Diabetes? Diet, Meds, Food Program?

[TwinKristi]

Someone inquired about DC for a 2yr old who has diabetes. She said her last DC made her provide food since there were carb counting issues and such. Anyone have experience with this? Administering meds as needed? We haven't set up a time yet but I wouldn't mind working with them at all.

Added- also, how will this work with the food program? I know they ask if there's any disabilities and such and if she needs a dr's note for an alternate diet will they still pay?

[itlw8]

Why do you need to serve an alternate diet? As far as the food program they love it when you serve a healthy diet. and far to many of us serve too many carbs.

Truly it won't be that hard to learn to plan the meals for the whole group. planning is the key. Truly it is the way we should all eat

[Lucy]

Really, you only have to make sure the child eats healthy. And you have to closely monitor that he DOES eat what you've served, because of the carb counting. You could very easily adapt the way you feed the diabetic child to what you feed all the other children.

This is a document from the ADA:

http://care.diabetesjournals.org/content/28/1/186.full

Specifically, read this section:

Nutrient recommendations are based on requirements for all healthy children and adolescents because there is no research on the nutrient requirements for children and adolescents with diabetes. Children and adolescents should adopt healthful eating habits to ensure adequate intake of essential vitamins and minerals. In general, U.S. children are not eating recommended amounts of fruits and vegetables, although children with diabetes may be doing somewhat better than the general population in some areas. A 1996 report on dietary intake of 4- to 9-year-old children with type 1 diabetes found that energy, vitamin, and mineral intakes were adequate while fiber intake was less than recommended. However, many children consumed levels of saturated fat well above the National Cholesterol Education Program (NCEP) recommendations.

_________________________

I would suggest charging them extra because of having to administer the insulin.

[Childminder]

I have two children with diabetes in care. First was two when diagnosed and is now four, second was six and is now ten but only comes summer.

It can put a little bit of a stress on a time that is always a bit more hectic, lunch or meals, but once you get the routine down it goes quite smoothly. At first it was quite daunting figuring out the carbs, using the formulas and amount of insulin, I had no issues with finger pricks and injections, it was fear of a wrong calculation but now we are good to go.

They are both now on pumps which makes life so much easier! I poke the finger and count the carbs but when I enter that info into the pump it calculates amount of insulin and administers it. Your little one is probably too young for the pump yet.

These kids, especially the youngest, are my heroes! They remind me to "pokey" them if I forget, they remember the numbers if I get distracted, they never complain.

I do not know if it's possible to charge more for them being in care I charge the same. I think we have something in regs that we can't charge more to special needs children but I wouldn't if I could. Check and see I guess if you wish.


.

[Josiegirl]

I've had a dcg in my care since she turned 1. They found out she was diabetic when she was just barely 4. It was a whole learning process, dcm would come and do her finger prick before meals, then administer her insulin after meals. It was a pain for the poor mom so I learned how to do it. I'd given my dad insulin so that part wasn't new to me, but doing it to a 4 yo was very different. However, she was amazing about it, truly amazing. She now has a pump and does it all herself, I merely watch. She'll be 6 in Aug.

I think, looking back, the most challenging part was replacing the higher carb foods with other things she'd eat. She loves chicken, cheese, and cucumbers, which helped. But you can't live on those foods alone. I just figure ahead of time how many crackers, etc., she can have, then fill in the rest with something carb free. She can even have a cupcake, either without frosting or Cool Whip puts out some low carb frosting. Yogurt that I serve for snack has 16 carbs. If she eats a whole one, I fill in with something else carb free. If she wants crackers at the same snack, I give her half a yogurt, then the # of crackers she can have. Sandwich day-I buy Sara Lee 45 calorie light bread, it's half the carbs so she can actually have a whole sand, and usually the filling is protein anyways. She loved her cold cereal, but it's so high carb. I found out she loves Honeycomb and it's so big that it can fool the eyes. I measure it out, she's happy.

It's really not that big of a deal, it might take a wee bit more reading labels at the store in the beginning but it turns into habit very quickly. She can pretty much eat anything but you just have to be more careful about portions and choices. Unfortunately she's not a veggie lover. She loves fruit but ya have to portion that out too. No juice here so that's not a problem. Oh she also loves her ranch dressing but if you shop around, you can find something a lot less carbs than regular, same with syrup, jellies.

I'm on the food program and it works out alright. I've never charged her extra. DCM and I are always letting each other know about a good idea or recent find at the store she likes and works.

Good luck with your decision, these little children who have diabetes are extremely brave, IMO.

[sharlan]

Let me double check, but I don't believe that we are allowed to administer insulin in CA. We can check glucose levels, but can't treat.

[sharlan]

I remember having a discussion with another provider about the administration of insulin, but I can't find it in our Title 22 regs. Check with your analyst.

[Denise]

Diabetic here and not on meds ... totally diet controlled at this point. I find tons of fun and interesting recipes on Mellissa Sevigney's sight ... I breathe, I'm hungry. There's even ice cream! Easy crackers ... and a pumpkin crepe cake to die for.... here's the link: http://www.ibreatheimhungry.com/ There's also a food product out there that I purchase from Amazon that is LOW CARB and FUN, crunchy and yummy. A couple of my friend's non-diabetic kids tried it and now beg their mom to buy them. Let me find a link ... http://www.amazon.com/Kims-Magic-Oni...pr_product_top

[Childminder]

Denise, are you type one or two?

[Blackcat31]

Originally Posted by Josiegirl

I've had a dcg in my care since she turned 1. They found out she was diabetic when she was just barely 4. It was a whole learning process, dcm would come and do her finger prick before meals, then administer her insulin after meals. It was a pain for the poor mom so I learned how to do it. I'd given my dad insulin so that part wasn't new to me, but doing it to a 4 yo was very different. However, she was amazing about it, truly amazing. She now has a pump and does it all herself, I merely watch. She'll be 6 in Aug.

I think, looking back, the most challenging part was replacing the higher carb foods with other things she'd eat. She loves chicken, cheese, and cucumbers, which helped. But you can't live on those foods alone. I just figure ahead of time how many crackers, etc., she can have, then fill in the rest with something carb free. She can even have a cupcake, either without frosting or Cool Whip puts out some low carb frosting. Yogurt that I serve for snack has 16 carbs. If she eats a whole one, I fill in with something else carb free. If she wants crackers at the same snack, I give her half a yogurt, then the # of crackers she can have. Sandwich day-I buy Sara Lee 45 calorie light bread, it's half the carbs so she can actually have a whole sand, and usually the filling is protein anyways. She loved her cold cereal, but it's so high carb. I found out she loves Honeycomb and it's so big that it can fool the eyes. I measure it out, she's happy.

It's really not that big of a deal, it might take a wee bit more reading labels at the store in the beginning but it turns into habit very quickly. She can pretty much eat anything but you just have to be more careful about portions and choices. Unfortunately she's not a veggie lover. She loves fruit but ya have to portion that out too. No juice here so that's not a problem. Oh she also loves her ranch dressing but if you shop around, you can find something a lot less carbs than regular, same with syrup, jellies.

I'm on the food program and it works out alright. I've never charged her extra. DCM and I are always letting each other know about a good idea or recent find at the store she likes and works.

Good luck with your decision, these little children who have diabetes are extremely brave, IMO.

This is how my DH eats. He is type 1.

He eats whatever he wants, just measures it out. He weighs his food though because it's more accurate for serving sizes.

Lucky for him though he LOVES veggies so that helps a lot.

His go-to snacks are meat sticks, pepperoni, nuts, cheese sticks or fresh mozzarella.

He is a good candidate for the pump be he refuses to get one as we know several people with one and from what we've seen, it is just easier to do it manually.

I can see a child with a pump being MUCH easier to manage but my nephew had a pump (he got diabetes at 4) and because he relied so heavily on the pump just doing it's job without really monitoring himself (or his parents), he ended up being air-flighted to the children's hospital several times.

He finally got rid of the pump and does much better now. But that's just our experiences, I am sure the pump works great for some.

Also like itlw8 said, the diabetic diet is really how everyone should eat anyways. It's an ideal diet.