Making PS questions for my diabetic child

[Selket]

I posted on the restaurant board too but thought folks here might have an opinion if they didn't see the post there.

My son, age 2, has type 1 diabetes just recently diagnosed. I've made all my PS's for dinner at 5:30pm for our upcoming August trip. At home we normally eat dinner around 6 p.m. and I thought this would give us the best chance of getting seated and started eating by 6ish - and not get caught in any long waits for seating. I *do* plan on taking an afternoon break so this meal would probably be the first thing we do at the park (if the meal is in the park) or at the hotel before going, etc.

I plan to eat breakfast in the room and lunch either at the hotel (CR) or fast service somewhere (the chefs at the CR will make lunch for him if we need it - they have been very helpful!). The same child (age 2) is also deathly allergic to peanut items so we have quite a few constrictions on eating.

Do you think with a 5:30 PS we can be eating around 6? I really want to eat (with food in front of us) at 6 p.m. or close to it.

Any other tips? Anything I'm not thinking of?

Since the restaurants will be making special meals for him what if have a problem and run a bit late - will they still serve us? (I don't plan to run late!)

Thanks

 

[gardendame]

Hi there,
Please post how this worked out when you return. I have 3 children, the 2 youngest have type 1 diabetes also.
Just to give you a 'FYI', you may want to ask your doctor about the Lantus/Novolog therapy with an insulin pen. I know you are recently diagnosed, so this may not be an option yet, until you get the hang of things. However, once we switched to this regimen, we were able to be a lot more flexible with our meal schedules.
The Lantus is the 'long-acting' and is taken only once a day instead of the twice a day dosing as more traditional long-acting insulins (NPH, etc.) It does not 'peak' and stays in their system for 24 hours. Because it does not peak, we no longer have-to-have a snack every 3 or so hours. When the kids are hungry, we count the carbs in their meal/snack, and dial the correct dosage into the Novolog Jr. Pen.
HTH!

 

[Selket]

DS is on NPH and humalog right now but the lantus/fast acting sounds like a good way to go for flexibility. So far he doesn't need insulin overnight cause of the honeymoon! He is very sensitive to insulin too - and takes quarter unit doses sometimes - we have diluted humalog.

I have made arrangments and have phone numbers for all the restaurants to call them a week beforehand. I'm just wondering about how my timing for dinner sounds - any other tips. So far excercise doesn't seem to affect his numbers! He does tend to get excited if we are out some place (like Chuck E. Cheese) and not eat much though!

 

[jiminy14]

Responded to your post on the restaurant board.

 

[minniesfriend]

My 7 year old has type I also (diagnosed age 5). I always made my PS at 5:30 in order to eat by 6:00 and it usually worked out fine. I would always tell the CM at check in that my son has diabetes and was on peaking insulin. I asked if dinner would be later than expected to please let me know.

Sometimes, if it's an odd situation where he might not eat what he's supposed to eat, we will give insulin right after he eats. Yes, I know you're not supposed to do that but we found that, at times, you gotta do what you gotta do. So, check with your doctor. I also always carried a small meal (sandwich) that I knew he would eat "just in case." Oddly, most restaurants do not have fresh fruit that is kid-friendly (apples and bananas).

We are usually unable to obtain nutritional info at the restaurants. So, try to have an idea what's on the menu so you can get as an accurate carb count as possible.

If you find you are running late, get the concierge to phone the restaurant for you to let them know you'll be there soon.

Our first few trips were made with Humulin (peaking) and Humalog (short term). Then, we went to Lantus and Novolog which, as gardendame said, is much more flexible. We were unable to use the pen and continued with the syringe. Now we are pumping.

I'm sorry about your son's diagnosis. Feel free to send a PM if you need anything.

 

[StitchGirl88]

my cousin was diagonosed when he was 3 and my aunt and uncle took him to disney when he was 4 and the chef at chef mickeys was great about it. THey called 24 hours in advance ike they had to do and got there food when they got there because they new in advance and made what ever he wanted. So just call 24 hours in advance and tell them your childs age and explain that your child has diabetes and needs the food when you get there or around the time you get there. Hope this helps.

 

[Talking Hands]

Sorry but this doesn't work now. With PS and not a reservation you can wait and it doesn't matter if you have diabetes or not. I have had to leave a restuarant where I had a PS and go elsewhere to eat because I could not wait as long as it would take.
I always have a snack with me now to avoid that situation. I far preferred reservations because I knew I would be seated in a reasonable time and with PS it is not guaranteed even for medical needs.

 

[phillybeth]

Ran into a situation like this with my FIL, stubborn hardheaded man. He insisted on taking his insulin about 15 minutes before our PS times, even though we told him that we might not get seated for quite a while. We lucked out the first few times, but one dinner PS we weren't seated until 30 minutes after our PS time- by that point FIL was in the lounge with my MIL forcing him to drink a coke. He tested after the soda and was still below 60! Please make sure that you have snacks, glucose tabs or whatever your doctor recommends on hand.

 

[Selket]

Many thanks for all of the tips. We generally have the biggest problem for lunch with his NPH peaking and that we can't control so we'll probably do counter service. For dinner we have a bit more flexibility and can give the humalog when the meal starts rather than while waiting so it shouldn't be too much of a problem. I carry emergency foods and snacks - usually enough to replace a meal if need be.

I generally like to eat and give the dinner insulin around 6 because we often stay up and test when that insulin has finished and then give the overnight (he has just started taking overnight). It is complicated to explain but if he didn't get his insulin until 8pm I'd probably be up testing him until1 a.m.

Because of the heavy crowds being reported this summer I might move the trip to the Fall (September if possible) just to hopefully avoid some of the issues of long lines and waiting - and maybe even some cooler weather.

Thanks again!

 

[Ambassador]

We are on the Lantus/ Humalog program, which provides great flexibilty. As others have suggested, it is okay to administer after a meal, to assure the correct dose. We have learned that you must be prepared, and carry extra a everything. Once on a mountain hike, after a hypo-episode began, it was discovered that all the snacks were a few miles away in the car!

The crowds will be significantly smaller in September, which may give you greater control and confidence.

We have always made 5:30pm PS arrangements, and been seated by 6pm, simply because of the young age of our junior delegates.

 

[rhanditresmom]

Just chiming in here, we just recently went on Lantus...it is the best thing that has ever happened to DS! He was 18 mos old when diagnosed and has been on Humalog and NPH forever! We now have so much more flexibility, and lows are almost a thing of the past! Of course, we really have to be diligent about carb counting, but that is a necessity anyway. This is going to make all of our trips from here on out so much better. He loves it because he doesn't HAVE to eat a snack if he's not hungry. He also doesn't HAVE to eat a carb with his meals if he doesn't want to. Lantus is WONDERFUL!!!!

 

[tink2dw]

Can you explain why you have to count carbs??

I thought it was fats butter,mayo you needed to watch out for??

I have alot of lows.

 

[Selket]

tink2dw - Many diabetics count carbs or use food exchanges or some method of judging their carb intake because more carbs mean the need (usually) for more insulin. At least with William - who is only 2 yrs old - we don't place too much emphasis on his fat intake although we try to keep it balanced - but he does have a moderate amount of fat in his diet. Fat of itself doesn't generally have so many carbs - like butter - although it can affect how your body absorbs the carbs you ate with the meal. If you can figure out your carb/insulin ratio then you will know how much insulin to give yourself based on the amount of carbs in your meal. This allows a great deal of flexibility for times when you are not so hungry vs. that time you are very hungry and have dessert too!

Perhaps talk to your dr and a nutritionist because you really shouldn't be having those lows!

I plan to ask William's dr. about the lantus. He still doesn't seem to need insulin overnight all the time so the honeymoon period must still be going for him. But I plan to switch to lantus when he his honeymoon gives up.

Thanks!

 

[SueM in MN]

Selket, I just want to say that I am impressed.
It was just a little while ago that you came here for the first time asking for advice after your child was diagnosed with diabetes, and already you are able to give very good information to help others.
I'm sure your trip will go very well. It seems like you have things covered quite well.

 

[Selket]

Sue - LOL! I guess when your toddler is diagnosed with diabetes you rather have to learn things quickly - sort of like getting thrown into the deep end of the pool! You have a few days in the hospital to adjust and then you take over the controls yourself. We still have our problems with William - especially since is is very sensitive to the insulin so it seems a tiny bit too much or too little makes him either too high or too low. His carb/insulin ratio is different in the morning and evening too. Sometimes my understanding of the problem doesn't help me with the solution! LOL!

I'm still apprehensive about our trip because he can drop 300+ points in 30 minutes - especially before lunch. We have to monitor him very closely and I'm afraid that he will not have fingertips left in a few more years. Having him diagnosed with the peanut allergy a month later was not helpful either!


Thanks for your help Sue as always (and everyone here). I really enjoy this board. Although our issues are quite diverse it is always interesting and sometimes eye-opening to see how people respond and cope to the challenges presented.

 

[Talking Hands]

Don't worry. Those finger tips survive and with the newer meters you can use your forearm as well as they require less blood and you don't need to drop it on the strip, the strip sucks it up. Needs less blood.
Been at this 27 years and I still have my finger tips.

 

[Selket]

TH - we were advised not to test on his arms yet and I'm trying to remember why. I think because the readings could be different or less accurate or some such thing. I don't know if that is because of his age or this is true for everyone? I remember asking both his CDE and the pedi endo about it and both said don't do it yet. I will have to re-ask at his next appt. We test him about 15x a day because he can really do some drops at unexpected times. And HUGE drops - like 350 points in 30 minutes!

Some weeks we cruise fine and some he seems to need more insulin than ever and then all of a sudden he seems to need less. I think that is part of the honeymoon period and perhaps illness (?) - we couldn't figure out his last cycle of needing more insulin than usual - he didn't seem sick or wasn't exercising that much. We also registered some moderate ketones on him for the first time ever as he was running so high.

It is a very complicated disease! I am concerned about how much we will get done and waiting in lines with him. I carry emergency sweet items but generally on those big drops I need more than candy - I will probably have to bring a small lunch size cooler in lines with a substantial snack in case we get stuck. I haven't yet figured out how to correct his lows with something like fruit juice - he might drink it (more might not!) but then still continues his drop - it is a very temporary solution. I generally have to get food in him as well....like a meal. If I keep giving him sweets then when he finally eats the meal he goes too high. He is allergic to peanut butter, doesn't always eat cheese, etc. Part of the excitement of having a toddler with diabetes I guess!

 

[BCV23]

Carol, although this is old advice as our son developed Type I 16 years ago at age six, it still might help you. Our ped endo team told us to treat a low with juice AND a slower metabolizing carb. Our favorie became a slice of bread but when at WDW a banana, applesauce etc would work too. Cheese or peanut butter or other proteins are too slow to be digested to give that added kick needed after the juice. Our guy was on R/NPH in those days but it still might help you.

We too have been told not to test in my son's arm...not accurate enough. My husband sees the same team for his Type II and one of them told him testing in his arm was fine for him. He does not experience the same swings that our son does though.

 

[Selket]

Thanks for the tip BCV! I try to carry some crackers with me - he generally won't eat bread yet. Correcting a pre-lunch low is difficult because it seems to make him go too high later = he is sensitive to the tiniest dose of insulin and to food too it seems!

I don't know how you ever survived with Regular insulin - we had him on it the first 2 days out of the hospital and nearly went insane! The dr. switched us right away to humalog and NPH. I don't know why they still use R/NPH for new diabetic patients in the hospital....especially a 2 year old! Of course our 1st day home with him he got sick and wouldn't hardly eat and we had give him the R/NPH shot. We were feeding him table sugar eventually - he wouldn't eat anything else. The humalog is much better and I look forward to trying the humalog/lantus routine when he starts needing insulin overnight on a regular basis - and eventually going on the pump.

Thanks again!

 

[BB&T mom]

I am new to this but for me Carbs bread & White potatoes effect my blood even just 4 SMALL fries and I heard at the park they offer carrots instead of fries??????????I do not do either.. Is there anything else they will give you besides fries & carrots maybe a pickle? coleslaw? I can handle fruit much better than any white potatoe product. I was told to no testing on arm not advanced enough reading very to much I never tryed it though.