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Tips for carb counting with a fussy toddler

R

rachelk14

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Relationship to Diabetes
Parent of person with diabetes
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Hey all,
My 2 year old was diagnosed last July and since September we have been on Omnipod 5 and G6. To say we are struggling still is an understatement, not a day goes by where we don't have at least one hypo and a pro-longed period of highs, which is making me incredibly nervous for his long term health to say the least. I think our biggest issue is carb counting and getting these accurate - he is SO fussy and unpredictable that I just cannot say whether or not he'll eat something, even if that something is a 'safe' meal or snack. Ensuring he waits 10-15 mins before having a meal can also be an issue, to the point he has demanded breakfast at 6am before and had a complete meltdown when I tried to make him wait, as well as having the opposite issue where it takes him a solid half hour before he takes a bite.
If anyone has any words of wisdom, or tips or advice I'd be more than grateful!
Thank you
 
It’s so difficult. My kid was 8 when diagnosed so we have had fewer issues but it’s still not easy.

We have never prebolused because it just created too many issues. What happens if you give insulin at the time of eating? Would that be a lesser evil?

If he’s hungry then give him food, something low carb if you can and work out the insulin as you go. My now teen will often have a pre meal snack of 10-15g carbs which we then add into the carb count when he has his insulin with his meal.

We have a jar of m&ms and a lot of other snacks that are always acceptable so we often do a rough carb calculation and then offer those or juice to make up for any carbs not eaten. If he won’t even take juice then this makes it harder. And with toddlers they often want to graze rather than have strict meals. If you do snacks between meals that can help balance everything out but it will depend where they are in each growth and developmental cycle as to how hungry they are.

Hypos are common with kids. It’s just so hard to do all the maths and even if you get the maths perfect it’ll be too hot or too cold or a new moon or something else that will mean it’s not right. We have fewer hypos on the pump but even so they didn’t really settle down until he was well into puberty.

As for highs. A managed high (he’s on insulin so being treated) is different from an unmanaged high. And how high is high? We’ve had periods of being in the high teens a lot and still had good hba1c. Obviously that’s not ideal but it’s just how it is sometimes.
 
Hi Rachel. Welcome to the forum

I am not a parent but I am sure others who are will be along with wiser words. Just some thoughts. I find it difficult waiting after injections before I eat but now have developed a routine where I do something specific in that wait time, rather than just ‘not eating. (I suspect I can hear a ‘she clearly does not have a two year old !!!’ coming through the forum).

For fussy eating could you inject for half the carbs before the meal and then top up once you see how much he eats.

With regards to ‘damage done’ with highs. Many of us spent years with no idea what was happening in between meals. The damage comes from prolonged poor control and years of having T1. In these early years you are clearly working hard and doing the best that you can. It does get easier as they get older and I will tag @Tom1982 and @Thebearcametoo who will no doubt be much wiser as they deal with their children.

Keep questions coming. Nothing is considered silly. Just ask
 
Yeah it’s definitely hard work, especially at first and there’s so many tricks and tips to take in but everyone is different and what works for some/most, in our case didn’t. The couple of key things it took me an age to learn are:
* Try to keep calm! Kids are so much more resilient than you think. Josie (my daughter) is 7. She was diagnosed at 4 and we had nightmares with skin/cannula reactions with the Omnipod Dash. This resulted in long prolonged highs up in the 20s for ages at a time in some cases. We carb counted absolutely everything, tried every bolus idea going and even changed insulin types. Eventually you’ll find what works best for you and everything gets that bit easier.
* The consultants and nurses all want what’s best but they don’t know everything. If you’re spotting patterns and think something is worth a try, suggest it to them and have a chat.
And I’m sure you’ve done this, but we set our dexcom alarm to 5.0 so I’m we can treat the low and give it a chance to work before she drops too low.
It does get easier.
 
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