post-meal and bolusing for them accordingly, so how many would anyone eat at one sitting if it was treated as pudding? I will literally have to hide them somewhere or he will be constantly picking at them throughout the day and they will be gone in no time. I assume there will be some nutritional information on the tins but if not, how many grams of carbs would you say are in each chocolate roughly please? Roses and Celebrations I believe! Thanks.
 
I'd say each chocolate is around 7g carbs and a reasonable 'pudding' amount for me would be 4-5 chocolates, although your son may think it should be more! The problem with bolusing for them is that the larger the bolus, the greater the likelihood of either a miscalculation or the peak of the chocolate and insulin not coinciding, resulting in a high or low level. I'd definitely put them out of reach and try and fill him up with other, less carby, things if at all possible. Good luck! 🙂
 
Thank you for that information both of you. I am going to have to hide them and dish them out a bit at a time. The 'norm' round here is for me on the day after Boxing Day to think "Oh I fancy a chocolate", open the tin, to find half of them gone and all the horrible ones left as quickly as that. He truly is a glutton. Personally I can only stomach 2 or 3 at a time, so to go for one when I feel I fancy one can end up disappointing. A neighbour brought an unwrapped tin round last night and he was pestering all night to be allowed to open them. They are now hidden!

Maybe it can be a bit of bribery with this new insulin regime - prove to me you are doing it, or at least testing, and I will dish a couple out each mealtime. At least if I have some idea how many carbs he could have 3 or 4 after dinner each night until they are gone.
 
Perhaps re wrap them and give them to someone else as a gift.
This way you wont have the worry and Son wont be able to just eat at will.

Could you then get a pack of fun size chocolates and dish out a couple at meal times that way they gone very quickly as not that many in a pkt.
 
The complicating factor is that different types of Roses and Quality Street have different nutritional content - the values per 100g on the packets assumes eating an equal ratio of each type eg all chocolate has higher fat and lower carbohydrate than all toffe and chocolate covered toffees are different. However, difference for, say 4 chocolates / toffees / creams isn't huge, so probably not worth worrying about at Christmas.

While people giving chocolates to your family may appear inconsiderate to your son's situation, it's equally possible that they don't want to change things for other members of your family. I certainly wouldn't want to be used as an excuse for fewer chocolates in the house, although I realise that my situation (female, diagnosed as adult, never been overweight) is different - I eat chocolates before a bike ride / walk / run / kayak (well, not walking, running nor kayaking this year due to knee injury) or after a meal, and my blood sugars and weight remain pretty constant through the holiday season.
 
Oh dear, I have a confession to make.
I buy the girls a tin of chocolates each for Christmas, always have done. Carol gets a Quality Street and Fi a Celebrations.
We then have them as a pudding after the evening meal, shared between the 4 of us. I usually allow 4 chocs each.
I usually fill a small plastic box with some of each tin and hide the big tins.
 
**sigh*** o dear Tina, you really have got your work cut out here:(

I think this is a tricky one, because on the one hand it sounds like your son needs to be completely re educated about eating, but on the other hand you don't want to 'spoil' Xmas by being heavy handed.

My daughter was Dx 2 weeks before Easter and she already had 6 Easyer eggs in the cupboard! We rationed them out gradually, but fortunately I did not have to hide them as she was very good. But if your son is likely to sneak any food you will have to hide it I'm afraid. :(

As I've said on your other post IMHO he needs help (councellor and or dietitian) to deal with all these changes to his life style. But a few treats over Xmas won't hurt.
 
Monica said:
Carol gets a Quality Street and Fi a Celebrations.
We then have them as a pudding after the evening meal, shared between the 4 of us. I usually allow 4 chocs each.
I usually fill a small plastic box with some of each tin and hide the big tins.
Click to expand...

I really do think that's the way to go with the ones we have. At the end of the day they are here as gifts, and we were told right back at dx that it was fine to have a chocolate bar/biscuit/cake as part of his lunchbox, so why not have 3 or 4 chocolates for pudding once a day, as long as he has the insulin to cover them. That's of course IF he has the insulin to cover them.

As you have experience of the mixed insulin, were you given fixed amounts to eat at fixed times? We have come away with very little actual knowledge about that part of it, just told it has an 8 hour life, to inject 15/20 mins before breakfast, then if he has is lunch at break (10.30) which is what he does, he will need a snack at proper lunchtime (1ish) to avoid an afternoon hypo. No talk of how many carbs per meal though, so don't know what we are really doing, Just told 20u of the mixed one. Not even sure what it's called until we collect it, memory like a sieve I'm afraid!
 
I think it's going to be a case of allowing him to decide what breakfast and snacks he's having as I very much suspect if you allowed him free range on this, that over the days it would actually work out that he's eating similar intake of carbs each time.. And seeing how the injections pan out..

I suspect that the combination in the morning of 3 insulin's actions, his background, and the mixed insulin should give him quite a good rein without BG's going through the roof..

Sorry I can't be any more help than that..

As to the sweets..

I think that you do need to put a daily ration, but also try to give him some choice to how he consumes his ration so he feels that he still has some control left.. Advice him that yes if he eats just one, then there's no need to inject as it isn't going to have the greatest impact on his BG's, but if he's going to eat 2 or more, then he needs to inject which would mean it's better to have them at a meal time..

I would point out that you do not want to treat him like a two year old, but if he's starts taking sweets or abusing his rations, then you have no other option than to treat him like a two year old, and sweets will be taken away..

It would also be helpful, if the whole family join in with rationing and see who can eek out their ration the longest during the day..
 
Tina63 said:
As you have experience of the mixed insulin, were you given fixed amounts to eat at fixed times? We have come away with very little actual knowledge about that part of it, just told it has an 8 hour life, to inject 15/20 mins before breakfast, then if he has is lunch at break (10.30) which is what he does, he will need a snack at proper lunchtime (1ish) to avoid an afternoon hypo. No talk of how many carbs per meal though, so don't know what we are really doing, Just told 20u of the mixed one. Not even sure what it's called until we collect it, memory like a sieve I'm afraid!
Click to expand...

Carol was on Mixtard (injected with syringe) for the first 3 months, then when we wanted to use a pen, they changed it to Novomix30. With Mixtard we had to inject 30 minutes before eating. With Novomix 30 we injected straight before eating. I suspect he'll be on Humulin3, which is very similar to Mixtard.
We weren't told anything about carbs either😱 (almost 5 years ago). We were told when to have a snack, when to have lunch and when to have dinner/tea and when to have a bedtime snack. The snacks - they told us she should have a piece of fruit. When I said "what's fruit?", she said OK, have 2 digestives. So for a while Carol had 2 digestives or hobnobs in the morning and 2 in the afternoon and 2 at bedtime (and 2 in the night if hypo!!!) I felt that was rather a lot of biscuits a day, so I looked how many carbs 2 digestives/hobnobs were and found alternatives with a similar amount of carbs. At night I ended up making her marmite toast in preference to 2 biscuits. With the meals I can't remember how I did it, but she ended up eating the same amount every time (by eye). I was never shown about carbs until Carol went on 3 jabs a day. Before D Carol was a good eater, only a little fussy. Now she's very fussy and I think that has something to do with having been on the mix and me "force" feeding her.
When Carol went on 3 injections a day the bedtime snack fell away, which Carol was quite pleased about.
Carol was very relieved when she went on MDI, because she didn't have to have the snacks anymore.
And now on the pump, she eats too much rubbish and has put on a bit of weight and moans about it non-stop!
 
Oh boy mixed insulins eek !

I was all ready there to dish out some help thinking your son was either pumping or on MDI (Multiple Daily Injections) and then read 'mixed'.

I am taking it he is newly diagnosed ish. Have you had a read of the new 'sticky' in the parents section. It might explain some bits about things.

Mixed insulin is a nightmare to get right. So I'm presuming he is on two injections a day, once before breakfast and once before tea time.

It is presumed that the fast acting bit of the morning injection will cover lunch time as well. Oh dear that always worries me. I would not give sweets at lunch time on mixed. I would at tea time but you can't up the dose of the mixed insulin to cover the chocolate as it will have a knock on effect on the long acting insulin bit of that injection.

My daughter was on mixeds from 5 weeks old until about 3 to 4 years old as there was nothing else, just to let you know I'm speaking from experience and not stabbing ('scuse the pun) in the dark here.

It is very rigid. However we did manage (after a fashion and not very well) a few Christmas'. I think we pretty much avoided anything sweet except the odd chocolate. I think I remember letting her have a few but only chocolate, none with any fillings in as it would just shoot her levels up.

I think you may find this.

I guess my way of thinking is watch the levels, if going high then drink plenty of water anyway, and let him have a few chocolates with breakfast (yep seriously) and at tea time. If he insists on lunch time then go with it and let him, it is only one or two (if you count Boxing day) days.

Do you know about ketones? Have you a blood ketone meter? If he does go high then you may need to do the odd ketone test.

However your son is newly diagnosed then he may be in honeymoon so have fingers crossed it will all be ok and a bit easier to manage.

Just don't panic, go with the numbers and not much beats a mother's gut instinct, seriously.
 
Hi Adrienne,
Tina's son has major problems with denial at the moment. So unfortunately he isn't taking his insulin as he should be hence the mixed being prescribed for him in the hope he will comply.
 
Adrienne said:
Oh boy mixed insulins eek !

I was all ready there to dish out some help thinking your son was either pumping or on MDI (Multiple Daily Injections) and then read 'mixed'.

I am taking it he is newly diagnosed ish. Have you had a read of the new 'sticky' in the parents section. It might explain some bits about things.

Mixed insulin is a nightmare to get right. So I'm presuming he is on two injections a day, once before breakfast and once before tea time.

I guess my way of thinking is watch the levels, if going high then drink plenty of water anyway, and let him have a few chocolates with breakfast (yep seriously) and at tea time. If he insists on lunch time then go with it and let him, it is only one or two (if you count Boxing day) days.

Do you know about ketones? Have you a blood ketone meter? If he does go high then you may need to do the odd ketone test.

However your son is newly diagnosed then he may be in honeymoon so have fingers crossed it will all be ok and a bit easier to manage.

Just don't panic, go with the numbers and not much beats a mother's gut instinct, seriously.
Click to expand...

Hi Adrienne

Thanks for your very informative note. He is not that newly diagnosed, almost 1 year, end of December last year. He is almost 17 and going through rebellion with it all. He was conforming brilliantly for a start and was on MDI and everything was going so well.

When he sat his GCSEs in the summer he let things slip a bit as he was scared of having a hypo mid exam, so started skipping the odd Novorapid at breakfast or lunch, depending on when his exam was. HbA1c was 6.1 in June so hospital very pleased, and I think they almost gave him the green light to skip the odd one by saying it was obvious he was still managing to get it under control later in the day.

By his next appt, September, he had skipped more and more, blaming lack of routine having been off school since end of exams, and it had risen to 9.1. They were very nicey nicey with him then, and he promised faithfully to get back on track. He didn't.

Here we are another 3 months later, HbA1c now 12! He has blamed moving into 6th form and with a completely new group of friends (his best mates all left) and says he isn't comfortable testing or injecting at school. He doesn't test - full-stop! Last tested 17th November! He does always faithfully do his Lantus, but only the occasional Novorapid, hence the current situation.

Because of that, his consultant said that something has to start working for him, so after giving him 3 options - staying on MDI, moving to twice a day, or this third compromise which he has taken is Humilin first thing to cover 8 hours (and obviously school hours), then Novorapid for after school snacks and dinner, and Lantus still at night. So he is going to be on 3 different lots, the big selling point seemingly being that he can get away without injecting at school.

All they really said was what does to give - 20u Humilin, 25 Lantus and 1:10 Novorapid in the evenings, but no advice about how much he should eat during the day. He's 6'2", 15st and almost 17, eats ridiculous amounts, so it's going to be a real trial. They have told him he needs to test regularly so they can see if they get the doses right, and the only advice was that as he eats his lunch early at morning break at school, that he will need a snack at lunchtime, but didn't say how much.

It looks like tomorrow will be the earliest we can get the new insulin, so he probably won't start it until Friday, so could make for a very interesting Christmas! I guess the only saving grace is that he is not at school or work (he has a weekend part-time job) for the next few days whilst we get this up and running. If, of course, he goes ahead and uses it.

I kind of feel frustrated it has come to this, because I KNOW MDI works for him, but of course if he won't do as he is meant to, things are spiralling out of control and the hospital obviously are trying all they can to bring him back into line. I think I will try and get hold of our DSN this morning (it's her office hours Wed morning) and just clarify a few things regarding the eating, and also wondering what will happen if he lies in until 11 or 12 - what would happen then as we would want our evening meal before 8pm. Does he just not inject for that if we eat at 6 and risk going high later, or what do we do? Oh I don't like change!

We do have a ketone meter - but he won't use it! Had a 26 the other week (after 16's a bit earlier in the day) on a day I insisted he tested as I knew he was high, and I asked him to check for ketones too, and he point blank refused. I guess he was scared what could happen, as it was us self-diagnosing his diabetes in the first place and I am sure he feared a hospital admission, so I got him to drink, have a small snack and big slug of insulin, and it did come down sensibly. I don't obviously know how bad the ketones were on that occasion.

Thanks for the advice on the chocolates though. He will be more than happy to have some for breakfast I'm sure :D
 
To Carol

Oh I wish my son didn't have an appetite!!! Nothing is ever enough for him, and anything I do have in he considers 'c**p' unless it truly is 'c**p' ('scuse the language - teen-speak!) He never stops eating, which I know is again at odds with diabetes. He does drink a lot too - Pepsi Max being his thing - in fact I would go so far as to say he is addicted to that now. Still, there are far worse things to be addicted to, and I do have the theory that at least it's sugar free drink and not food going in. The dietician suggested that early on, before meals, to fill him up before he eats - doesn't work for him!

Maybe a month or two on this, if it causes problems, will make him see the error of his ways and he will beg to go back onto MDI. Being seen in a month, just by the nurse so don't know that she will do an HbA1c, but she wants to see figures in the new diary she has given him. I'm very mixed about the changes happening over Christmas, but at least we will be all together as a family so we can keep a close (but not obvious) eye on him rather than worrying where he is and what his levels are up to. Something to be grateful for I guess.
 
Tina

With every post your son sounds more and more like me at his age. I too used to drink loads of Pepsi Max at my hieght during the Summers I would drink a whole 2 litre bottle of Pepsi Max a day, possibly I was just getting rid of the sugar. One nasty side effect of that is it does leave you very gassy and windy which has been a problem I have still even though I have cut my in take down quite a lot I was diagonosed with IBS.

Yes he will eat a lot his body is still making a lot of new things and prolly will for the next two years so will need a lot of energy mostly from his food. The problem with the Chocolate etc is if he is like me he will find it and help himself. My mom thought I could smell out chocolate no matter where she hid it. Diabetics like myself have an amazingly large sweet tooth and WILL indulge it simple as that. It is a real piggy.

I have been thinking about your whole situation if you'll forgive me and you don't say what part of the country you are from might it be an idea to see if you could bump into Shiv, or say some of the Circle D people who can maybe illistrate that living with diabetes is quite normal.

One of the problems in the Western World is this false idea that to be popular and have friends you have to live this perfect life which is a total falacy and needs to change why I wished that girl who was Diabetic on X Factor 'Amilie' sorry never watch it had won and then when being interview would get on with her diabetic care (Blood testing and possibly injecting) without stopping.

Hope all this helps sorry if I sound a bit doom and gloom.
Marc
 
Hiya Tina

I'm so sorry, I had no idea. I just dip in and out of here when I have a minute.

Have you thought about joining the teens Children with diabetes email group. There parents of teens on there who are ahead of you in the 'game' with older children who have done that rebelling stuff and others who are going through it with their teens as well. There are boys that eat their mums out of house and home, girls and boys missing injections at school for the same reasons.

Even if you can't change anything now with your son, just being in touch with other mum's who 'get it' may help you.

Take a look www.childrenwithdiabetesuk.org

I too recommend getting in touch with Shiv. She is marvellous.

Actually I think 1 year diagnosis is still very very early days. At your sons age he is going through the process a bit like us mums in mourning the loss of his 'normal' life. Don't shoot me down in flames here everyone with diabetes as I know everyone leads normal lives but to a teen this is the end of the world and the end of his life as he knows it.

He'll come out the otherside but when, who knows.

Take a look at the teens email group Tina, you can join and put the same message there and you can always un join if you like.

Take care.
 
I would say,Adrienne, that we don't lead a normal life (if anyone does? 🙄).

Our 'relationship' with food is not normal. We have to see it as carbs/100g and have to then slot it into the day. We also have to be more in tune with our bodies and try to guess the state of the glucose/insulin cycle.

Then there's the injecting and testing regime that for some of us isn't really a social problem, but for others is a huge obstacle and carries taboos.

I always feel that the 'normal' tag is just a way of sweetening the pill but for me it's easier to see it as it is. A bit of a strange way of life but it enables us to carry on within the normal world, much like others who have to adapt for various other reasons, soem visible, some not.

Sorry if others feel different, but for me, it's a lot easier to see it this way than try to do things like others do. We can do them, just differently.🙂

Rob
 
Robster65 said:
I would say,Adrienne, that we don't lead a normal life (if anyone does? 🙄).

Our 'relationship' with food is not normal. We have to see it as carbs/100g and have to then slot it into the day. We also have to be more in tune with our bodies and try to guess the state of the glucose/insulin cycle.

Then there's the injecting and testing regime that for some of us isn't really a social problem, but for others is a huge obstacle and carries taboos.

I always feel that the 'normal' tag is just a way of sweetening the pill but for me it's easier to see it as it is. A bit of a strange way of life but it enables us to carry on within the normal world, much like others who have to adapt for various other reasons, soem visible, some not.

Sorry if others feel different, but for me, it's a lot easier to see it this way than try to do things like others do. We can do them, just differently.🙂

Rob
Click to expand...
That makes a lot of sense to me Rob. It's exactly how I feel about living life with the Big D.
 
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