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why can/ can't you eat anything and just shoot insulin for it ?
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vickiens posted:
hello, my step daughter is diabetic her last a1c was 10. something and her father and i continually argue that she doesn't eat right he says she can eat anything she wants as long as she shoots for it. I know this is not right and i'm just hoping i can get a little support from other people who really know.
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MrsCora01 responded:
I am first going to suggest that you post this on the T1 board , as food/insulin issues are very different between T1 and T2s.

The truth is somewhere in the middle between where you and your husband are at. Obviously, with an A1c of 10% she is not dosing correctly in the first place. While it is "technically" true that as a T1 you can eat carbs and then bolus, the bottom line is that no one in this world can eat whatever they want. They will be unhealthy and probably get fat.

I don't believe that it is emotionally healthy to severely restrict available food choices for a growing child (you don't say how old she is so I'm assuming she's a kid) but she does need to eat a healthy diet. Good carbs (lots of fibre) lots of veggies, some fruit (not juice as it causes too many spikes) and a variety of lean proteins and of course dairy as well.

Hope this helps a bit. She needs to know all her insulin to carb ratios as well as her insulin sensitivity factor in order to correct when she is high. Her average blood sugar is somewhere around 240 which is about double what it should be. So she needs help in learning how to manage things properly.

Cora
T1 1966, Dialysis 2001, kidney transplant and pump 2002, pancreas transplant 2008
 
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phototaker responded:
Cora knows what she's talking about with type I diabetes people, but as a type 2 diabetic, I'm thinking an A1c of 10 is not good.
I agree with Cora about young people not being told to diet, but on the other hand, your step daughter needs to learn a healthier way of eating other than stepping up her insulin shots. She probably might need to lose weight. She might be thin, so that would make a difference. I would think "once in a while" for special occasions, that would be okay to have that piece of pizza or a birthday dessert. Again, I'm not a type I, and really don't know anything about that.

I know Cora says she agrees with both of you, too. The thing that makes it difficult is talking with someone else about taking care of themselves in a different way. Does her doctor agree that it's okay to do this?
 
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vickiens replied to MrsCora01's response:
Thankyou for replying to my question. I should have mentioned shes 21 and thinks she knows everything about diabetes, She has a few mental disorders and can be a handful to say the least. she is a type 1 brittle diabetic her blood sugars have been in the 20's and so high that the hospital meters can't read them . she has all the ratios, how much she shoots for what level I'm just worried this idea that you can eat two or three donuts and shoot for 2 or 300 carbs is a good thing or is it causing more damage .
 
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vickiens replied to phototaker's response:
Thankyou for you time, She has gained 30 lbs and i agree something special once in awhile. I don't think my husband and step daughter tell the dr. everything and its a fighting battle when i get after them. She is 21 with mental disabilities so its very hard to get her to cooperate. I was basiclly wondering if all this shooting of insulin was good or is that causing damage to
 
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MrsCora01 replied to vickiens's response:
Basically, she is hurting herself in several ways. Eating 3 donuts will be unhealthy for anyone. All that refined carb combined with the fats from the frying would make anyone ill. In addition to that, running high blood sugars will also cause damage. Sorry, but I doubt very much if she knows/understands her ratios. If she did, her blood sugars would be much better. It requires a lot of testing and research to get them fine tuned. In addition to that, as she is just out of her teens, it is possible that these numbers could be changing. The doctor can give her starting ratios, but she will need to do the work to figure out (with the doctor's help) exactly how to fine tune it.

Sorry to sound so down, but there is obviously a tremendous amount of work to be done.

Cora
T1 1966, Dialysis 2001, kidney transplant and pump 2002, pancreas transplant 2008
 
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phototaker replied to vickiens's response:
When you say mental problems, it is something that can be handled through therapy,like depression, or does she have something like bi-polar or has schizophrenia, which can also be dealt with medicine to help?

It's hard to reason with someone who has mental problems.

Good luck!
 
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amanda2581 replied to MrsCora01's response:
I thought this board was for typ2 and typ1 when they changed it around I swore I read that we share a board now.slipper
 
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amanda2581 replied to vickiens's response:
I am on insulin and for one thing I never touch Donuts,But I do not shoot extra insulin unless I wait 2-3 hrs and if I am over my number limit I than go to sliding scale and shoot according to that,But I never eat something bad and just shoot some extra insulin that is just not the way it is done,My doctor has me on 5units of humalog before my meal .Than if I have a high number 2-3 hrs later I do my sliding scale .I have to stay in a calorie and carb range, so I can lose weight and keep my numbers in line .Hope that helps.
 
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MrsCora01 replied to amanda2581's response:
Sorry Slipper, I didn't mean to be exclusive, but I do know that there are several T1s who do not bother to post here but who do check the member created T1 board. The advice given so far has been great, but the more info that can be passed on, the better. In addition to that, I do know that on occasion things can get confusing between T1 and T2 and while those of us who post regularly usually know who has what, it can be confusing for a new poster.

I meant no disrespect to any of the T2s here.

Cora
T1 1966, Dialysis 2001, kidney transplant and pump 2002, pancreas transplant 2008
 
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MrsCora01 replied to amanda2581's response:
I am on insulin and for one thing I never touch Donuts,But I do not shoot extra insulin unless I wait 2-3 hrs and if I am over my number limit I than go to sliding scale and shoot according to that,But I never eat something bad and just shoot some extra insulin that is just not the way it is done,My doctor has me on 5units of humalog before my meal .Than if I have a high number 2-3 hrs later I do my sliding scale .

This is what I mean about the difference between T1 and T2. Most of the T1s I know use 2 different ratios to calculate the amount of insulin required, rather than set amounts and sliding scale. Most of us use an insulin to carb ratio (I:C). For example, my I:C was usually 1:20 (one unit of humalog for every 20 g of carb eaten) except for between the hours of 6 am and 11 am when I was more insulin sensitive and I used a ration of 1:25. And then there was my ISF (insulin sensitivty factor). One unit of insulin would bring me down 85 points so I would do the math and bolus accordingly. Being on a pump at the time made things much easier as I could bolus in very small increments.

So basically a T1 typically injects before or just after a meal and takes a total amount based on the number of carbs eaten and the blood sugar level before the meal. So for example, if my glucose before breakfast was 185 and I ate 1 12 g slice of toast with an egg for breakfast, I would take 1 unit of insulin to bring me down the 85 points to 100 and 1/2 of a unit for the 12g (1 unit for every 25 g of carb). At one point in the 70s or 80s some docs advocated the "hammer" method (take a certain amount and then hammer it down later if your sugar was too high). But that isn't used that often any more as many of us ended up with high a1cs (once that test became available) and it was due to the spikes.

Cora
T1 1966, Dialysis 2001, kidney transplant and pump 2002, pancreas transplant 2008
 
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krhudson replied to MrsCora01's response:
I do things the way Cora just described. I unit for me will lower my blood sugar about 50 points in my formula typically 25 points an hour. I take 1 unit per 20 carbs. If for example, my blood sugar is 150 in the AM at breakfast and I eat 60 carbs I would first consider the 50 point reduction = 1 unit to consider myself to be at a 100 bloodsugar then for 60 carbs add the 3 units for a total of 4 units.

If I have oatmeal or a slightly spiking item I will pad with an extra unit so I can get the 2 hour blood sugar in line back down to 150 and I will get a continual drop of 25 points per hour for the next 2 hours to a total of 4 hours. I am at 100 about an hour before the next meal. With the perfect carbs 4 units is fine and my 2 hour runs between 135 and 140. That is what I should be doing. That was an example from the old me. Now my AM fasting is 75-95.

I totally disagree with checking my blood sugar in 2 hours and adding to the the dosage since my initial insulin has not run its full course yet. I have attempted it in the past and had lows as a result of the difference in bad carbs vs good carbs. The only reason for that 2 hour correction is because of a bad carb selection. If my carb selections were better than I thought or I had more than normal activity that day I should not have taken the extra units.

If I know in the beginning I am eating a bad carb choice, I add an extra unit from the start. When waiting for 2 hours, time has been lost and the body may not be having fun and the A1C may not look well. The added 2 hour injection will than mean 4 whole hours being off in numbers. It also takes Humalog a little time to work and if the blood sugar is already up, that is not good.

That is a reactive method that I disagree with totally. I think if we know our ratios and limitations on the food we eat we should not have to resort to that.

kr
 
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Louise_WebMD_Staff replied to amanda2581's response:
This is the community for all types of diabetes but we have a special Type 1 Diabetes community just for people with Type 1 Diabetes and their family and friends.
~Louise
 
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amanda2581 replied to MrsCora01's response:
I was just wondering if we share a board not critisizing you you gave great advice as do all of you on here,slipper
 
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auriga1 responded:
Well, vickiens, you are correct when you say she shouldn't eat anything she wants and then compensate by dosing her insulin. That's not what the insulin should be used for. Because she is eating what she wants and then using insulin, she has gained the 30 pounds.

Insulin, food and exercise all go hand in hand. Every diabetic should have goal of an A1C of 6.0 or below. With an A1C of 10, she is not doing something right. Does her father know where her A1C should be? Her doctor surely realizes what is going on just by looking at her A1C.

I am a Type 2 diabetic who uses two insulins, one basal and one rapid-acting, to keep my sugars at the level they should be. My first A1C was 13.2 and now I have it down to 6.0. This was accomplished by eating the right carbs and the right AMOUNT of carbs at each meal, along with exercise and insulin.

I follow basically the same regimen that Mrs. Cora had been doing and what Krhudson does. I use 1U of insulin to 12 grams of carbs for meals. I check my blood sugar before a meal and then need to add the carbs up when dosing my insulin. When exercising, that dose is much lower as exercise will utilize that blood glucose running around in the blood stream after any meal with carbs.

I understand it is difficult dealing with her mental disabilities, but her dad is not helping by coddling her. Diabetes is a serious disease that can destroy the body down the road. With those lows so low and the highs very high, this is so dangerous for all the organs in the body; the kidneys, her eyes, blood vessels, nerves, etc. She is too young to be going down such a road. Eating the foods she loves probably makes her feel better emotionally, but it is not helping her body and her diabetes.

I sincerely hope you can get her father on the same boat as you are before anything really bad happens to your stepdaughter. I don't mean to sound like a doomsday sayer, but both of them need some more education regarding diabetes and its devastating effects to the body.


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