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  Back to Chat Lunch for 180 More Days and Counting

On Wednesday, August 20, 2003, dietitian Judy Singley hosted a chat about "Lunch for 180 More Days and Counting". Here is the transcript from that chat.

Moderator   (server) Wed Aug 20 08:00:00 PM EDT 2003
Our chat about Lunch for 180 More Days and Counting starts at 9pm Eastern.


michelle   (152.163.252.2) Wed Aug 20 08:47:33 PM EDT 2003
hi everyone

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:00:28 PM EDT 2003
Hi everyone - Welcome to the Nutrition chat

Janace mom of Sarah, dx'd at 21  (24.158.124.35) Wed Aug 20 09:02:10 PM EDT 2003
hi Judy! I thought I would see what you are going to say!

Laura B Sam's mom, 13, dx'd 8/98  (68.40.169.224) Wed Aug 20 09:02:57 PM EDT 2003
Hey Judy - Hi Janace!  Smile 

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:03:20 PM EDT 2003
HI Janace - HOw are you?

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:04:00 PM EDT 2003
HI Laura!!! Grin 

Mary Beth Mom of Catie, 13 / Ohio  (24.54.3.155) Wed Aug 20 09:04:35 PM EDT 2003
Help, I hate packing lunches!! Am planning on having the girls pack their own lunches...but that will last for maybe 2 days!!! LOL

Janace mom of Sarah, dx'd at 21  (24.158.124.35) Wed Aug 20 09:05:31 PM EDT 2003
Judy--I am good. Sarah graduated! Yea! I'm mailing you stuff tomorrow. Now tell us some good things to pack in our lunches!
 Smile 

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:06:11 PM EDT 2003
How about the prepackaged lunches - from Oscar Meyer? THey have Turkey - althought that probably won"t be enough, but it is a start

Laura B Sam's mom, 13, dx'd 8/98  (68.40.169.224) Wed Aug 20 09:06:34 PM EDT 2003
Breakfast, too. We struggle with mid-morning highs during school. Not sure what that's about, but I want to start the year off better this time.

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:07:04 PM EDT 2003
The carb counts are on the label and then you can other foods - like fruit and or nuts....

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:07:25 PM EDT 2003
Or trail mix

Laura B Sam's mom, 13, dx'd 8/98  (68.40.169.224) Wed Aug 20 09:07:53 PM EDT 2003
Those lunchables are really high in fat and sodium, though. We used to get them... then the kids started actually looking at the labels and decided they didn't want to eat them anymore (although the turkey is the healthiest, and not bad).

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:08:21 PM EDT 2003
Breakfasts are interesting, because of the cereal and milk combo andor juice - both will cause high blood sugars after eating them

Mary Beth Mom of Catie, 13 / Ohio  (24.54.3.155) Wed Aug 20 09:08:27 PM EDT 2003
I always assumed that the pre packaged lunches were loaded in sodium and fat

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:09:13 PM EDT 2003
HOw about frozen waffles/pancakes with sugar free syrup and Canadian bacon?

Janace mom of Sarah, dx'd at 21  (24.158.124.35) Wed Aug 20 09:09:18 PM EDT 2003
our school cafeterias here have gone to lots of high carb, fatty things like pizza, hotdogs, etc.

Laura B Sam's mom, 13, dx'd 8/98  (68.40.169.224) Wed Aug 20 09:09:30 PM EDT 2003
One thing we did last year... several times a week, when our family was actually in one place eating dinner together, I'd make enough for 8 people instead of 4. So, stew, or pot pie, or roast, or even burgers. Then we'd pack them up as lunch portions for the next day or so and Sam and Carolyn would bring those. They really like doing that. Sam likes leftover stir-fry.

bloomy,(MI) mom of robbie, 8, dxd 12/22/02  (67.72.226.232) Wed Aug 20 09:10:01 PM EDT 2003
hi everyone, what about the school lunches, robbie prefers them to home packed lunches

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:10:02 PM EDT 2003
I do believe that non-processed foods are best for all of us..

Laura B Sam's mom, 13, dx'd 8/98  (68.40.169.224) Wed Aug 20 09:10:20 PM EDT 2003
Ah! Good idea on the waffles and bacon.
I think we also may try slim-fast shakes again - making them with the powder and milk, and ice and a banana...

Mary Beth Mom of Catie, 13 / Ohio  (24.54.3.155) Wed Aug 20 09:10:25 PM EDT 2003
my daughter always packs... never buys her lunch.

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:10:34 PM EDT 2003
Left overs are wonderful - and usually non-processed.

Mary Beth Mom of Catie, 13 / Ohio  (24.54.3.155) Wed Aug 20 09:10:48 PM EDT 2003
Laura, can Sam and Carolyn use a microwave at school?

renee Melissa, 20, dx'd at 9, pump 7 1/2 yrs  (152.163.252.2) Wed Aug 20 09:11:11 PM EDT 2003
Judy - hi - this is Renee from Phila-JDRF....one of hte best things I got from your workshop at the Animas evcent at the Marriott was that larger sized hoagie roll that you showed us was 90 gms of carbs!!!....what an eye opener!!!

Laura B Sam's mom, 13, dx'd 8/98  (68.40.169.224) Wed Aug 20 09:11:31 PM EDT 2003
Judy, we tried playing with different cereals with different glycemic values. It didn't seem to make much difference. They all made him high. Nearly as high as a bagel would. Seems like the Humalog couldn't work fast enough.

Mary Beth Mom of Catie, 13 / Ohio  (24.54.3.155) Wed Aug 20 09:11:31 PM EDT 2003
my husband always adds a spoonful of peanut butter to his slim fast shakes

Janace mom of Sarah, dx'd at 21  (24.158.124.35) Wed Aug 20 09:11:47 PM EDT 2003
there is a microwave for kids and teachers to use at our middle school

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:11:56 PM EDT 2003
Bloomy, if robbie prefers school lunches that is fine. With children lots of times it is really about what they like to eat.....

Laura B Sam's mom, 13, dx'd 8/98  (68.40.169.224) Wed Aug 20 09:12:16 PM EDT 2003
Yes, there is a microwave at school. Although lots of times the kids just eat the leftovers cold. Even the burgers! Blech. Razz 

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:12:38 PM EDT 2003
Hi Renee - yes some of those rolls and bread products are very high in carbs

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:13:17 PM EDT 2003
I think it is important to know the grams of carb, by measuring the food and then hopefully the insulin can be dosed accordingly

Laura B Sam's mom, 13, dx'd 8/98  (68.40.169.224) Wed Aug 20 09:13:41 PM EDT 2003
Anyone tried those little tuna + cracker packages? Expensive... but tuna is pretty healthy. Carolyn just decided this summer that she likes tuna, so we may try those. Sam won't go near tuna.

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:14:17 PM EDT 2003
Laura - all of the processed cold cereals I have tried caused the quick rise in blood sugar....

Janace mom of Sarah, dx'd at 21  (24.158.124.35) Wed Aug 20 09:14:35 PM EDT 2003
I'm trying to watch carbs for myself. But I am finding white things--bread, crackers really jack up my readings longer

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:15:04 PM EDT 2003
Primarily because of the processing of the cereal and milk which will alos cause a quick rise

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:16:29 PM EDT 2003
White things for many people will cause the quick rise - adding fat can slow down the rise, like peanut butter on a bagel

Laura B Sam's mom, 13, dx'd 8/98  (68.40.169.224) Wed Aug 20 09:16:52 PM EDT 2003
What if you add a protein to the cereal+milk? Like a piece of cheese... will that slow down the carbs?

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:17:32 PM EDT 2003
The interesting thing about the glycemic index is that the foods were tested on people that do not have diabetes..

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:18:11 PM EDT 2003
Adding cheese to cereal and milk might work - everyone seems to have their own personal glycemic index

Janace mom of Sarah, dx'd at 21  (24.158.124.35) Wed Aug 20 09:18:11 PM EDT 2003
how about a big spoon of peanut butter with breakfast for a slower burn.

Laura B Sam's mom, 13, dx'd 8/98  (68.40.169.224) Wed Aug 20 09:18:23 PM EDT 2003
What implication does that have (re: glycemic index)... would values be different for diabetic people? Or for people with different kinds of diabetes? Theoretically?

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:18:41 PM EDT 2003
So, you try it and see what happens..

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:19:13 PM EDT 2003
Diabetes is really a trial and adjustment disease

Laura B Sam's mom, 13, dx'd 8/98  (68.40.169.224) Wed Aug 20 09:19:23 PM EDT 2003
PB, the cure-all! Grin 

Patti Mom of Patrick, 17, dx 6/02  (24.159.79.116) Wed Aug 20 09:20:00 PM EDT 2003
We have the added stress that seniors have the privilege of leaving campus for lunch. So they race off to the fast food places and gobble down lunch. Patrick decides to stay at school and visit with teachers a couple days a week so that he can eat decent - leftovers- food. Hate that the school sets it up that way.

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:20:05 PM EDT 2003
It would seem to me, based on your cereal experience that the values are different..

Janace mom of Sarah, dx'd at 21  (24.158.124.35) Wed Aug 20 09:20:52 PM EDT 2003
Laura--have you tried the Diabetes Choice or Glucerna drinks. Sarah uses them for a breakfast on the way to school--they are supposed to have a slow burn

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:21:18 PM EDT 2003
The interesting thing is when I am working with patients a Type 2 eating oatmeal, sometimes has a high blood sugar after, but a Tpe 1 will not and in fact they will sometimes go low...

Teresa mom to John 17,dx'd@ 4 and Samantha non-D (Indiana)  (198.68.15.60) Wed Aug 20 09:21:19 PM EDT 2003
Judy, I was just wondering if you ever practised here in Indiana?

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:21:53 PM EDT 2003
It is the different insulin respose to the food.

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:22:08 PM EDT 2003
REsponse to the food

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:22:37 PM EDT 2003
So, all of us have to pay attention to our own responses to the different foods.

Laura B Sam's mom, 13, dx'd 8/98  (68.40.169.224) Wed Aug 20 09:22:57 PM EDT 2003
Haven't tried those - don't know if Sam will be up for it (they look 'medicinal')... but I'll suggest it.

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:23:23 PM EDT 2003
No, I have neveer practised in Indiana what makes you ask

tom father of angie,10.dx'd 4 months  (66.26.222.73) Wed Aug 20 09:23:27 PM EDT 2003
how long on average do newly diagnosed type 1 diabetics stay in the honeymoon stage?

renee Melissa, 20, dx'd at 9, pump 7 1/2 yrs  (152.163.252.2) Wed Aug 20 09:23:38 PM EDT 2003
Patti - sounds like your son is unusually mature for a 17 yr old!! Good for him for putting his health needs before peer choices

tom father of angie,10.dx'd 4 months  (66.26.222.73) Wed Aug 20 09:23:56 PM EDT 2003
and how long before they can start on the pump?

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:24:08 PM EDT 2003
Sometimes even though they look medicinal they can be good tasting, for something quick and easy

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:25:07 PM EDT 2003
Patti - your son is making healthy decisions for himself..

Janace mom of Sarah, dx'd at 21  (24.158.124.35) Wed Aug 20 09:25:29 PM EDT 2003
Sarah doesn't think they are too bad. Most of the time she is late getting to school for work or class and she could drive and drink at the same time. I can't remember if she liked vanilla or chocolate best. But you could fortify what's in the can. We got two or three samples from some vendor at the Orlando CWD conference. Didn't you pick up any? Razz 

Laura B Sam's mom, 13, dx'd 8/98  (68.40.169.224) Wed Aug 20 09:25:31 PM EDT 2003
Ok - another breakfast (and maybe sometimes lunch) question. Occasionally, Sam will only want protein... like an omelet with just eggs, cheese, and ham. No bread. Water to drink. He has no idea what to bolus for this. In fact, last time, he didn't bolus anything and went way high. I'm sure it's because as the protein metabolized, the sugars were released... Can you explain and help figure what to do in this situation?

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:25:33 PM EDT 2003
Do you know that there are carb counts available for the fast food restaurants?

Patti Mom of Patrick, 17, dx 6/02  (24.159.79.116) Wed Aug 20 09:25:34 PM EDT 2003
Thanks Renee - don't get me wrong, he is a typical 17 year old except that he is very (scary) bright and finds adults much more interesting than most of his peers. Awareness of his health needs is just one more way he is different that his peers - not always a good thing.

Teresa mom to John 17,dx'd@ 4 and Samantha non-D (Indiana)  (198.68.15.60) Wed Aug 20 09:26:04 PM EDT 2003
When my son was diagnosed we had a wonderful dietician named Judy Dunston or something like that. She was also type 1 and great with the kids. I didn't know if perhaps there had been a name change and you might be her. I really miss her. She got us through those firt rough couple of months.

Laura B Sam's mom, 13, dx'd 8/98  (68.40.169.224) Wed Aug 20 09:26:20 PM EDT 2003
Hi Janace - Actually, I did try some and thought it was good. Sam really likes making the shakes in the blender... you add ice and it really can be doctored up to taste like a 'real' shake.

renee Melissa, 20, dx'd at 9, pump 7 1/2 yrs  (152.163.252.2) Wed Aug 20 09:26:45 PM EDT 2003
I understand Patti..but if he's going off to college next year, you'll find that his awareness is VERY valuable when dealing with dorm lifestyles, food, etc...

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:27:04 PM EDT 2003
You can actually go on line or there is a great boodk THe Doctor's Pocket Calorie, Fat and Carbohydrate Counter-You can order it on line Calorieking.com

Laura B Sam's mom, 13, dx'd 8/98  (68.40.169.224) Wed Aug 20 09:27:23 PM EDT 2003
Tom - You've found your way into the nutrition chat tonight. I think if you're looking for a discussion about honeymoons and insulin pumps, you might get more of a conversation in the regular parents chat room tonight! Smile 

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:28:06 PM EDT 2003
Tom, The honeymoon phase varies for each individual

Patti Mom of Patrick, 17, dx 6/02  (24.159.79.116) Wed Aug 20 09:28:17 PM EDT 2003
He does very well with food selections out when there is data available. Just can't see eating that way each day and also doesn't want to spend all his cash that way. He is anxiously awaiting their first long lunch and a visit to the sushi resturant - then he will chase highs all afternoon from the rice!

Janace mom of Sarah, dx'd at 21  (24.158.124.35) Wed Aug 20 09:30:02 PM EDT 2003
Patti--there was a very good article in Diabetes Forecast about getting your diabetic son/daughter ready for college. It talked about how to handle food, roommate, etc challenges.

renee Melissa, 20, dx'd at 9, pump 7 1/2 yrs  (152.163.252.2) Wed Aug 20 09:30:44 PM EDT 2003
is Sarah in college Janace?

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:30:52 PM EDT 2003
Laura - THe protein question - The way I would figure that out-is use his after blood sugar - lunch and because he was high he will figure out how much insulin to lower the high blood sugar and then that gives him how much insulin he needs to take when he eats the same breakfast agian Cool  Cool  Cool 

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:31:51 PM EDT 2003
Laura - and then use an extended bolus

Laura B Sam's mom, 13, dx'd 8/98  (68.40.169.224) Wed Aug 20 09:32:12 PM EDT 2003
Ok, so if he was 300 two hours post-prandial, and we target 100, and his correction ratio is 1:30, then we should do about 7 units for that meal next time, right?

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:32:21 PM EDT 2003
Protein causes a much slower rise in blood sugar and the Humalog and Novolog work faster..

Janace mom of Sarah, dx'd at 21  (24.158.124.35) Wed Aug 20 09:32:25 PM EDT 2003
Sarah just graduated! Wink  She was diagnosed 3 years ago while she was in college--200 miles from me. She was living in an college apartment. so it wasn't quite the dorm experience.

Laura B Sam's mom, 13, dx'd 8/98  (68.40.169.224) Wed Aug 20 09:33:10 PM EDT 2003
Extended bolus... or just bolus an hour later? If he boluses 7 right away with no carbs on board, he'll plummet way too low too fast...

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:33:36 PM EDT 2003
I would look at the 3 hour not the 2 hr pp - because his blood sugar will still drop after the second hour

renee Melissa, 20, dx'd at 9, pump 7 1/2 yrs  (152.163.252.2) Wed Aug 20 09:33:45 PM EDT 2003
what about using a temp basal rate Judy in that all protein meal situation???

Patti Mom of Patrick, 17, dx 6/02  (24.159.79.116) Wed Aug 20 09:34:33 PM EDT 2003
Thanks Janace - I will be sure to read that. He has spent a month away at academic camp each of the past two summers and it was a real challenge to keep his diet on an even keel as the food tended to be casseroles and breaded meats. The salad bar and sandwich bars at lunch were his best meal each day. I loved that they treated them each weekend with a brunch - donuts, danish, and not a piece of fruit or bread in site. But he did manage and it was a learning time for him.

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:35:06 PM EDT 2003
Actually - 1 hour later would work - to not have any insulin working in the beginning of the meal, but will he remember and if not extended

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:36:00 PM EDT 2003
Renee - you could use a temp basal, but it may not be enough to cover and or prevent the 300

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:36:16 PM EDT 2003
Have you used the temp basal for that situation

Ellen (FL) Zack 15  (152.163.252.2) Wed Aug 20 09:37:01 PM EDT 2003
Do you have an incentive to suggest to get kids to check bg in school?

Laura B Sam's mom, 13, dx'd 8/98  (68.40.169.224) Wed Aug 20 09:37:03 PM EDT 2003
We do the two hour post prandial because that's when Sam really feels bad if he hasn't bolused enough... we don't correct fully (still take into account the insulin on board)... but if he's over 200, we know he needs some extra. And if he's 300, we've really miscalculated something or something is funky with the set/pump.

Janace mom of Sarah, dx'd at 21  (24.158.124.35) Wed Aug 20 09:37:13 PM EDT 2003
Patti--I don't remember which issue of Diabetes Forecast that article was in. I am pretty sure it was DF and not Countdown. But I remember thinking that they covered a lot of good information--telling friends what they could eat and what food they had to leave alone!

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:37:23 PM EDT 2003
Laura - do you know if Sam's blod sugar drops after the 2nd hour?

renee Melissa, 20, dx'd at 9, pump 7 1/2 yrs  (152.163.252.2) Wed Aug 20 09:37:23 PM EDT 2003
Melissa uses the temp basal with pizza or Chionese food ( when she remembers) so it's not the same thing we're discussing here since she does the requisite bolus "up front" & adds the temp basal increase to offset the delayed rise from the protein

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:38:41 PM EDT 2003
I rememeber you mentioned that in Philadelphia - it may also be the effect of the fat content of those meals.

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:39:00 PM EDT 2003
If that works for Melissa - that is great!!!

Laura B Sam's mom, 13, dx'd 8/98  (68.40.169.224) Wed Aug 20 09:39:12 PM EDT 2003
Yes, quite often that 3rd hour is the charm. But, as I said, if he's over 200 at 2 hours post prandial, he needs a bit more insulin. We've learned that through trial and error (lots of error!). Rolling Eyes 

renee Melissa, 20, dx'd at 9, pump 7 1/2 yrs  (152.163.252.2) Wed Aug 20 09:39:31 PM EDT 2003
depends on the day of the week! LOL..what works one week may not work the next!

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:40:34 PM EDT 2003
What we are all setting out to do is eat the healthiest foods that are available at both meals and snacks, and then make sure that we take enough insulin to cover it.

renee Melissa, 20, dx'd at 9, pump 7 1/2 yrs  (152.163.252.2) Wed Aug 20 09:42:17 PM EDT 2003
Judy - do you have any patients ( kids) on Lantus + Humalog for carbs? If so, how are the schools dealing with the need to inject for lunch or snacks or classroom parties, etc? Until Lantus, it was fairly uncommon I'd guess for kids to get routine injections at school?

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:43:08 PM EDT 2003
Laura - that is exactly right - he will need more insulin, but to figure out how much to take in regards to the eggs, one time I would wait the 3 hours so you can identify the insulin needed.

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:44:13 PM EDT 2003
Yes, I do have kids on Lantus and Humalog/Novolog and most of them have to go to the nurses office to inject with either the insulin pen or syringe.

renee Melissa, 20, dx'd at 9, pump 7 1/2 yrs  (152.163.252.2) Wed Aug 20 09:45:16 PM EDT 2003
what about schools that don't have full-time nurses??? What happens to those kids at lunchtime??

Ellen (FL) Zack 15  (205.188.208.6) Wed Aug 20 09:47:34 PM EDT 2003
Do they all inject AFTER eating? I'm petrified at the thought of kids taking a shot of Humalog for a meal and then possibly not eating it all, or worse, having a fire drill en route to the cafeteria.

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:47:42 PM EDT 2003
Actually, I have not had any kids that have not had FT nurses.... I am sure that the school has to provide support for the child - I am sure that is covered in the 504 plan

Patti Mom of Patrick, 17, dx 6/02  (24.159.79.116) Wed Aug 20 09:49:20 PM EDT 2003
Laura - were you at our house this morning. He adjusted his basals so was testing more - ate a lovely omelet for breakfast and was 190 2 hr pp. Will tell him to test at 3 hours next time. Thanks!

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:49:50 PM EDT 2003
That is scarry, and I have actually had children that I have worked with, that when they go low have to go to the nurses office to be treated. I voiced my concern about this with the school, and they changed there policy. The child could treat their low in the classroom.

Janace mom of Sarah, dx'd at 21  (24.158.124.35) Wed Aug 20 09:50:51 PM EDT 2003
I am working with our school board president to get in the classroom testing!

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:51:06 PM EDT 2003
If you know that your childs habit is to not finish their meal, then giving insulin after the meal makes sense. If the child is on the pump they can give half up front, and then the remainder at the end of the meal.

renee Melissa, 20, dx'd at 9, pump 7 1/2 yrs  (152.163.252.2) Wed Aug 20 09:52:10 PM EDT 2003
pumps needs "reminder buzzers" for that situation...whenever my daughter tried that approach she'd forget the other half...

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:52:25 PM EDT 2003
Janace - That is so important - the nurses that I talked with said it was the blood thing

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:52:44 PM EDT 2003
Patti - is your son taking Humalog or Novolog?

Patti Mom of Patrick, 17, dx 6/02  (24.159.79.116) Wed Aug 20 09:53:44 PM EDT 2003
Humalog - but he was wondering if Novolog might be worth trying. What can you tell us about it? Thanks

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:53:55 PM EDT 2003
Renee - I know, many children and teens do forget - so I think maybe an extended bolus and then cancel after if they do not eat all of the food and refigure

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:56:04 PM EDT 2003
One more thing about school lunches - I think that a sandwich on whole wheat bread with a piece of fruit with a fun food - determined by your child - within reason would be a healthy lunch

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:57:40 PM EDT 2003
Although the research may not support it, I have found with both myself and with people I have worked with that end of peak action time for Novolog is closer to 4 hours and it may be better for covering the effect of the protein

renee Melissa, 20, dx'd at 9, pump 7 1/2 yrs  (152.163.252.2) Wed Aug 20 09:58:15 PM EDT 2003
as opposed to Humalog, you mean??? Melissa finds the Novolog to be much better too

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:58:51 PM EDT 2003
Yes as opposed to the Humalog

renee Melissa, 20, dx'd at 9, pump 7 1/2 yrs  (152.163.252.2) Wed Aug 20 09:59:33 PM EDT 2003
time for me to go..nice to chat with everyone..thanks for the info Judy!! NIght

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 09:59:33 PM EDT 2003
Some of the new pumps will actully have reminder alarms

Laura B Sam's mom, 13, dx'd 8/98  (68.40.169.224) Wed Aug 20 10:00:04 PM EDT 2003
I think we may be one of the few families for whom Novolog doesn't work... but for Sam, the 'tail' of Novolog just took too darned long. He really needs the immediate peak of Humalog to do the trick. I think we're in the definite minority on that one, though.

Patti Mom of Patrick, 17, dx 6/02  (24.159.79.116) Wed Aug 20 10:00:13 PM EDT 2003
Thanks Judy and everyone else - you have given us much to think about! Smile 

Janace mom of Sarah, dx'd at 21  (24.158.124.35) Wed Aug 20 10:00:15 PM EDT 2003
thanks, Judy. I'm going to bug out.  Wink 

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 10:01:00 PM EDT 2003
Good night Patti and Janace

Laura B Sam's mom, 13, dx'd 8/98  (68.40.169.224) Wed Aug 20 10:01:42 PM EDT 2003
It is 10:00, which is the official 'close' of this chat... however the room will stay open until 11:30 eastern time for those of you who want to continue the conversation. Thank you, Judy, for being with us tonight!

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 10:02:10 PM EDT 2003
Laura - again I do believe that managing diabetes is really about figuring out what works best for the individual, so that they can be in the best blood sugar control possible.

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 10:02:43 PM EDT 2003
Flexibility on the part of the Health care team and the family with diabetes is so important

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 10:03:13 PM EDT 2003
Good night Laura - it was nice to chat with you

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 10:03:46 PM EDT 2003
Good night Renee

Judy Singley, R.D., C.D.E. IDDM - 45+years   (64.12.96.46) Wed Aug 20 10:04:26 PM EDT 2003
Good night all!

Linda Mom of Andrew, 11, dxd at 8, pumping  (24.76.53.46) Wed Aug 20 10:33:28 PM EDT 2003
Hi Cassy, how are you and the family doing?

Moderator   (server) Wed Aug 20 11:25:00 PM EDT 2003
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