Food schedule and tips

Hi all im 15 years old and diabetic i was diagnised at 9 and at the moment im struggling alot with food schedules and any tips to keep my diabetes under control if anyone could try and suggest any food schedules and tips for me that would be great as im feeling down at the moment and feel like ive hit a brick wall with my diabetes and life. Thanks

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@T1Will HI Will,

what schedule do you want to have? I tried the rigid schedule thing, and I tried the eat the same thing at the same time every day thing, and all it did was make me angry.

you can make insulin work to fit what you want to do, be it sit in school, play football or soccer, climb mountains, parachute… whatever.

I started pumping so that I could eat whenever I want, travel into other time zones, and control my basal so I can sit and watch TV (ha not) or ride my bike and be super active. I don’t really have a schedule, I have my family and my work and my recreation and I make insulin do what I want it to do for me to have this life everyday.,

This whole thing works better if you bend your therapy around what you want to be doing, and not the other way around. soooooo, how do you want to see it?

Hi joe i dont have a pump and im looking for a low carb diet to stop me using so much insulin and to be more healthy i guess.

Hi @T1Will Will, there’s nothing wrong with lo carb/keto/atkins to minimize your insulin, however, you’re 15. Are you at the weight you want to be at? If you are trying to lose weight, minimizing insulin and carbs is very important and likely part of the overall plan. If you’re a lanky 15 year old trying to build muscle and body mass… it’s probably not.

Where are you at? What’s your goal?

Honestly I have never tried a rigid food schedule. I have developed a set of rules when I do eat, and I hope you find them helpful:

-Big meal, big error (or something like that). The higher the carbs and larger the insulin dose, the larger chance your dosing will be off. We are working within an imperfect system (we can never know truly how many carbs we are eating) so if you keep your carb count low your inaccuracy will be low! I tried the Paleo diet which was great because I could eat a lot with very low carbs.

-Don’t eat within 3 hours of going to bed! I find my body may continue digesting at night and leave me with high blood sugar in the morning.

-There is a limit to how much food you can eat in one sitting! If I eat more than 13 units worth of food, my body does not digest fast enough. My blood sugar will go down to normal, but when the insulin wears off but my body will continue digesting and drive up my blood sugar! So if I know I’m eating a meal that is over 13 units, I will need to split it up into two separate injections. But mostly I never eat more than 13 units!

It can be frustrating when you encounter an unknown reason for bad blood sugars. Just attack it like a scientist! Isolate situations, record circumstances and results, and figure out causes/reactions. I’m a counselor and am a fan of the theory of “learned helplessness” when it comes feeling down. feeling down because you feel helpless to control your blood sugar is totally reasonable and understandable! Once you figure it out you will learn that you are fully capable of controlling this!

@joe, we are just starting to investigate the idea of a pump for my daughter. Would you kindly tell more about how it helps with eating routine, basal level and, especially travel? We go to Italy frequently to see my husband’s family. We are thinking about how challenging it will be to count carbs there. There may be a lot of guesswork involved. Thanks!

@cminer hi Cathleen,

All pumps have a programmable basal rate, meaning no more need for a shot of long acting and no more long acting insulin. All pumps use fast acting insulin and deliver basal rates by tiny increments all throughout the day and night.

The best part about using fast acting insulin as basal is you can turn your basal rate up or down, depending on your activity level, it’s not a “shot you can’t take back” like a injection of basal insulin. If you are going to be way more active you just turn down your basal rate by a real number or by a percentage. Thew worst part is that if something happens to the pump, you can be all out of insulin in 4 hours and so therefore you risk very high blood sugar and DKA if you do not test often and have a a backup plan.

Since you travel to another time zone, you don’t have to get a long acting shot at 4AM or other weird time, you just change the clock on your pump and you’re done.

Pumps do not automatically add insulin for meals. All pumps require you to know how many carbs you are eating, and then it uses the fast acting insulin as a meal “bolus”. It uses the same fast acting insulin but pumps in the whole bolus for meals and for corrections. Estimating carbs won’t change with a pump. The only thing that’s easier is you can easily correct if you are a little high after a meal because the pump is already in you and so adding a correction does not mean a separate injection and you can do so very simply.

Pumping with a closed loop pump like the 670g or with a “basal suspend” pump like the T’slim requires you to have a CGM, The CGM talks to the pump and in the case of a low blood sugar it can stop pumping insulin and alarm. .

Only the minimed 670 can add insulin on a high blood sugar. I am not a huge fan of current CGM technology, because of accuracy and reliability, so I don’t use this function.

Everyone that pumps is at a slightly greater risk for local infection, additional scarring, and more prone to DKA. For me, it’s not that pumps are the greatest thing ever… it’s that, for me, it stinks less than shots. I hope you understand what I am getting at.

So enjoy your trips to Italy! test more and bring extra supplies. Always have a carb source on you. If you are already in the habit of testing 2 hours after a meal you’ll be fine… if not, now is the time to understand the way sugar peaks and comes back down. This will be less scary once you get into it - and then it’ll be more routine. good luck!

@joe this is all extremely helpful information, thank you! (Good thought about relying on CGM. We calibrated Eva’s new Dexcom and it was 70 points off!) We are working up to the idea of traveling again…still have so much to learn and this forum is a wonderful resource.

Hi Will,
Even if you had a pump, your best management tools (besides your head) are still planning your food and testing enough, especially if you don’t want to burn through insulin like it’s going out of style. My daughter is finding that out now at college, where there’s unlimited food in the dining hall and a lot of her friends go back for seconds. We have a friend who’s in her 90s and has been Type 1 since she was 12…still no pump, still going, still sharp, and for most of her life, managing was mostly about the food because the insulin wasn’t fast-acting and the testing didn’t get accurate until the mid-1980s or so. It obviously worked. So anyway, making yourself a daily plan isn’t bad or wrong, as long as you are willing and able to do things like pack your own lunch or at least know the carb value of what you’re eating out and eat somewhere you can choose a decent balanced meal without overloading on carb.

My recommendations: the popular versions of keto/low-carber/Atkins are mostly baloney, sometimes literally, with a lot of unnecessarily fatty and high-salt items and ingredients instead of ordinary things like vegetables and little real understanding of how to count carbs. The all-meat-eggs-bacon-cheese-coconut-oil thing is ridiculous, basically a heart attack on a plate and not really good for anyone, much less anyone with T1D. The excess saturated fat can mess with your digestion and also make your insulin less effective. You probably already know more about counting carbs than the popular magazine writers, and you could make healthier choices for noncarb/low-carb foods. Veg, not grease. A piece of fruit, not doughnuts.

Do it right–go back to basic training. Talk to your doctor about a reasonable number of carb grams per meal–start with 45-60 per meal, with maybe 15 grams halfway in between for snacks. You might be able to last on just meals without snacks, or you might need more carb than that if you’re active, but being active can lower your insulin dosing for meals and basal. And don’t panic about the numbers–that’s often lower than what some of the keto fans are actually eating or recommending even when they think they’re eating “no” carb. Make sure you’ve got some protein and fiber (the nonstarchy veg, whole fruit), and choose carb foods when you can that are a bit less carb-dense–nonstarchy veg is about 4-5% carb by weight, fresh whole fruit is about 1/8th or 13% carb by weight (if you have a scale, weigh it in grams and divide by 8); cooked pasta and beans, about 30%, bread is 50 percent by weight (weigh in grams, divide by 2)–anything much more, like baked goods or snack chips is in the 60-75% range and less predictable, and things with cornstarch can spike unaccountably.

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