I recently wrote this as a post on Facebook because I know a lot of parents who encounter my daughter are confused about what she can eat, and I don't blame them! When we received our diagnosis, the amount we had to suddenly learn was mind-boggling. Not everyone needs to know as much as we parents do, but those around our children - especially at meal time! - should know the basics. Hopefully by sharing information like this, we can help people understand how different this disease is and how it is often misunderstood. (What? Diabetics CAN eat sugar? What?)
Anyone is welcome to share this post. You can let people know that if they don't have time to read it all, they can skip to #9 for the bottom line. Conversely, those would like to go a little deeper will benefit from reading #10.
Here's what I came up with:
1. T1s can eat anything. Nothing is off-limits, technically. When we were in training, the dietician said that our daughter should probably never have syrup or regular soda, though.
2. Anytime a T1 eats, unless their blood sugar is low and they need to bring it up, they need to get insulin into their bloodstream immediately, or faster. (We actually give it up to 20 minutes ahead of time, because even "fast-acting" insulin isn't as fast as our digestive system.) See below for the details of "why," if you are interested.
3. The amount of insulin we give is based mostly on the amount of carb grams in the food, not sugar. If you are ever in a position to give food to my daughter, the answer will usually be, "Yes, she can have it. We just need to know how many carbs are in it."
4. The ONLY time we are concerned with sugar, for a T1 reason, and not general health, is to evaluate the type of sugar in a food that we are using to bring up a low blood sugar. Some types of sugar work faster than others, which is why we will give her juice or Skittles when she is low instead of chocolate. (Fat slows everything down.) For almost everything she eats, we think of where it is on the glycemic index.
5. Some T1s use multiple daily injections, or shots, when they need to eat (so, a shot at every meal). Often times, this means they are given a set number of carbs to eat at certain meals, based on how their bodies use their food at certain times of the day. Some, however, who take shots, can just use a formula for how much they are planning to eat to decide how much insulin they will need. That is called their sliding scale.
6. My daughter has an insulin pump. You will see it as a small white box attached to her arm or leg. (Other pumps look different.) Inside it is a needle and a resevior of insulin. She must wear this at all times, though we change it and refill it every other day. It constantly drips insulin into her bloodstream, since our bodies are constantly producing glucagon.
7. To give her insulin through the pump, all we need to do is program her blood sugar and number of carbs into a small black device. We have the device pre-programmed to calculate the insulin based on many factors. So, other than that, we just hope it's a good amount!
8. There are an estimated 60 factors that contribute to changes in blood sugar, so we never know when her blood sugar will drop or rise. This is why she also wears a continuous glucose monitor, and we watch it on our phones throughout the day and night. When our phone alarms us, she is either high or low and we can fix that either by giving her sugar or insulin, or adjusting the drip of insulin she is already getting. If she is low, she will likely eat something sugary without getting insulin for it. Insulin brings blood sugar down; sugar (obviously) brings it up.
9. Bottom Line for those who need to know: If a T1 is going to eat something, it is most likely fine, as long as we know how many carbs it has. And we don't want anything sugar-free, thank you. Because, eww.
10. The science behind metabolising food, for those who want to know more: When your body consumes food, it breaks it down by fats, proteins, and carbs, etc. Carbs are used for energy. Your pancreas produces insulin, a hormone that carries the carbs (which have now been broken down into sugar - hence why we check the sugar in the blood) to all the cells in the body so that they can function. Someone with Type 1 Diabetes has a pancreas that does does not produce insulin, rendering it useless. When there is no insulin, the carbs/sugar stay put in the bloodstream, unable to get into the cells to be used as energy. For this reason, someone with a high blood sugar feels like they have no energy. They literally need the insulin to get the sugar from the blood into the cells. A body that goes too long without insulin (and this could be only a matter of hours) will go into a state called diabetic ketoacidosis (DKA), where the sugar in the blood is so concentrated, it begins to rot, turning to acid, with a by-product of protein. The acid will start eating away at other organs in the body, namely the brain. A T1 in DKA is an emergency situation and must be treated in the hospital to bring the BG down safely and quickly to minimize the chance of brain damage or death. Because protein is produced when a T1 is in DKA, the condition can be detected by a urine test.
Unfortunately, there is no pill for this disease. Insulin has to reach the blood stream immediately, by injection. But scientists are working on different cure ideas, so we have much hope. Please don't hesitate to ask me if you have ANY questions!
While We Are Waiting...
My youngest child was diagnosed with Type 1 Diabetes in 2014, when she was 7 years old. This blog tells the stories from our life with T1D, while we are waiting for a cure!