Dietician appointment

[Nikki35]

So, yesterday i had my first dietician appointment. He joined forces with my DN at the hospital and i had a joint appointment with them both. Great!

Bit of history - mum of 4 (oldest 15, youngest 6) yo-yo weight until 5 yrs ago. I used to be 19st and a size 22. Now 11st 7 and a size 12.
Since losing the weight i have a poor relationship with food. I can not sit and eat a whole plate of food. Im a grazer i guess. Since being diagnosed as diabetic in november it has only got worse...

The dietician said i should be aiming for carbs with each meal ideally. I have an issue with the quantities of food and told him so. I eat very little, and if i can skip carbs then i do.

Does anyone else have this going on?
I know im not going to get back to previous weight. And i'm not starving. Just wondered if others have been advised to eat carbs at every meal? Or if there are any grazers out there?

 

[Ralph-YK]

Welcome from a T2.
Carbohydrates: the general advice for everyone is eat carbohydrate and not manage them. Regardless of any condition they have.
As diabetics we need to manage carb (& some insulin too).
As you're type 1 I take it you're on insulin. Ask for a carb counting course (Dafne?).
You'll also need to self monitor. Test before and after eating to see what happens (2 hours).
Others here should be able to give more specific T1 advice

 

[Robin]

I think the 'carbs with every meal' for Type 1s stems from the fact that the mealtime insulins we have ( I'm on Novorapid) were developed to mimic the reaction of the pancreas to a 'typical' meat-and-two-veg meal that was typical of what was consumed, say 20 - 30 years ago.
Since that's what we've got to play with, it makes sense to try and match your food to what the insulin is doing. I find that if I don't eat some carb, a meal consisting of mainly protein and fat gets into my system too slowly for the insulin, and I end up hypo after a couple of hours.
The exception is breakfast, where my blood sugar is going up because of the morning liver dump, in which case I find a protein breakfast is my friend, because the insulin first mops up the excess glucose in my bloodstream, followed by the later release from the protein I've eaten.

 

[Northerner]

So, yesterday i had my first dietician appointment. He joined forces with my DN at the hospital and i had a joint appointment with them both. Great!

Bit of history - mum of 4 (oldest 15, youngest 6) yo-yo weight until 5 yrs ago. I used to be 19st and a size 22. Now 11st 7 and a size 12.
Since losing the weight i have a poor relationship with food. I can not sit and eat a whole plate of food. Im a grazer i guess. Since being diagnosed as diabetic in november it has only got worse...

The dietician said i should be aiming for carbs with each meal ideally. I have an issue with the quantities of food and told him so. I eat very little, and if i can skip carbs then i do.

Does anyone else have this going on?
I know im not going to get back to previous weight. And i'm not starving. Just wondered if others have been advised to eat carbs at every meal? Or if there are any grazers out there?

What insulin are you using Nikki? If you are using a once/twice a day slow-acting insulin, plus a faster-acting insulin to cover the carbs in your meals (a regime known as 'basal/bolus' or MDI (Multiple Daily Injections), then it's up to you how much carb you eat, and when, as you can adjust the faster-acting insulin to match the amount of carbs in the meal. On this regime it's not true that you need carbs at every meal - if you are not having carbs in a meal, then you don't have to inject for the meal (although some people find that a carb-less meal still requires some insulin, only experience and testing will tell you this). I do tend to eat carbs at every meal, up to a total of around 100-150g a day in total 🙂 I was a grazer also before diagnosis, but I have modified my eating habits as I don't want to have to inject small amounts of insulin for, say, a bag of crisps or a biscuit - there's also the danger if you do injections too close to one another then you end up 'stacking' the insulin. This means that you still have circulating insulin from your previous injection and inject more, it then becomes difficult to determine how much insulin you have 'on-board', which can make things unpredictable. For this reason, if I snack I'll choose protein-based snacks like nuts or cheese 🙂

 

[trophywench]

Frankly I'm absolutely with Alan Shanley here - everything in moderation. By which I think I should have protein fat and carbs at least at lunch and dinner times.

Annoyingly my BG behaves better if I also have breakfast when 99% of my life I've never actually wanted it!

There will usually be starchy carbs with these meals but doesn't have to be a great splodge of mash pile of pasta etc. Lunch carbs could well be two buttered Ryvitas and some protein - as long as I can measure it and have the right amount of insulin and it's enough cos I'm just not hungry - I'm not bothered. Veg gets eaten with whatever, whenever, as does fruit cos you don't get a balanced diet unless you do.

I have no idea whether anyone approves what I eat - they aren't me and aren't there with meanyway. Easiest thing to do is just say Yes and then eat how YOU want to eat - with the caveats that Northerner has mentioned and providing you ARE getting enough of all the 3 food groups on a regular basis.

 

[Nikki35]

What insulin are you using Nikki? If you are using a once/twice a day slow-acting insulin, plus a faster-acting insulin to cover the carbs in your meals (a regime known as 'basal/bolus' or MDI (Multiple Daily Injections), then it's up to you how much carb you eat, and when, as you can adjust the faster-acting insulin to match the amount of carbs in the meal. On this regime it's not true that you need carbs at every meal - if you are not having carbs in a meal, then you don't have to inject for the meal (although some people find that a carb-less meal still requires some insulin, only experience and testing will tell you this). I do tend to eat carbs at every meal, up to a total of around 100-150g a day in total 🙂 I was a grazer also before diagnosis, but I have modified my eating habits as I don't want to have to inject small amounts of insulin for, say, a bag of crisps or a biscuit - there's also the danger if you do injections too close to one another then you end up 'stacking' the insulin. This means that you still have circulating insulin from your previous injection and inject more, it then becomes difficult to determine how much insulin you have 'on-board', which can make things unpredictable. For this reason, if I snack I'll choose protein-based snacks like nuts or cheese 🙂

Im on the basal-bolus (novorapid and levemir) and i carb count for each meal. I have sometimes over estimated on the insulin but only because i dont take my activity level into account. I'm wondering if the dietician was panicking about my general daily food intake. He also advised me that i was allowed a 2 finger kitkat each morning - happy days!
My morning levels are actually better for not having breakfast. I haven't had breakfast at 'breakfast' time because i cant force food down my neck so early in the morning.
Thankyou for the advice peeps 🙂.I shall continue as I am. I was fairly confident doing it my way so shall keep doing it!