Too much Carbs ?

[amjm88]

Im a type 1 Diabetic and am on the pump. I use the carb-counting method to determine the bolus of each meal/snack.
I try to limit myself and eat healthy carbs (fruits ) vs. the cookies and sweetened cereal but always find myself eating way too much cookies and/or sweets. Especially when I get the munchies.
I often eat a few cookies , bolus , then grab a few more and deliver another bolus 5 minutes later followed by a small scoop of ice cream and then deliver a larger bolus just to be sure it covers it all ( sometimes this results in a low). Same thing with other snacks such as crackers or any other food available in the kitchen.
My question is should I try to limit myself on carbs ? and if so how? My sugars sometimes rise because of all the carbs/sweets even though Im pretty sure I've counted accurately.
Im confused and would appreciate any advice , Thanks.

[JDRF-Team-LRS]

AMJM -
As DM said, you've taken a brave step forward.  Maybe you know this, but the important first step in "doing better" is to face ourself.  Believe me, we've all been in denial and I think we all can relate to wanting to see GOOD numbers on our meters (I *still* do that!! ;-)  ).  It's a long journey and we sometimes slip into cycles of not bothering.

Seems to me that you're "bothering" again ;-)  

I can also relate to not sharing "bad news" with parents or docs.  They'll tell us what we know, and don't wanna hear, ... we'll see the disappointment and/or worry in their eys, we'll risk losing their trust.  I wonder if you can turn that around.  YOu seem to be a very bright young woman and you seem to have learned plenty.  

Might you be able to ask your mom to help you adjust your routine to your current needs?  Can you work with her to get a referral to a doc who DOES specialize in diabetes?  There are so many tips 'n' tricks and new insulins and new research results -- it'd be terrific if you can benefit from working iwth someone who's "up" on that stuff.  This disesese is hard 'nuf to manage, might as well get the best resources available.

Perhaps your mom is busy and you might like to do some homework to help get that referral going?  Visit the JDRF website (www.jdrf.org) and click on Chapters -- look for chapters or brances in your state & your area.  On a day you feel comfident, give 'em a call & ask 'em for a list of diabetes doctors in your area.  They'll be very helpful and will be eager to help you find the team that'll make your road easier to travel.  You might be lucky 'nuf to meet up with other diabetic and pumper teens that you can share with.  We adults are great (I think so!) and yet there're things that only other teens seem to *really* understand.  Be alert, tho', that you get your medical advice from real docs, diabetes educators, etc.  There're plenty of folks -- some of whom are teens --  who do things that are healthy or safe.

It is normal that needs change.  There'll be changing again in the decades ahead.  Two years is a long time in a teen's life ;-) and honestly -- your needs for insulin have changed, and will continue to change for a while.  It's not "your fault" -- tuck that thought away DEEP in your psyche.  It's not your fault that you have this disease.  It is not your fault that your needs are changing.

Finally, good for you that you're a CLEAN & COOL teen.  It's not so easy these days, and yet the rewards are great: respect from adults and a great foundation upon which to build your own adult life.

Hope we hear more from you amjm :-))  It's been a pleasure sharing DM stuff with you.

[jdrf team dm]

Dear amjm88,

I thank you for reaching out to the Juvenile Diabetes Research Foundation.

You have recieved very important information from LRS and please take this information to heart. I am a mom of a 27 year old son that was diagnosed at 8 and like all of the volunteers here,I am not a doctor. Your post reminds me very much of my son at your age. He fudged on tests, ate sweets and was not able to be honest with his doctor or us. His A1c could run anywhere from 10 to 12. This was obviously too high.

Your honesty is wonderful in this forum, but I would love to see you to be able to share this with your doctor. She will help you with the carb situation and "munchie's". Please do not feel bad or embarrassed about confiding in her. She is a physician and deals with these types of situations often. I would also recommend that you see your pump trainer and if you have access to a dietician, this will help you with the carb counting. With the pump trainer, you may need to learn how to cover the carbs a bit better with your insulin.

I am impressed with your knowledge and concerns and it sounds that you realize the possible complications that can result from running high blood sugars. It is wonderful that you are trying to bring down your A1c. 10 is diffently too high. This is the best thing that you can do for your future health.  I truly hope with your added testing that it will be lower this time. Your attitude is something to be proud of. Please talk to your  doctor and be straight with her. I realize this can be hard, but for your future health it is vital.

Please contact us at any time and let us know how you are doing. After all of your testing, I hope your A1c is down.

Best to you,
dm

[amjm88]

Thank you JDRF-Team for your reply.
I am 15 yrs old.I have had diabetes for approx. 2 yrs.My numbers are sometimes within my target range. However , in the past yr.I dont think my sugars have , in fact I hardly would ever check my BG in fear that it would be high. Now , Im trying to get my numbers closer to my target range .  My doc ( I dont think she is an endo , she works at my local health clinic and does not 'specialize' in diabetes )told me last time that my A1c was 10 , I believe. Sometimes , I must admit ,I find it difficult to be honest w/ my doctor.I often write fake numbers in my logbook just to please her and my mom.
I have not met with my pump trainer since the day she hooked my pump up w/ me ( I have been on the pump since Sept. of last yr.) so I dont know if I should contact her or not.
I am a female so , I think my cravings for carbs are especially around that time of month.
But I also tend to get hungry and head for the carbs ( such as crackers w/ cheese , cookies , ice cream ) most of the time. It may be a bad habbit of mine or becuase , as you mentioned, my BG is high. When Im low, I recognize the feeling, and find it hard to resist any type of Carbs ( or food at all!)because my body seems to be demanding food.
I've never taken any type of drugs and never plan too.So my 'muchies' do not occur for that reason.
Thanks so much for your help. The past couple months Ive been checking my BS consistantly(3-6 times a day)and trying to carb-count more accuratuly in hopes of improving my upcoming hemoglobin A1c.The main problem has been eating too much Carbs ( and carb-couting accurately itslef)at meal times and  when I find myslef 'bored' with nothing to do but snack. Do you suggest limiting myself?
Thanx again, any additional advice and/or suggestions would be appreciated.

[Rubydoo]

Will eating other snacks curb the need for the carbs? When I have the munchies, usually before "that time of the month" but know that I can't have any more sugars I will eat cheese and celery or nuts or pork rinds and sometimes beef jerky. These will sooth the munchies for me and not send my blood sugar up or require insulin.

[JDRF-Team-LRS]

amjm,
You've asked a great question and one that I think many of us diabetics try to understand.  I'm not a physician, but I have had our disease for ~35 years, have read & listened a lot to my docs, etc.

There are few things to think about from a diabetes perspective.  Are your daily numbers "generally" within the target that you & your doc have agreed is safe?  Is your a1c at the targeted level, too?  Are you able to be honest with your endo?

The reason I sak these questions - even tho' your question is about carbos - is that MANY teens go thru a dangerous phase where we "do it ourselves" without the consultation of the pro's.  I sure did that as a teen, and my niece is still doing it.  

The goal is that we somehow find balance -- balance between the foods we eat, our insulin, and our exercise.  One kicker in the teen years is that our needs CHANGE and often our needs for insulin increase.  If it's been a while since you worked with your pump trainer to compute your insulin: carb ratios, now might be a good time.  It might be necessary to evaluate your basal profile, too.

If you're a female, you may need to address PMS issues:  our basal insulin requirements often increase and we may have cravings that we don't have at other times of the cycle.  I think of those as "episodic" cravings, and personally, I do the best I can, but I don't fret over them.  

If the cravings for carbos are with you most of the time, my best guess is that your blood sugar control could use umprovement.  You might need to adjust your basal profile (work with your pump trainer).  We can crave carbos when our blood sugar is either too high or too low.

It's hard to know if you're eating "too many" carbs but there's a way for to begin to analyze it.  Take a few days and jot down exactly what you're eating (I know it's a pain but it's quite revealing).  Try to eat the way you "normally" do, including snacks & cookies.  Then review that with your endo, pump trainer, or certified diabetes educator.  Perhaps in the summer, you simply *prefer* carbos than heavier foods?

Diabetes is a tough disease and every day we have so many things to think about & try to balance.  There are plenty of non-diabetes issues to contend with, too, and some of those cause us stress and/or food cravings that affect our diabetes, too.

Finally, if getting the "munchies" is from weed or other recreational drugs, there's not much I can say that you don't know already.  In college, I used weed and while it didn't affect my blood sugar directly, it surely affected my ability to make good choices about what (not) to eat.  I simply lost the discipline it takes to take carea of myself.  I did try to be reasonable and have "healthy" stuff around to snack on, but honestly, I didn't do very well during those times.  If this is part of the cause for your cravings, I hope you'll choose to move thru this phase rather quickly ;-)

I hope this gives you some useful things to think about.  Waddya think?