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BucksMum

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Hi,
My daughter was diagnosed T1 around 4 months ago. She's 8 and although it's not been easy for her, she has done amazingly well coping with everything. She injects herself and is very keen to be in control of her condition.
We do multiple daily injections but have not her been taught to carb count. I don't feel that her blood glucose levels are particularly well under control at the moment (they are still all over the place) and her hba1c (in June) was 84 (9.8%). Any suggestions anyone has to help us get things more under control would be much appreciated....
Anyway I expect I'll be posting lots in the weeks to come with lots of questions and looking for advice, but just thought I'd say hi!
Thanks!
BucksMum
 
Hi BucksMum, welcome to the forum 🙂 Sorry to hear about your daughter's diagnosis, but it does sound like she is dealing with it very well for one so young! 🙂

I would say it's early days yet as far as HbA1c is concerned. You learn through experience, and I'm sure as time goes on you will be able to make improvements that you are all happy with. Is she on fxed doses then? I'm surprised that carb-counting isn't taught to everyone pretty much as soon as they are diagnosed, after the general dosage ratios have been sorted out. It's not difficult to carb count, really it's just deciding the ratios at different times of day and what adjustments you might need to make for exercise, weather, illness etc. that can be tricky and therefore come with experience. There is a free guide to carb counting at:

https://shop.diabetes.org.uk/store/literature/information-books/carbs-count-e-book.aspx

I would highly recommend getting hold of a copy of Type 1 Diabetes in Children, Adolescents and Young People by Ragnar Hanas - the 'Type 1 bible'. Also, JDRF do a special children's support and information pack which your daughter might like to have (especially Rufus! 🙂)

Please feel free to ask any questions you may have and we will do our best to help out! 🙂
 
A good possitive attitude !! Sounds like you are on the right track 😎 You have joined a good forum with some good addvice 🙂
 
Hi Bucksmum and welcome from a fellow parent.🙂

It's still very early days for you on such a big learning curve but carb counting will be a very valuable tool in getting things going in the right direction. We were self taught and looks like you may have to be too if your team has not introduced you to this yet.

What sort of regime regarding the insulin is your daughter on ?
 
Welcome to the forum 🙂
 
hey tess

welcome to the forum sounds like you and your daughter are doing well and experience will come in time good luck and enjoy the forum their a great bunch
 
Thanks

Thanks everyone.
My daughter is on a fixed regime, ie same levels of insulin at each mealtime, with the levels adjusted from time to time according to blood glucose levels.
I rang the diabetes nurse today to discuss things as her levels have been high (over 10) over the last few days, and we are increasing her insulin levels in the morning and at lunchtime and we'll see how things go.
I would really like to start carb counting as I feel that would give us better control but the nurse said that the levels of insulin she's on at the moment (between 2 and 4 units at each injection) are too low for carb counting. It's frustrating as I don't feel we h ave things unr control at the moment - the nurse herself said that we should be consistently achieving blood glucose levels of 5-10 at the moment.
Anyway I'll see how we go over the next few days.
Xxx
 
Just wanted to say Hi and welcome from me( mum to teenager 17 dx dec2011) I would try to push for input /support with carb counting - we statrted from day 1
 
Hi and welcom. She may be going through the honeymoon period, as the dose she is on is quite small. If she is this wont last for long and then carb counting is a lot esier. I went through this, some times i was taking just 1 unit.
Why not just add up what carbs she is having now? see how it is affecting her blood sugars? make a diary, and take that to the nurse.
You can get food scales to help you work out what carbs she is having
these are the ones i have.
http://www.lloydspharmacy.com/en/lloydspharmacy-nutriscales-17928
some things like bread, will tell you how many carbs per slice.

But i would not adjust her dose, let the nurse advise you on that side, she/he are trained in this
 
What does Ragnar Hanas say?

ISTR the starting position for children is 1u per 15 to 20g carbs, whereas for adults it's 1u to 10g and you experiment with it after that.

Don't take that as gospel though, but would have thought 1u to 20g would be on the safe side and give room for manoeuvre.

I think !
 
Just to add we are still in the Honeymoon period- dx 19 months now! so this can vary
 
Hi

My son is 8 and we have carb counted from the beginning. He is on 1 unit per 20g for breakfast and 1 to 15 for lunch and dinner with 3 units of Lantus in the evening. I would recommend the Carbs and cals book by Chris Cheyette as it is a quick reference guide and you will be able to get a good idea of how your daughters diet affects her levels. Speak to your DSN about carb counting, it's hard at first but I'm a carb expert now 🙂

Good luck
 
Completely agree about carb counting. We didn't wait for a lesson, bought the Ragnar Hanas book and Carbs & Cals and started from there (you'll get very good at reading the backs of food packets too, and great for your daughter's maths skills :D).
Sliding scales may work fairly well if you eat similar meals all the time, but not if you have pasta one evening and salad the next ... If you keep a record as others have said of how much insulin she had, and what she had to eat, you'll soon start to see what her ratios are. It's a moving target unfortunately, especially during the honeymoon period, but we found that William had pretty good control most of the time if we were vigilant and kept good records. At one point his ratio was 1:75 (a half unit pen comes in very handy here).
 
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