I honestly wouldn’t change your approach from prior to diagnosis. So what if he ends up high for a few hours, just make the celebration around lunch time and you will have plenty of time to correct before bed. Happy family memories are worth more than a few hours of being out of range.
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Yeah, I’m sure we’ll find those foods. I found myself getting “fearful” of foods and I don’t want that either. I find dinner to just be so difficult because often (for us at least) it’s usually were the more difficult foods to bolus for come in. Ethan is pretty predictable in what he wants for his lunch, and we are pretty consistant there, and I’ve got some good alternatives for breakfast that he really enjoys. So for the most part those times of days are good but dinner is many times a struggle, and evening hours is when I LEAST want to deal with highs or lows. Plus, with him being a growing boy, I anticipate we’ll no more “figure out” a food or meal, and boom, a grow spurt or activity or some unknown throws a monkey wrench in that.
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And I’m sorry to hear about the Celiac!!! At one point, Liam had to have a stomach biopsy because the Endo believed he may have had it and wanted to get the biopsy to see…fortunately he was not. I’ve done a bit of research into it because of that possible diagnosis and was NOT looking forward to that being something Liam had IN ADDITION TO diabetes…it would really limit the food intake. I’m hoping he continues to NOT have celiac!
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I can confirm the “tweaking” never stops. 
Welcome to the party!!!
THanks! County carbs for the most part seems to be the least complicated part of it! lol. Though I usually “eyeball” our frosting, tasting along the way until I get it how we like it. This year I’ll do my best to measure out. I tried to convince him of cupcakes b/c I figures the portions would be easier to get the carbs right on, but alas, it was a no 
I do fully intend as Chris said to make our celebrations around lunch time to give us the rest of the day to settle any swinging sugars. You all are absolutely right- he’d never forget a birthday that had to be “different” from the rest.
It’s also important to me that he has as much normalcy as before (aside from the injections) beause I don’t want him resenting food and or diabetes. I feel like if I restrict food and experiences (within reason, no more or less than before), in short order he’ll be angry and then we’ll have even bigger problems on our hands. So the more I can let him be a kid and enjoy the things and foods he enjoys, the better.
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Yes, Ethan does not have celiac as of now, but I’m holding my breath that with a parent and sibling, he very well may develop it in the future. I thought that diagnosis was bad . . . it was just a warm up!! lol. He basically ate gluten free prior to diabetes because it was just easier to not have it in the house. But after diagnosis I knew his food would be limited (because there are so many gluten free things he DOES NOT like), that I opened to kitchen to non gluten free foods for him. I still only back gf, so there’s limits there, but snacks and other foods are all fair game for him.
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As long as you monitor his BGs, administer correction boluses as needed and, if he gets too high for too long, doing a Ketone check(s), he’ll be fine. And he’ll have an amazing time.
We used to make our own cakes (my wife would design them herself), but now a days we do coldstone ice cream cakes because they are delicious and we all love them. 
Easy to figure out the total carbs for those, per slice. That’s our usual routine for the cakes here with the least amount of work. lol.
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So that brings up a question I’ve always had. What IS too high for TOO long. We haven’t had ketones since diagnosis (yes, I still check most mornings). But I have alway wondered how high he’d have to be, and for how long, to begin worrying about ketones.
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Unfortunately, there isn’t any hard fast rule for all the situations where ketones can appear. There are some general guidelines that can be found here (from the Diabetes.org (ADA) website)
A caption of the info listed there, is below:
There are posts here in FUD that pertain to ketones that you may want to find and read because there are many other circumstances where ketones can appear…such as sustained periods of lows, vomiting and unable to hold down fluids, among others. Knowing the signs and knowing what to look for is important.
Also, if you were given Ketone strips…they should go into the trash. 
Get yourself a digital ketone meter/strips (covered by insurance). We use this one.
In 5 years, we’ve had LOTS of HIGH bg readings (meaning, over 400), and many sustained 300’s for 2, 3 or more hours at a time and we’ve never tested positive for Ketones. But you want to do the checks in those times you’re unsure just for peace of mind, if for nothing else.
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Ketones are a byproduct when the body burns fat instead of carbs. That generally happens to us when either the BG is too high for too long (like over 300 for 3 hours could do it, but this is nowhere near an exact rule) or when there’s no insulin available (like the basal shot was missed and there hasn’t been a meal bolus for a few hours, or the pump infusion set has failed so we’re starved for insulin.) Ketones can happen without high BG — I’m trying to remember if that was during illness/vomiting?
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Yes, one still needs insulin when sick to prevent ketones.
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However, the counter to “just eat anything and bolus for it” is that it will turn out some foods (especially in quantity) create just too much work to be worth it. I know I can eat Thai red curry, but I also know that if I do, I will be chasing high/climbing BG and will have to make repeated BG adjustments for about 7 hours.
So, I agree with this in theory, and absolutely think that grownups can rightly decide certain foods aren’t worth the hassle. But I think the difference is that this decision is yours to make. Our kids already have so many of their decisions constricted, and a lot of autonomy is lost w/r/t other necessary diabetes care, and even eating (have to eat when low, can’t eat over 180 ,etc.). So I err on the side of letting my kid eat almost anything and dealing with the high or low that results. Occasionally I’m just too tired to, say, bolus for something that will keep me up all night. But I really, really try hard not to do that. The only exception is sugar soda, because we’ve never bolused for that and also our other kids have never drunk it. To me it just seems like pure garbage, so that’s one of our house rules. Everything else is theoretically on the table.
When Samson is old enough he may decide that, say, pizza isn’t worth it or Indian food isn’t worth or whatever, but I feel like my job as a parent is to figure out why something is too much of a pain to bolus for and lower that pain at least enough that he can enjoy the meals other people do…
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Samson eats popsicles very often. Super easy to bolus for. We find that straight sugar in some ways is the easiest to bolus for. Anything with fat kills him, including scrambled eggs…
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Honestly, cake is one that a lot of PWD get stressed about initially, but it’s not so hard to bolus for. We let Samson eat it whenever it’s available, though he hates sheet cakes and the only kind of cakelike thing he likes is plain vanilla cupcakes without frosting.
Make what you ordinarily make, count the carbs, prebolus a little, and log it. In fact, I’d recommend making a spreadsheet with a list of “tricky” foods and just record what you bolus and the outcome. Once you start thinking of that information as “data” it makes it easier to be brave, and to know if one bolus didn’t turn out, you can keep trying until you get it right. I think part of the reason people give up on foods is because it requires being sort of systematic to tease out the pattern.
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My son has been over 300 for a day or so. It isn’t ideal, but things happen. There really is no TOO long, i.e. many college students stay in the 200-300 range for years. It is bad for their health, but it isn’t going to kill them in the short term.
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@diabeatit2020, I just wanted to check in and see how you guys are doing this week? Any luck on the bedtime snacks and overnight BG?
FWIW, every night is a bit of a crapshoot for me. The balancing act of (1) consuming enough calories, (2) balancing bg throughout the day and night so that I don’t crash during my momming, and (3) getting enough sleep are my continual balancing act. And I don’t so much “balance” it all, but rather really I prioritize two of the three each day! I wish I was joking, but I rarely hit all three in one day. Just one data point to share. Others on here may have a totally different experience.
Hoping this week is yielding progress for you all!
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Hi @T1Allison
How nice of you to check in!!. So the temporary solution was to fogo any carbs at bed time snack to avoid dealing with the Humulog at bed time. For about 2 weeks it was working great. We were pretty steady during the day, dinners worked out well, and he’d be in good range at bed time (maybe 120s- 140s, which for me I don’t mind.). He’d get usually some cheese and SF jello at bed time and be quite steady over night, no lows or highs. He liked it and looked forward to it, and it elimited a lot of stress. I did increase is basal to a full 7 units at bed time. All was working quite well. (not an ideal solution all the time bc I know he’ll eventually be hungry at night and want more, or we’ll want to do movie popcorn, or . . . or. . . or . . .but for now it was working)
Then this past week or so. He’s been spiking high after lunch and dinner. I’ve been tweeking is lunch and dinner ratios. Thought I had lunch dialed in pretty good (1:10), but today he stayed on the low end of things all afternoon (80s) and even had a juice box about an hour after lunch to stay in range. He’s been complaing of a head ache off and on all day so I don’t know if that has anything to do with it. Just had a snack so we’ll see how that goes.
For the past several days after dinner, he’s been nice and steady in range, but then about an hour to an hour and a half after his meal bolus he’ll start climbing, usually well into the 200s (one day up to 300). Seems to be independent of the dinner and type of food. I’ll give him a correction about 2 hours post meal bolus and that is a total hit and miss too. The day he was at 300, he got 1 unit (his CF is 150 at night), and he came in for a nice soft landing to about 120. But a day he was at 220 (with a quarter arrow up), he got 0.5 U, and I was doing juice about an hour and a half later with double arrows down 
I don’t know if he would have come back down on his own or not, but I hate seeing him go to bed climbing even higher. Last night I gave him a 0.5 u correction at 216 and climbing. He ended up to 240, but then came back down to a nice 115 about 2 1/2 hours later (no juice or aything needed). He did drift "low"over night (my low alarm is set to 80, at which I did a little milk and a PB cracker). We skipped his cheese/jello snack last night (not sure why!) so maybe the protein/fat in the cheese is more importantant to him that I thought. All his corrections have been done about 2 hours post meal time bolus.
Because he starts to climb about an hour after meal time I was thinking he needs more insulin with those meals. Or perhaps I should just delay when I bolus? Let him eat then bolus? Should I wait until I see the climb on the Descom to bolus perhaps (he’s usually in range at the start of both lunch and dinner, sometimes ever so slowly falling) I currently have him at 1:15 at dinner (was going to go to 1:12 today, but given his trending low today, I think I’ll leave it for today and see how he feels tomorrow)
I don’t know. Its like I get teased with 2 or 3 good weeks, and I feel like we settle in, gain a little confidence, then BAM, we get on a roller coaster we can’t seem to get off!!
Sorry for all the details. !! Just really want this to stop taking up so much mental realestate!!
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I completely relate to that. Subtle changes in my day to day life end up showing up in my graph and dosing one way or another. I just switched my boys from being dropped off at school (by me) to riding the bus. There is a bit of a walk to get to the stop…and thinking through how that relates to my coffee consumption, bolus timing, etc…so yeah. And then things change without seeing an identifiable reason.
It sounds like you are SO on top of paying attention to trends and influential variables. And your problem solving is great. I wish I had a super simple answer that would help with the odd timing of the rises and falls…but there are a lot of variables that influence it for sure. Maybe another parent will have more insight there. But I am glad to see you back around here again and hear how you all are doing! You guys really are doing a fantastic job. I know it may not feel that way. But you totally are.
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Trust that you are going to get much much better at dosing, but unexpected highs and lows still happen every week to my son. I can totally relate to the feelings you are having, that was me 5 years ago. Why do I not get the same result even though all my inputs are the same in the experiment. It is very frustrating. At the moment you are taking into account I am guessing 3 or 4 variables. Soon you will double that number. Even then you will get unexpected highs and lows, it is just that they will be farther apart. If you do find yourself on a roller coaster do stop hitting the highs so hard, we have roller coasted for 2-3 days, and it is never ending frustration.
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