Steroid induced diabetes

[Pandy8]

Hello All, I've made it in!
Looking for experiences of steroid induced diabetes, now acquired by my 18yo son. It's apparently T2 but he has 2 pens and everything I can read puts him squarely with the T1s at the moment,a year of treatment including two transplants , over 100 transfusions, chemotherapy, ICU, multiple infections and absolutely zero neutrophils tbh this is almost a sideshow. However, we are trying to get our heads round it all and hoping that we will be able to distinguish from his normal unwell any hypo signs.

 

[Pandy8]

As we live on mainly home-cooked food, I'm finding carb counting very difficult. Is there a list that gives pre-cooked carb values? Everything seems to list cooked. How can I separate cooked veggies to know what values to put on them? What about my usual veggie soups?! Somewhat panicked at idea it might be easier to go ready-made.

 

[Kaylz]

Fresh veg generally on packets give nutrition per 100g as sold, potatoes can be tricky as some state raw weight and others *when cooked according to instructions so be wary when checking potato packaging, supermarket websites give the nutrition information of the products when you click on them and scroll down so always easy to check there too, that's what I did when I was diagnosed xx

 

[Pandy8]

Thanks for your reply. I try not to buy things in packets, so suppose it will be trial and error. That's a good tip about supermarket websites, I'll have a look. Isn't there just a list of what carbs are in which vegetables?

 

[Kaylz]

Thanks for your reply. I try not to buy things in packets, so suppose it will be trial and error. That's a good tip about supermarket websites, I'll have a look. Isn't there just a list of what carbs are in which vegetables?

they give for loose vegetables too, the nutrition can vary depending the country, soil etc it was grown in and breed of potato provides a wide range of carbohydrate values as well, you could try websites like my fitness pal etc but they aren't always accurate so keep that in mind xx

 

[Docb]

A more general question which might help you out Pandy8. How accurate do you need to be? With us type 2's you can focus on a rough total carbohydrate you are aiming for and provided you are close to or below it, then that is good enough. I know things will be different for T1's but I have no feel for whether you need to be right to the nearest gram or to the nearest ten grams. Maybe some T1's could comment. Also, another thread prompted me to look at food labelling and how accurate the carb content on the label had to be. Turns out that estimates, rather than direct measurements are perfectly acceptable. The labels are a good and really useful guide, but they should be treated as a guide, no more than that.

One thing that occurs to me is that with home cooked food containing a number different items in the recipe, you will be a bit high on estimating carb content of some components and a bit low on others and to some extent the errors will cancel themselves out. There is probably no real substitute keeping some good records of meals you make with your estimate of the carb content and then testing to see the effect on your son's BG and then making adjustments next time you have that meal.

Hope that makes sense.

 

[trophywench]

A 60g spud (raw) = 10g carb when boiled and on the plate. Helpfully the guides they handed out when I was diagnosed told me that was an egg-sized spud. Only thing it didn't say was which bird had laid that egg! Seriously - it's a standard hen's egg.

It depends on the persons carb to insulin ratio as to how precise or vague it's OK to be when calculating the insulin to inject.

 

[everydayupsanddowns]

As we live on mainly home-cooked food, I'm finding carb counting very difficult. Is there a list that gives pre-cooked carb values? Everything seems to list cooked. How can I separate cooked veggies to know what values to put on them? What about my usual veggie soups?! Somewhat panicked at idea it might be easier to go ready-made.

Alas one of my old favourite apps ‘Cook and Count Carbs’ is no longer available. It allowed you to construct your own recipes from carb values and then divide by however many portions you were making.

perhaps something like Carbs and Cals (app or book) or the Collins Calorie Counter (book) might help?

 

[Pandy8]

Alas one of my old favourite apps ‘Cook and Count Carbs’ is no longer available. It allowed you to construct your own recipes from carb values and then divide by however many portions you were making.

perhaps something like Carbs and Cals (app or book) or the Collins Calorie Counter (book) might help?

A 60g spud (raw) = 10g carb when boiled and on the plate. Helpfully the guides they handed out when I was diagnosed told me that was an egg-sized spud. Only thing it didn't say was which bird had laid that egg! Seriously - it's a standard hen's egg.

It depends on the persons carb to insulin ratio as to how precise or vague it's OK to be when calculating the insulin to inject.

Jenny, I'm not sure what they want tbh. The paediatric oncologist, who is his usual Dr, gave a pretty wide target range for BG, ( try 4-10 but don't panic if up to 15, just give correction dose) having spoken to her colleague the endocrinologist, and his bolus is 1:10. We have diabetes clinic this week, so with luck more information.

 

[Pandy8]

A more general question which might help you out Pandy8. How accurate do you need to be? With us type 2's you can focus on a rough total carbohydrate you are aiming for and provided you are close to or below it, then that is good enough. I know things will be different for T1's but I have no feel for whether you need to be right to the nearest gram or to the nearest ten grams. Maybe some T1's could comment. Also, another thread prompted me to look at food labelling and how accurate the carb content on the label had to be. Turns out that estimates, rather than direct measurements are perfectly acceptable. The labels are a good and really useful guide, but they should be treated as a guide, no more than that.

One thing that occurs to me is that with home cooked food containing a number different items in the recipe, you will be a bit high on estimating carb content of some components and a bit low on others and to some extent the errors will cancel themselves out. There is probably no real substitute keeping some good records of meals you make with your estimate of the carb content and then testing to see the effect on your son's BG and then making adjustments next time you have that meal.

Hope that makes sense.

I think even a list of relative carb values would be helpful. I'm amazed that this sort of information seems not to be easy to find.

 

[everydayupsanddowns]

There are several nutritional websites, and even Google will now often offer nutrient values for ingredients.

You just have to be a bit careful between UK and US sources, because the US quotes values which includes fibre (and then specifies the fibre to deduct) while the UK deducts fibre already.

 

[Felinia]

I use an online website NutraCheck which can give you the cals and carbs for thousands of items and you can input the specific weight to be as accurate as possible. For example, my breakfast mushrooms weighed 107gm so that's what I input. Also it has a recipe builder so you can input all the weighed raw items, and divide by the number of servings. So that way I have got accurate readings for all my soups and stews. There is a downloadable app for your smartphone so you can carry it round the supermarket. And it works out at less than £2 a week. You get a week's free trial so if it doesn't work out, you can cancel. There are others so no doubt Dr GOOGLE would find them.

 

[Pandy8]

Thank you, I'll have a look at that. Of course it's all very well me looking all these things up and being very careful but my son is on steroids and starving hungry, so keeps snacking.

 

[rebrascora]

Hi
I am so sorry to read that your son is struggling with so many serious health challenges. I wish you all well with that.
Nuts and cheese are good low carb snacking options if he doesn't have any dietary restrictions on fat intake. Many of us here eat a low carb higher fat diet and find that it is easier to manage our BG on such a diet and that we lose weight and the fat and protein keep us fuller for longer, so we are less likely to feel hungry and pick at things we shouldn't. Contrary to popular belief eating fat does not make you fat if you are not piling other high calorie carbohydrates into your system with it and because it takes longer to digest you are not always looking for your next food fix. I appreciate that the steroids will make him more hungry but at least if he is snacking in between meals on low carb treats it will help to prevent his BG spiking too much. Not sure a young man would find olives appealing but they are another low carb option and veggie sticks with a sour cream and chive dip and occasionally a packet of pork scratchings instead of crisps is ok. Boiled eggs are also filling and make good healthy easy snacks.

 

[Pandy8]

Hi
I am so sorry to read that your son is struggling with so many serious health challenges. I wish you all well with that.
Nuts and cheese are good low carb snacking options if he doesn't have any dietary restrictions on fat intake. Many of us here eat a low carb higher fat diet and find that it is easier to manage our BG on such a diet and that we lose weight and the fat and protein keep us fuller for longer, so we are less likely to feel hungry and pick at things we shouldn't. Contrary to popular belief eating fat does not make you fat if you are not piling other high calorie carbohydrates into your system with it and because it takes longer to digest you are not always looking for your next food fix. I appreciate that the steroids will make him more hungry but at least if he is snacking in between meals on low carb treats it will help to prevent his BG spiking too much. Not sure a young man would find olives appealing but they are another low carb option and veggie sticks with a sour cream and chive dip and occasionally a packet of pork scratchings instead of crisps is ok. Boiled eggs are also filling and make good healthy easy snacks.

Thank you for your reply. Yes, we are really hoping for a better year health-wise for him next year, but feel he is not yet out of the woods re the bone marrow failure.
However, if we can at least get his diet right it might help his gut issues as well as the diabetes (which we hope will be temporary).
Thank you for the snacks tips. Curious as it sounds for an 18yo, he has never had a sweet tooth and after losing weight through two transplants, the challenge for him was putting weight on, until he started steroids. He then put on 8kg in 4 weeks and has added the diabetes to his list. He's happy with cheese, nuts, biltong, olives and eggs etc but they don't really satisfy the extreme hunger. I am hoping a reduction in steroids will help with the cravings, but that is dependent upon his condition.