Insulin before Versus after Food?

[Franlee6]

My five year old daughter was diagnosed with Type 1, two days ago whilst on holiday.

Hospital 1 gave fast acting as Insulin dose after counting the carbs of what she’d actually eaten fit breakfast/lunch etc.

Hospital 2 gives fast acting insulin dose pre meal based on what food she’s been served with the view that if She doesn’t eat it all we give her a milkshake/biscuits to ‘make up the carbs’.

The latter feels wrong to me, not only will I be giving my child food that they don’t want/need but I thought the whole idea of carb counting is so a diabetic can eat if, when and how much they like?

Spent yesterday evening trying to make her drink milkshake she didn’t want...

Any thoughts?

 

[Robin]

Hello, Franlee, and welcome to the forum ( in a 'sorry you've got to be here' way) You've got a lot to get your head round.
Most adults taking insulin and carb counting work out the carb count of what thy are going to eat, then dose accordingly ten to fifteen minutes before they eat. This is because the insulin takes a while to get going, so you want it to be there ready to deal with the carbs you are about to eat. With a child, though, as you say, you never know what they're going to eat, so I know that the advice is often to calculate the insulin afterwards for what they've actually eaten. The difference if you do that, may be that the blood sugar spikes up a bit after the meal, before the insulin brings it back down.
There are parents on here who have faced the same dilemma, @Sally71 is one I can think of, I have tagged her so she should see this soon.

 

[Northerner]

My five year old daughter was diagnosed with Type 1, two days ago whilst on holiday.

Hospital 1 gave fast acting as Insulin dose after counting the carbs of what she’d actually eaten fit breakfast/lunch etc.

Hospital 2 gives fast acting insulin dose pre meal based on what food she’s been served with the view that if She doesn’t eat it all we give her a milkshake/biscuits to ‘make up the carbs’.

The latter feels wrong to me, not only will I be giving my child food that they don’t want/need but I thought the whole idea of carb counting is so a diabetic can eat if, when and how much they like?

Spent yesterday evening trying to make her drink milkshake she didn’t want...

Any thoughts?

Hi Franlee6, welcome to the forum 🙂 Very sorry to hear about your little one's diagnosis, your heads must be spinning at the moment! Like @Robin I inject before eating, but it must be quite different when you are dealing with a child. What you might consider is giving some of the insulin upfront and then the extra after seeing what she has actually eaten. Of course, this would mean more injections, so it would depend on how you and she feel about that. Ideally, she would be put on an insulin pump so that there would be no extra injections, just a press of a button. Have pumps been mentioned at all? I suppose it's VERY early days for you, but do discuss it with her team if it hasn't been mentioned so you know how the land lies.

I'd highly recommend getting a copy of the invaluable Type 1 Diabetes in Children Adolescents and Young People by Ragnar Hanas. It's not cheap, but it's packed with information about all aspects of living with Type 1 (whatever your age - I was 49 when diagnosed!) 🙂

For yourself, I'd suggest reading Adrienne's essential guide for parents of newly-diagnosed children, written by one of our members. Also, the charity JDRF have a special KIDSAC for newly-diagnosed children which comes with a free Rufus Bear 🙂

Have a browse of our Useful Links thread for links to more resources.

Please let us know if you have any questions or concerns - no question is considered silly! 🙂 Let us know how things go 🙂

 

[Sally71]

We are pumping so that makes things like this a bit easier! But it's very early days for you, and your daughter is very young! Normally I'd prefer to do the insulin up front to give it time to get going while you eat, but at the moment it's probably a lot easier to do it afterwards when you know how much your child has eaten. They can be terribly fussy at that age can't they, and also she's got to adjust to all this change too! Then maybe as you get into a routine with it you can inject up front for meals you know she likes and will probably eat. Or inject for how much you think she will eat and see what happens, we do this when eating out, being on a pump though means we just need to push a few buttons if an extra dose is needed.

There are many ways diabetes can be dealt with, and no definite rights and wrongs a lot of the time, just go with what works for you! Everyone will be trying to give you advice and a lot of it will conflict, you have to learn to filter out the useful advice from the not so useful. Try things, but if they don't work the try something else until you settle on what suits you and your daughter best. What works brilliantly for one person might be totally useless to someone else!

Oh and I would highly recommend pumps if you get the chance to try one, not everyone does though
They can be hard work, but if you can stick with it they offer even more flexibility. Good luck 🙂