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Re: [IPk] sugar, sugar, everywhere
I am sorry to hear that your partner's cousin Molly has been diagnosed the
diabetes. I have a daughter of 7 and she has been D since 1999. It is
certainly difficult to cope with at first and yes, although we were told
that we should try to cut out sugar we were told to give biscuits as snack
(although we were told plain biscuits not chocolate ones) and told to give
things like mini kit-kats or Mars bars before doing sport or swimming. So
sugar and sweets were not exactly banned. Though I suppose in the first few
months we were finding out as much as we could about D. The book that
Ingrid recommended was the first book I came across that explained things in
detail and was and still is a great help. In the book it tells you how you
can eat sweets and adjust insulin for it. It is talking about a treat
though not everyday.
After coming across the ChildrenwithDiabetes list:- and joined their
support list. Mind you it takes a bit of doing converting all the mg/dl
readings even with a chart. It is also eye opening comparing the care and
education that they leave hospital with!
I joined the email support list and found that many of the parents
especially the ones on pumps let their children eats sweets, ice cream etc.
Of course, not all the time but on occasions at parties and celebrations.
After reading and finding out about carb counting (not taught at our clinic
or even mentioned) I started to swap digestive biscuits for smaller one with
chocolate on. They were the same carb count. Then I was able to swap all
sorts of things. I do give Sasha ice cream sometimes after tea and its
never been a problem because of the fat slowing things down. I eventually
worked out how to cover for extra carbs for parties etc and now she doesn't
have to miss out on too much although as I am usually at these parties I do
try to make sure that she doesn't just eat sweet things.
Sasha was on Mixtard 30 twice a day for quite a while but then when I found
out more about how things worked as asked for Actrapid and we split the
evening doses which gave us better control. At our clinic they don't
usually split the doses until the kids are over 10. This has worked very
well, giving us the extra Actrapid meant that Sasha could indulge in a ice
cream in the summer if she wanted one. Sasha has a twin sister who is not D
so it would be difficult to say, no ice cream/chocolate for her too, just
because her sister has D. I used to find one unit of A covered a small
scoop of ice cream. Given at the same time if the bg was in the right range
or high. Of course Molly may not be keen on having extra injections.
Sasha had been D for quite a while before I did this.
We now have Sasha on Novorapid in the evenings and this has been really
great. We couldn't use it before because Sasha has coeliac and her
digestion was slow. She has been on a gluten free diet for 6 weeks now and
I only wish it had been sorted out months ago. Her digestion is fine now so
I can now give extra units for parties when I see how much she has eaten. I
wish we had had it earlier as it would have made such a difference when she
decided she didnt want to eat her evening meal. I usually inject straight
after when I can see how much she has eaten.
Once Sasha went to a school friends house to play, the mum is a NURSE. I
told her not to give Sasha anything extra (she already had a snack to eat)
when I collected her she said she had given Sasha some sandwiches as she
said she was hungry. The mum thought that was OK and wouldn't effect her
blood glucose because it wasn't sweets!!!
Also tell Molly's Mum/Dad that if Molly goes to play with anyone that if the
friends mum/dad suddenly decides to take the kids out to the park or
somewhere TO TAKE SUGAR/HYPO STOP or biscuits. I have had this happen to me
twice. The parents who had been given a bag with stuff in suddenly decide
to take the kids out and didn't give a thought to taking the goodie bag to
the park!!! just left in at home not thinking what might happen. Other
parents tend to think that a hypo is a rare event and unlikely to happen!!
I always give the twins some sort of chocolate bar (mini ones) before going
swimming or at the park. She also has all different sorts of biscuits and
yoghurts and we don't have a problem with the sugar content. Or with sugar
in baked beans. Sasha's HbA1c is always below 7 mmols and the last few
have been 6.2ish. I am hoping that is because we try to keep fairly good
control and not just because she has got celiac making the absorption slow.
Her levels have been much more predictable lately and since getting
Novorapid much easier to treat. I will have to see if now her absorption is
normal if her HbA1c stays as low.
I am sure that you will be a great help and support to Molly and her family.
Mum of Sasha dx 1999 at 4 years old now 7
Coeliac dxed Oct 2001
----- Original Message -----
From: "Elizabeth/ Sonya" <email @ redacted>
To: <email @ redacted>
Sent: 20 December 2001 18:03
Subject: [IPk] sugar, sugar, everywhere
> So when the cousin, Molly, was in Crumlin (the Dublin southside children's
> hospital, for those of you beyond the pale) her parents were, surprise
> surprise, told no sugar, no chocolate. The good news is that the sheet the
> dietician gave them said that she shouldn't have these things initially.
> bad news is that the ward nurses were as ignorant about how food works in
> the body as I dreaded: when we were visiting they brought Molly's tea
> (horrible thing number one) chips, two slices of white bread, and a scoop
> beans. And then (horrible thing number two) a ward nurse came in and told
> Tina (the mother) that Molly shouldn't eat the beans because 'they have
> sugar in them'. I didn't follow her out of the room and set her straight,
> which I should have done. Tina is a chef by trade and knew how rediculous
> this was, so we had a brief discussion about it. But to top it off, the
> sheet the dietician gave her of 'eat one of these at every meal' had beans
> on it! So, dietician and ward nurses : never the twain shall meet.
> Despite the open-ended promise on the dietician's info sheet, Molly is now
> on 'no sweets, no chocolate, no ice cream'. And in her first week of
> diabetes, she left a party early because she 'couldn't' eat the ice cream
> cake. And this is what this advice creates: a situation where people with
> diabetes say 'can't'. I can't because I have diabetes. Additionally, our
> culture celebrates with processed and refined sugar, whether it be
> confectionary or alcohol. So, because of this advice, children like Molly
> are being denied participation in our culture's celebration. Or, they do
> anyway, don't tell their medical team, and don't have the tools for
> the celebration.
> So, in a search for evidence for the 'no chocolate' rule, I collared a
> diabetologist (who shall remain nameless) as he left the diabetes centre
> today. And I asked him, what is the justification for telling people they
> can't eat chocolate? And he said, it has sugar in it. And I said, well,
> of food has sugar in it, and all carbohydrate including sugar is converted
> to glucose in the body. And he said, but sugar is converted differently.
> I said, but starches actually convert to glucose faster than sucrose, so
> what is the justification? And, like many doctors when challenged about
> something, he got angry and said in an angry tone, look, eat chocolate if
> you want, but you shouldn't... I stopped him at the shouldn't and said,
> not trying to make you angry, I'm just looking for the science to support
> this advice. And he said, I have read any research on this, so you should
> talk to the dietician, but you shouldn't eat sugar.
> When I was at the INPUT open day in manchester, a woman whose name I
> (sorry!) was passing out questionnaires on her research into how diabetes
> management is not, in fact, evidence-based, even though they claim it is.
> And indeed it is not: research on glycaemic impact demonstrates that
> starches raise blood sugars more quickly than many things 'with sugar in'
> (sugar generally meaning sucrose). However, this doctor and most local
> diabetes specialists are passing on advice that is based on nothing more
> than medical tradition.
> I know that part of the reason for this tradition is that on-average
> seventeen year lag behind research findings and application in clinical
> practice. However, this particular issue makes me very angry because of
> cultural impact it has.
> I won't make this too much longer. I'll finish asking for some research
> suggestions: if you know of any studies explaining why people with
> shouldn't eat chocolate or ice cream cake, please send me details of them.
> If you know of research explaining why people with diabetes should enjoy
> these things as occasional treats in a well balanced diet (just like
> else), please send me details. I took the doctor's advice and I've made an
> appointment with the dietician for the 29th January. I'm sure she'll be
> sorry she met me, but I have to start somewhere.
> Tony, I've added an article for _identity_ about carbs, glucose, and GI to
> my long-term to do list. I move so slowly it probably won't happen until
> next year, but it's coming.
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