Meal Plan needed?

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Momoftwo Posted: Thu, Nov 4 2010 6:57 PM

Hi. My son was diagnosed with Type 1 diabetes 6 months ago. He was 17yrs old at the time.  His treatment was aggressive, the classes presented included nutrition and carb-counting BUT, he does not have any type of meal plan at all. (He is not a Joslin patient.)  He uses Lantus long-lasting insulin and Humalog fast-acting insulin.  

I thought the point of quick-acting insulin was to allow this type of freedom. He tests before a meal, calculates the carbs in the meal and takes insulin to match the carbs based on a doctor specific ratio, and tests again 2 hrs later. 

Any comments? I don't want to 2nd guess the doctor, but it seems everything I read says a meal plan is a major component of good care. 



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There is no specific meal plan for a person with diabetes, whether you are type 1 or type 2.  Good nutrition is the best meal plan along with exercise which also applies.  Many type 1 people eat like everyone else and adjust insulin according to the ratio for their bodies.   This may not be the best method for good management of diabetes, but teenagers often think they are indestructable.   If the meal has good nutritional balance and is not overloaded with carbs, he should be okay.  Be prepared to let him have a holiday (for special treats - and these are coming) when he can make adjustments to allow for the treats.  Since I am a type 2, I will not give type 2 recommendations.

Does he adjust if the two hour reading is higher that it should be.  If it is, he should talk to the doctor for instructions about adjusting or testing again at 4 hours or near the expiration of the Humalog effectiveness.  If the doctor has not explained hypoglycemia (low blood glucose readings), make sure that you have the doctor cover this.

If you have good insurance, talk to the doctor about an insulin pump as these can often assist in much better management of diabetes.



Type 2 (10/2003)   Lantus and Novalog   Now added Metformin      Retired


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Posts 21

I was diagnosed 9 years ago, so I'm not sure if things have changed since then.  My first appointment after diagnosis was with a nutritionist who worked with me to develop a meal plan.  At that time, I didn't go to Joslin, but I switched to Joslin very early on.  I still use that meal plan that I was given 9 years ago.  I think it is very helpful for a diabetic to have a plan.  Over the years I've met with a lot of nutritionists (I have Celiac too) and have learned to count carbs, etc.  I would definitely ask the doctor if he feels it would be beneficial for your son to meet with a nutritionist. Carb counting is very important, but how does your son know how many carbs to have during each meal?  That's where the meal plan comes in to play.

Dx 2/01, pumping with Cozmo, Celiac, dx 8/05


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jen1229 replied on Sun, Nov 7 2010 11:08 AM

I found this Board and through it I found my dietitian (she is no longer with Joslin).  She helped me tremendously.  She showed me how to fit the foods I like into my diet and taught me how to count carbs.  She gave me a new meter and when I went on insulin she taught me how to adjust for the foods I eat.  I still have the paperwork she gave me, and refer to it when I get off track.  I would suggest that you get a referral to a Registered Dietitian particularly one who is a Certified Diabetes Educator (CDE). 

Jen  - LevemirConfused and Novalog Wink A1c 5.8



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Delia replied on Thu, Nov 18 2010 11:39 AM

For one, I don't think there is anything wrong with second-guessing your son's doctor, in fact a second opinion is a good thing, because it gives you a broader understanding of what's going on.  

As for a specific meal plan, sure it's beneficial, but you have to know that it can get boring and bothersome. I would think it's better to have a list of what is and what isn't good (no to any white bread but yes to pita bread for diabetics from Joseph's Bakery), of good combinations and suggested portion sizes. That way your son will be able to quickly put together a meal from what he has on hand at any time. A meeting with a nutritionist would definitely let him realize which direction to go in so you wouldn't have to worry (especially if he's getting ready to go off to college soon).

Hope you find a good solution and your son does well :)

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