What’s the purpose of having to time how long my daughter can eat?

I’m just curious if anyone else has a 20 minute time limit for their child to eat? I was instructed to only aloud her 20 minutes then stop her and give her insulin. She barely has enough time to eat and is always watching the clock.

@Mommaof6 I can’t say I have heard of having a time limit to eat before. Perhaps what the Doctor meant was 20 minutes into the meal, would be the time to take her insulin. That would be to coordinate the carb reaction with the insulin reaction is the only thing I could think of.

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@JanS no we had to take her food away from her in the hospital at 20 minutes and when sent home we were instructed to do the same thing. I will ask her doctor when we go for her first appointment on the 24th

hi @Mommaof6 I am very sorry to hear about this difficulty. There may be a valid reason but I fear that someone gave you instructions that were not entirely clear.

for young kids, you can bolus for the carbs AFTER they eat them. you will likely get a spike (rise) in blood sugar during that first hour after injecting insulin…but nothing extraordinarily bad will happen. 20 minutes is a good time because if you were to wait for an hour… that after meal blood sugar rise could be into the 300’s. This “20 minutes” is not cast in stone and should have been explained to you.

after diagnosis your daughter’s body is starving form the lack of insulin. as she takes insulin her appetite will increase as her body regains some weight.

Please consider reading the book “Think Like a Pancreas”. Please consider having a nice talk with the pediatric endocrinologist and have them clarify and explain what you are supposed to do. Diabetes is a disease where you have to learn how to use insulin because you will make well over 90% of the insulin decisions. The doctor will surely not be available for you continuously and you will need to be very good at insulin. No worries you will get very good at blood sugar and insulin in the coming months. cheers and good luck.

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as an afterthought, @Mommaof6, for myself, I have no time limit. I can even take insulin (via a pump in this example) to allow me to “graze” at a buffet for hours. I have sat at a restaurant and had meetings over meals that have lasted hours. HOliday feasts at my house are 3 hours long. When you know all about insulin, you eat like (I mean however, however long, and whatever) everyone else eats. sorry I just wanted to clarify

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@Mommaof6, I agree with @JanS & @joe. There is something lost in the translation unless there is something so new, none of us have heard of it. I did a quick literature search and found nothing.

As Joe was sharing, reading between the lines, you and your daughter will learn how insulin acts in her body and what the best time is to cover her carbohydrates (some abbreviate as CHOs). The science is when your daughter eats, the carbs are digested and get into her blood stream. The injected insulin takes time to get into her blood stream from the injection site under her skin. The goal is for them to meet head on. Insulin too early and blood sugar bottoms while insulin too late and blood sugar sky rockets. All of this is the reason for the CGM.

There are two points here. 1) Different meals will act differently. Pizza will act one way because of its fat, while baked chicken & green beans will act another because of lower fat content. 2) The same food may act differently on different days, even though everything else looks the same.

Keep asking questions. No question is out of line for anyone just joining the diabetes world.

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Thanks everyone for your input. I will definitely be bringing this up at the doctor appointment next week.

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I have heard people tell me “Take your time and eat - slow down.” I guess I do tend to rush through meals sometimes, and I used to hear about health benefits of eating at a more leisurely pace, although not specifically in reference to diabetes.
I did a Google search on how long it should take to eat, and found this in WebMD’s archives: https://www.webmd.com/diet/obesity/features/slow-down-you-eat-too-fast
Unfortunately I couldn’t find a date so I don’t know how old it is. It does say it can take 20 minutes to feel full. That might help prevent hunger-related snacking later on (my personal thought), which might be helpful; but as others have said it looks like you’ll need to revisit this with the person who gave you the instruction, or discuss it at your upcoming visit as you plan to do.
How are things coming along for you?

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20 minutes is not enough time to finish eating, but 20 minutes is enough time to wait before injecting insulin. If the doctor will not allow her more than 20 minutes to eat, then I would change doctors or pediatricians. I could see having a time limit of 45 minutes to an hour, but no less than that.

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@ksannie it wasn’t our doctor but it was the doctor that took care of her while she was in the hospital. We will be going to our 1st endocrinologist appointment in a few days and I will definitely address this. But while she was in the hospital they would set a timer and after 20 minutes stop her. And that’s the instructions I was sent home with as well.

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The way I’ve always heard it is that digestion takes about 20 minutes to start raising blood glucose levels. Fast insulin analogs such as Novolog or Humalog may take that long to start dropping it, though this may vary from 1 person to another. So if she’s in range before the meal it MAY be best to shoot just before starting, though 10 or 20 minutes before eating may wok best for her individual situation. Only way to know is to try each methods for about a week (to make sure it’s become consistent), and if it doesn’t seem to match her needs switch to a different pattern until she finds her bast match.

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Hi Natasha @Mommaof6, setting a time limit of 20 minutes for eating a complete meal doesn’t sound right to me; it runs contrary to a few things that I’ve been told. But then, of course, I’m not an expert.

For nutritional and metabolic reasons, I’ve been told to take my time eating [but not waddle], and chew thoroughly, at least 32 chews per full-bight size. There are a few “eating studies” that conclude that persons who gulp down food do not receive all the intended nutrition and tend to get fatter than persons who eat exactly the same meal but rather take time and chew thoroughly.
As @tedquick wrote, the 20 minutes might possibly been referring to the time period it might take before and increase in blood, or body, glucose level is noticed.

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@Mommaof6. I have no doubt that this will all become clear at your next appointment. Cheers and good luck :four_leaf_clover:

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My question is for Joe. I’ve been a type 1 for 6 years and I do not know how to bolus for a buffet or long holiday meals. I usually just eat one plate and quit. Also, I read in one of your other replies to another question someone had that you keep your basal rates low enough throughout the day that you can go for a couple of meals or so without going too low? How do you do that without spiking after eating? Thank you.

My son was told to try to eat within 30 minutes of receiving his shot because that is when the insulin is strongest. We try to stick with it but I too don’t like it. It makes him rush through his meals which I know is not at all healthy and tended to make meals stressful as opposed to enjoyable. <3

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Hi @sixboys, I realize that you were asking @Joe for this question, so I hope you don’t mind if I also throw in my 2 cents worth of information. [Also, if you want someone’s attention, it would help if you place an “@” in front of that person’s User Name.]

For long, drawn-out business and social buffet gatherings [I have also used this method at six-course Wedding Feasts], I would sometimes split my bolus dosing into multiples. Really not knowing how much I will eat - I usually eat lots, I first “scout out” the tempting spread and take a guess at what I will be eating in an hour’s time; with my pump, I will enter the guessed-at carb count, and do a 30 minute “extended bolus”. I will ass along the way and try to count what I actually ate. If the feast or buffet is still on-going, I may do another bolus calculation but first carefully assess my insulin-on-board and probaly not correct for BGL reading above target. A lot of experimenting during many years trying to figure out how best to manage my diabetes.

For your other question about “maintaining a low basal rate”. Basal insulin is just what it says - insulin needed in background. Basal rates in your pump Profile or Pattern, should be set so they can maintain your glucose level all day long, without you needing to take correction doses or eat. Yes, very hard to do - especially because there are so many factors that affect glucose levels. I periodically fast for 18 hour periods just to Validate my basal settings. This came in real handy last year when I had been fasting since an early evening supper for a surgery scheduled the next morning where I’d be under anesthesia; the surgery was delayed until afternoon, and somehow my pump kept me well in-range and high enough so I didn’t need to eat anything.

@sixboys I think @Dennis said most of what I was thinking so I’ll shorten my reply to this: for a holiday meal (for my clan that means a 4 hour sitting) I bolus with each course when there are carbs. Appetizers I may skip the starches, I’ll bolus for a course with bread or pasta, bolus again for the deserts etc. it’s worked pretty good.

For a buffet I bolus a square wave and hope for the best butwith a lot of experience I know each time around I have 15 to 30 grams carbs and I know how many times I am going up.

As for lowering a basal… sorry not sure but I lower basal for working outside and on bike rides when I know my active level will be high. Hope this helps. Cheers good luck :four_leaf_clover:

Thank you both for your answers to my questions. I started eating my food before I took my insulin because my sugar would be low within 15 minutes of taking my insulin. I am thinking my basal rates were too high. I will lower my basal a good bit and experiment with it. Thank you again for your advice!

Oh and as for the buffet or parties I was always afraid of stacking insulin and having lows. Thank you again.

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@sixboys The right way to tell if your basal is correct or too high or low is to skip a meal. You start with in range blood sugar and you simply don’t eat (for example lunch) then watch your blood sugar for 4 hours taking readings and notes. If you get to dinner and you’re low- your basal is too high. If your sugar is high, then your basal is low and if you are in range it’s perfect. You do it again for breakfast and dinner on separate day’s do you don’t starve, and that’s how you tell.