A friend’s 11-year-old was just diagnosed with Type 1 diabetes. As my friend said, this kid has been healthy as a horse all her life, and has decided to overcompensate :eek:
I want to take them some food - what with being in the ICU ‘n’ all, they haven’t had time to do much food prep. I do not want to harm their kid, obviously.
So - I know carbohydrates are the issue here. Does a diabetic need to minimize carbs such as pasta, or just see to it that she gets enough insulin to compensate for whatever carbs she does eat?
Are there any carbs in meat? Are there sufficient carbs in dairy to be worrisome?
Certainly I’ll document whatever I bring ‘em, but any guidelines to help with deciding what to cook would be most welcome. Presumably not a big ol’ batch of brownies but would any reasonable casserole do the trick?
There are two types of diabetes, type I and type II.
Type I diabetes (“insulin-dependent” or “juvenile-onset”) is a condition, usually but not always genetic, in which the pancreas does not produce insulin. The typical remedy is to inject insulin manually, and the body regulates its own blood sugar.
Type II diabetes (“insulin-independent” or “adult onset”) is a condition where the cells that are stimulated by insulin become resistant. The pancreas is still producing insulin normally, but the insulin isn’t doing anything. The blood sugar then has to be controlled by diet. Type II diabetes is typically what people talk about when they refer to obesity leading to diabetes.
People with type I diabetes still have to watch their diet, but not as carefully as people with type II. One of my friends with type I diabetes has a nifty insulin pump which injects her constantly throughout the day – before a meal she can manually increase the level.
I attended a diabetes research fundraiser at one point and get incessant mailings from the Joslin Diabetes Research Center. I have no clue whether they’re big or small or even legit, but there’s some information on that page.
In the ICU, the child will probably not be eating anything brought from home.
Parents would not be allowed to eat at the bedside. CDC mandates that. Because of the close quarters and varied activities often, involving body fluids, the ICU is considered a contaminated area.
So, taking food for the parents would be fine, they would be provided a place to eat. So, go ahead and bake those brownies!
Just an FYI plants, flowers and Mylar balloons are also not allowed. The plants and flowers because they contain bacteria that a compromised patient could become ill from. The Mylar balloons because they can short out the monitors and other electronics.
There are hospitals that don’t follow all of the above, but food for home for a new Type I diabetic would make someone’s head explode.
Once she goes to a regular ward, she’ll have more freedom, but the dietitian would have to approve anything even then.
Here is a link from the American Diabetes Association. Perhaps you can get a subscription to this newsletter. The newsletters by email are very interesting and informative:
That all makes sense, PN, thanks for weighing in. My only personal experience with an ICU was the NICU, where obviously outside food was no issue (well, I brought in “outside food” but it had been processed and turned into breastmilk first :D) I don’t recall seeing any balloons etc. there and I’m sure they would not have allowed plants!
She’s actually been discharged to a regular ward as of 48 hours ago. I know her mother has been bringing in real food from home - with hospital permission - as the food at that particular hospital is, shall we say, “alternately edible”
Yerba Buena - interesting comment that a Type I diabetic doesn’t have to be as careful as a Type II. I’ll freak out a little less while trying to decide what to cook for them. As long as I provide ingredients/amounts to the family, they should be able to figure out how it’d fit, right?
ZipperJJ - thanks for the links. Yes, I meant real meat, not the prepackaged Tyson-y stuff which is closer to toxic waste than it is to being anything edible
You do not do the child any favor by bringing her food. Her food intake will be a problem for her until she understands why she has to do and what the consequences will be if she does not do what is required to maintain her health. Habits of a lifetime have to be altered. If it got so bad that she had to go the ICU, she does not have the luxury to ease into it. She has to follow it now.
If I understand the way diabetes is usually diagnosed, it’s normal for her to be in the ICU and doesn’t indicate that things “got really bad.” Kids developing Type I diabetes generally suffer with the symptoms for a while before someone realizes there’s something serious happening, at which point they’re taken to a doctor. When the doctor figures that diabetes may be the problem, the kid will be taken to the hospital so insulin can be administered and a number of tests can be done to determine how severe it is and so on.
Unfortunately, for TIDM, the presentation often is a medical emergency, diabetic ketoacidosis (DKA). It is not so indolent like TIIDM, where you may have years of being thirsty, hungry, and peeing a lot before the diagnosis is made.
A presentation with DKA almost always is managed in the ICU – things can rapidly turn bad as it is basically a starvation/dehydration state compounded by having high levels of blood glucose causing more dehydration. People in DKA often need several liters of intravenous fluid as well as an insulin drip for a day before they can be stabilized.
Type I DM is usually an autoimmune condition, and can be associated with other autoimmune conditions like hypo/hyperthyroidism, Addison disease, and a few others. It is associated usually with a specific cellular marker used in recognizing self from nonself; there appears to be some cross-reactivity with the cells in the pancreas that secrete insulin (the beta cells of the islets of Langerhans). Oftentimes, this is precipitated by a mild viral illness, like the common cold. One becomes diabetic when, IIRC, greater than 80% of the cells are killed off. The cells don’t regenerate, so you lose that function permanently and it is expected that you lose all insulin secretion pretty quickly. This explains the need to supplement insulin.
Diet at first will be tightly controlled; it is a field unto itself, with full-time diabetes educators on staff at most hospitals. The first few months will probably be quite intensive monitoring of diet, and correlating specific foods with shifts in blood sugars, and calculations of correct insulin doses. Food, I’m sorry to say, is not the best gift at a time like this.
Um, yeah - it hadn’t occurred to me when I made the OP that folks might think I was planning to bring food to them in the hospital :smack: - Definitely NOT my intent - I wanted to bring some casseroles over to the house for the parents to eat, andd depending on when the child was discharged, for her to eat as well. Nope, I had no desire to repay years of friendship by harming their kid :eek: I just had no clue what would be appropriate.
I wound up making a couple of tried-and-true casseroles with very detailed lists of what was in them, including totals of carbs, calories etc. from all the ingredient labels, and taking them over a few days later.
Yes, in this situation, the child had (in hindsight) been heading downhill for some weeks, but it went critical very suddenly. She was a Very Sick Kid. Another friend had a child dx’ed a month or two earlier, and that kid avoided the ICU, just barely, because they caught it a bit earlier.
I should have realized that. Sorry if I sounded snarky. Actually, cooking a couple of different things that are “approved” might be helpful in itself. They can sample them without the hassle of cooking it, and if they like it, you can forward the recipe to them. I hope your little friend is feeling better.
but would any reasonable casserole do the trick?