Hi Shivles. I have been reading your posts for some time, both here and elsewhere and have enormous sympathy for you. There is so much information, but diabetes is a difficult condition to manage. My son is older than your child but there are similarities as he has special needs, and therefore appears much younger, is very small for his age and completely dependent on me to make all decisions about his treatment and diet. My wishes therefore are that he should have as normal a life as possible, whilst maintaining the best levels achievable in difficult circumstances. I know that it might be controversial to say, but I do not believe that it is possible to maintain excellent levels and continue to eat in the same way that you did before diagnosis. You can bolus early, bolus again later and try everything but it will never quite work out as far as I can tell. They don't have functioning pancreases and MDI does not mimic that at all. I won't touch on pumps as we don't have one at the moment but I will comment on food. The way that we have mostly achieved good results is to subsitute foods for carbohydrates that my son had previously. Breakfast seems to be a nightmare for most diabetics. My son used to love his toast and porridge but it just does not work for him. I don't like him going into double figures so we don't have carbs for breakfast. However, if you do want bread, there are low carb options that can be substituted and will limit the rise that you get. There is high protein bread from Lidl (and I believe some other manufacturer has just introduced a similar range), there is Bergen and Liv Lo (Sainsbury) and another that you can get in Waitrose. They all taste pretty good but make life easier. I have also substitued other carbs for lower options. There are "no carb" pastas available in most of the supermarkets and a brilliant icecream that has virtually no carbs. I don't tell my diabetic team how we achieve our good HbA1C as I don't think that the NHS have moved with the times. My advice would therefore be to reduce carbs until you get the sort of levels that you would like post meal and then start to carefully introduce some to see how each and every one works. I don't know whether carbs are essential in our diet, I don't have that sort of expertise and of course your child is still growing. I just know what has worked well for us.
i would have an experiment with bread. Try out 50/50 for a week then white bread then brown bread etc. white bread is a much faster acting carb than 50/50 or brown or wholemeal. Even though the slices have the same amount of carbs its all do do with how fast it is absorbed. She may not like the idea of brown bread or non sugary cereal etc but little changes here and there will become the norm for her. I don't know how old she is but kids accept changes must faster than us grown ups lol. Presenting her with a new type of breakfast may be a challenge but keeping it simple with 'this won't make you feel yucky' (hopefully! lol) I also wonder if maybe she gets dawn phenomenon on top of a varying ratio, I would def speak to the DSN about the morning issues x
