Monday, October 31, 2011

Karl's First Diabetic Halloween

Karl's 17 now, and his interest in Halloween has been declining for a while, so his heart wasn't set on doing the whole Halloween shtick. Still, he wore his aviator costume today (an Air Force surplus flight suit plus a white scarf, white gloves, and black aviator's helmet and goggles from a costume store).

Karl in his flight suit on Halloween, after he'd taken off the
 accessories and put on his habitual hearing protection.

As far as sweets go, he got just five sugar-free candies and a McDonald's ice cream cone, which at 38 carbs was a pretty low-carb Halloween debauch! But added to his dinner, the total came to 92 grams of carbs, which is a lot for him.

He's been seeing high after-meal bloods-sugar levels whenever he gets more than 75 grams of carbs or so, so tonight we tried lower his carb ratio from 20 to 18. That is, his insulin dose was calculated at (92 grams / 18 grams per unit) or 5 units, where before we'd have calculated (92 grams / 20 grams per unit) or 4.5 units. We hoped the extra half-unit would keep his blood sugar around 100, but it didn't -- it shot up to around 180. Sigh.

(Yes, a lot of people insist that 180 after a meal is okay. It's not, though. It seems that anything above 140 or so causes damage.)

We've just realized that french fries at fast-food joints have a size that's smaller than small -- at McDonalds, a kids' fries has only 13 grams of carbs, compared to 29 for a small. That would have gotten Karl down to 79 grams of carbs, which is a range that works better for him. (The Burger King equivalent is a "value fries.")

Karl's autistic and has very strong food preferences, and is upset if he doesn't get his fries, but he's not that concerned about portion size. And that's part of the reason why he's not too worried about losing Halloween candy. He had some candy, and it was enough.

(Will the microscopic McDonald's kiddie cone be enough to make him happy? We'll find out soon!)

His favorite meal when dining out is chicken strips, which in spite of the breading are fairly low carb. A 10-piece McNuggets meal has 30 grams of carbs.

None of this is truly low-carb by Atkins standards, or those of Dr. Bernstein (who recommends only 30 grams of carbs per day), but anything under about 75 grams per meal seems to work well.

Karl's blood sugars will probably be back to normal by morning, which means that every day starts with a blank slate.

Karl's blood sugar over the last week. The two last readings are from his mild Halloween excesses!

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