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I dont have my daughter on that tight of a meal plan, her Endo and Nutritionists have said to me " if she wants it give it to her" Grant it she can no longer grab a bag of chips or banana or whatever whenever she wants it all has to be acconted for, but for lunch today for example she had: turkey and cheese sandwich on whole grain white bread, a gogurt, and 13grams of sunchips, it was a total of 64 carbs, when she was first Dx she was on a 60 or less carbs per meal... but if she wants 80 i give it to her... and her #s are still good and bad... but her A1C is 6.7.. its been as low as 6.3.... am I making mistakes?

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I'm not eating "very" low but maybe 90-100/ day, a bit less than rx'ed for me. I've replaced a lot of carbs w/ stuff like eggs for breakfast, carrots (which have carbs...), lower carb bread, etc. I think carbs are more likely to cause weight issues than protien, or at least they did in my case? As I've reduced carbs, I've lost weight. I plateau and cut out some more and lose a bit more. I've gone very slowly at it. I'm not sure my own kid would be a huge fan of that sort of plan either but we all enjoyed burgers w/ low carb buns and veggies instead of fries the other night and were ok.

A few thoughts (trying not to reiterate what others have said):

  1. I think your flexible approach is good.  It's very common for people diagnosed with T1 as children to develop "food issues" because of the intense focus on food.  By not making a big deal of things if she wants more, you are setting her up for healthy eating habits as she gets older.
  2. That said, help her understand the impact of certain foods on her BG. It's ok for her to have a treat now and again, but "treats" (i.e., things that make her BGs wacky) should not be a regular occurrence.  If you do this, she will hopefully learn to correlate feeling better with better food choices. 
  3. Make sure to have lots of low-carb snack items handy, as well as other "safe" foods.  There may be some foods that have lots of carbs in them, but are safe for her to eat regularly in moderation.  For me, fruit and non-fat frozen yogurt are two such foods - they have lots of carbs BUT they cause a very predictable rise and fall of my BG.  I can easily bolus for them and usually wind up within range. Help her make low-carb choices whenever possible, as this will decrease the fluctuations in BG levels. 
  4. An A1C of 6.7 is awesome!!  Even the low 7s would not be bad (IMO).  Keep in mind that children tolerate slightly higher BGs better than adults do.  At her age, persistent lows could interfere with brain development.  And you also don't want her developing hypo unawareness.
  5. Does your daughter use exercise at all to help control her BGs?   When I was a kid, treats or food excursions were used as rewards for intensive exercise.  It was the one time I knew I could eat something without my BG going haywire!  Phil Southerland writes about this in his book as well. It was a common management tool back in the day, one that we have unfortunately moved away from.
  6. Do you know what foods are most problematic for your daughter?  For me, my "problem" foods are white flour, bread, pasta, and rice.  Because these foods cause me so much trouble, I really try to stay away from them as much as possible.  To the extent you can, help your daughter identify her "problem foods" and encourage her to make choices that don't involve these foods whenever possible.  Again, this doesn't have to be absolute.  I will eat rice from time to time, but I do so rarely and I know when I do, I'm going to possibly be in for a long night. 

 With T1, it's hard to balance everything - keep the A1c but don't become so rigid with food that you create emotional issues.  You want her to have a normal childhood but the obsession over preventing complications can stand in the way of creating a "normal" environment.  It's all a balancing act and it sounds like you're doing a really good job.

I just checked my pump to see how many carbs I eat in a day, man it is a lot, but I believe what I have learned and why I think I am low carbing, is that I avoid carbs that I know will result in a definite high (and a long lasting high.)

Autonomy is important for many reasons. Before you know it, she is going to be staying away from home for stretches of time, whether she's staying after school for activities or hanging with friends. You need to make sure that she knows how to handle her diabetes in those settings without your guidance. At her age, she should definitely be operating the pump herself (under your supervision). Also, things happen and (I think) as a parent it would be reassuring to know that if you were separated from her for any reason (i.e., she got lost in a mall or you were hospitalized for a period of time) that she could take care of herself.

yes she know hows to give herself boluses, she knows how to get info from the pump!! but she doesnt know how to change her pump, nor does anyone else in my household know... whick i know needs to change, and soon enough she will be able to change it hersef!! I do take alot of the responsiblity and I think thats the control freak in me.... but I know I have to make some changes!! but right now in my household theirs alot going on... So as soon as evertyhing stablaizes assuming it does I will need to teach others how to change her pump!!!!!!




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