utterly confused!

[hybriduno]

Hi, we as parent s are new to this >4 days in<
Our 8 year old has been diagnosed with type 1 , and today (4 days later) the nurse came to see us.

While she was here she said theres no reason why he can't enjoy the food he used too, as long as there in moderation.

So then came the question, can i have pizza? to which she said yes as long as the fat content isn't to high.

So whats to high....how do we adjust his insulin to it.

we really have been left in the dark with it all and as you can imagine its worrying

 

[Pumper_Sue]

your son can have pizza, it can be difficult to bolus for pizza due to the fat as it causes a very late rise in blood sugar.
So plenty of pizza is needed to test all methods of delivering the insulin at the correct time 🙂

 

[Northerner]

Hi, as Sue says, pizza can be difficult for some and how it affects your son personally can only really be determined by trying it and doing some tests to see what occurs. You might find bev's Pizza Food Experiment useful to see how others handled pizza:

http://www.diabetessupport.co.uk/boards/showthread.php?t=6288

I'm personally fine with it, hope your son doesn't have too much of a problem 🙂

 

[hybriduno]

Thanks guys she basically said that we would need to inject his novarapid after his meal instead of before, so do i check his blood sugar before pizza and give him insulin to suit those blood sugar levels? or do i wait till hes finished eating?

 

[Northerner]

Thanks guys she basically said that we would need to inject his novarapid after his meal instead of before, so do i check his blood sugar before pizza and give him insulin to suit those blood sugar levels? or do i wait till hes finished eating?

Check before eating, then (if he doesn't mind too much!) hourly or two hourly. 🙂 Tell him it will be worth it in the long run! 🙂

 

[everydayupsanddowns]

Quite often Pizza seems to need 2 injections like this:

1. Work out the dose for the whole meal
2. Inject a proportion up front say 50% (you might need to try 40%... 60%... or whatever)
3. Inject the rest of the dose two hours later (or 1 hour... or 3 hours...
4. Test BGs before, and at say 2hrs and 4hrs

That's what Sue meant by experimentation... Keep notes and if it works OK do the same again, if there are highs or lows change one thing and try again. The idea of 2 injections is to 'spread the action' of the insulin to cover the slow absorption of the pizza (fatty things absorb more slowly).

Everyone is very different. First off you might want to try 'all up front' but watch to make sure they don't go low at 1-2 hours after food only to zoom high 3-4 hours later.

Still all that experimentation is a good excuse for lots of pizza!

🙂

 

[hybriduno]

Thanks guy's were finding it all very difficult to get in our heads (lack of nhs information isn't helping), but im sure we will get there in the end
He's excited that he can have a slice of pizza now though 🙂

 

[Pumper_Sue]

Thanks guy's were finding it all very difficult to get in our heads (lack of nhs information isn't helping), but im sure we will get there in the end
He's excited that he can have a slice of pizza now though 🙂

Only one slice 😱 take his temp quick he must be ill
If you google bdec it brings up a carb counting course which will help no end.

Learn together by having carb counting guessing games. This way he learns in a fun way 🙂

 

[Northerner]

Only one slice 😱 take his temp quick he must be ill
If you google bdec it brings up a carb counting course which will help no end.

Learn together by having carb counting guessing games. This way he learns in a fun way 🙂

Here's the link to the course: http://bdec-e-learning.com/

But don't worry if it makes your head spin a bit at this point, your son will still be settling down after his diagnosis and finding the right levels for his insulin 🙂 (took me a few weeks before I started carb counting my food)

 

[everydayupsanddowns]

He's excited that he can have a slice of pizza now though 🙂

That't the GREAT thing about modern treatment methods for T1. There's nothing we can't have any more. Chocolate... cake... pizza... takeaways...

It all boils down to how much and how often... and whether or not you want to put the work in to develop an effective strategy or just decide that a 'challenging' food is just not worth the bother.

Pretty much the only thing I don't eat now is breakfast cereal - I'm sure I *could* but I just don't enjoy it enough to put the work in!

 

[fencesitter]

Welcome to the forum! Good for you for starting to ask questions so soon. I have a 15 yr old, diagnosed 2 years ago. We found essential info from our health care team OK, but if we wanted anything more detailed we dug it out for ourselves. This forum has been fantastic for getting good ideas and support 🙂 On the pizza question, the odd slice might be fine if you just inject as normal, but for a whole one it's definitely worth trying a split dose. Good luck with the experiments

 

[bev]

Thanks guys she basically said that we would need to inject his novarapid after his meal instead of before, so do i check his blood sugar before pizza and give him insulin to suit those blood sugar levels? or do i wait till hes finished eating?

Hi Hybriduno,

I'm afraid that is not good advice. Quick-acting insulins take at least ten minutes to start working so if you inject after eating it doesnt stand a chance at matching the release of carbs. The aim of this is to try to match the peak of insulin to the peak of carbs that are released in the bloodstream.

My son (14) uses a pump and for pizza's we give 45% before eating (at least twenty minutes) and then spread the 55% over 8 hours as it takes this long to digest. On MDI (injections) we used to do two or three injections to match the BG levels. You will get the hang of it but it isnt the same for each person so it will be trial and error and lots of pizza eating!🙂Bev

 

[Northerner]

Hi Hybriduno,

I'm afraid that is not good advice. Quick-acting insulins take at least ten minutes to start working so if you inject after eating it doesnt stand a chance at matching the release of carbs. The aim of this is to try to match the peak of insulin to the peak of carbs that are released in the bloodstream.

My son (14) uses a pump and for pizza's we give 45% before eating (at least twenty minutes) and then spread the 55% over 8 hours as it takes this long to digest. On MDI (injections) we used to do two or three injections to match the BG levels. You will get the hang of it but it isnt the same for each person so it will be trial and error and lots of pizza eating!🙂Bev

I suspect that might be far too much to take in at this stage bev, only 4 days after diagnosis and the first time trying pizza. 😱 You have to start somewhere and I think injecting after eating, whilst it may produce a higher than hoped-for level, is less likely to lead to a hypo. The information gained will be useful for the next pizza experiment when perhaps ( based on the results first time round) the insulin might be given before eating.

 

[bev]

I suspect that might be far too much to take in at this stage bev, only 4 days after diagnosis and the first time trying pizza. 😱 You have to start somewhere and I think injecting after eating, whilst it may produce a higher than hoped-for level, is less likely to lead to a hypo. The information gained will be useful for the next pizza experiment when perhaps ( based on the results first time round) the insulin might be given before eating.

Hi Northerner,

I disagree.😉 I remember spending hours confused as to why things didnt work out and adding up the carbs over and over again thinking it was the maths out - when in reality if we had known from day one that you inject ten minutes before or more this would have taken one of the 'trial and errors' out of the equation so we could have focused on the rest of it. There is nothing more upsetting than being a parent and not knowing what you are doing - or worse still - not being given the right information from the start. Hybriduno is clearly asking all the right questions so it seems to me that she will be more than capable of taking all this information on board and if it helps another parent to get things right then job done!Bev

 

[Pumper_Sue]

she will be more than capable of taking all this information on board

Bev, she is a he 😛🙂

 

[trophywench]

Well that just shows you.

With pizza I don't get a rise at all for abouthalf an hour, then it's modest until 2 hours and dwindles to nowt. Then 5 or 6 hours later - Wham.

So that's the reason you weren't told to do what you worked out to do.

Because it's DIFFERENT for all of us !

 

[bennyg70]

Well that just shows you.

With pizza I don't get a rise at all for abouthalf an hour, then it's modest until 2 hours and dwindles to nowt. Then 5 or 6 hours later - Wham.

So that's the reason you weren't told to do what you worked out to do.

Because it's DIFFERENT for all of us !

Took me 20 years to realise this is what happened to me ... Well done on hearing it after 4 days!

 

[hybriduno]

ok so we went to see the dietitian today and she basically told us some interesting stuff 🙂 which cheered him up 🙂 so my son chose his dinner 🙂 lol he had

pasta in a sauce (30 carbs)
home made pizza (30.2 carbs)
sugar free jelly (0.5 carbs)
Milk shake (27 carbs)

His results so far

before meal 13.3
1 hour after 13.5
2 hours after 11.5
3 hours after 20.0
4 hours after 22.6
5 hours after 24.8
6.5 hrs after 21.5 <12:30 pm
morning level is 11.2 @ 7:30 am

 

[HOBIE]

I keep out of the way of pizza. Too much carbs & feel hungry with only having two or three bits.

 

[Northerner]

ok so we went to see the dietitian today and she basically told us some interesting stuff 🙂 which cheered him up 🙂 so my son chose his dinner 🙂 lol he had

pasta in a sauce (130 carbs)
home made pizza (30.2 carbs)
sugar free jelly (0.5 carbs)
Milk shake (27 carbs)

His results so far

before meal 13.3
1 hour after 13.5
2 hours after 11.5
3 hours after 20.0

Was that all in one meal? That does look like a lot of carbs - I probably only get through about 150g a day, but I'm not his age. There is quite a jump at 3 hours, so it looks like this is the spike - whether it reduces will depend on his 4 and 5 hour readings. If they are still high or incerasing then there is probably insufficient insulin.