diabetic question and stuff

[peaceful nurse, RN]

Ok so Here is my current dilemma... My little type 1 can take up to half an hour to eat.. if she sits down in time ( its preschool and that hardly ever happens) do I stop here when the scheduled time is over? they are given 20 minutes for snack and her meals are timed 2.5 hours apart however it is more like two since they don't sit down on time and she take a long time... do you tell her she has so many minutes left and then she is through. It is just so complicated.

[MrNurse(x2), ADN]

I have explained to the teachers that food is medicine to my T1D. She must snack whether her classmates do or not. Our school does lunch together and there is a no eating until everyone is in the cafeteria. Numerous times I have told my student to start lunch immediately. My office is a cubicle in the same room as lunch, so I can explain easily enough. Let her take as long as she needs, it is better than her dropping.

[NurseBeans, BSN, RN, EMT-B]

If I am remembering correctly, and since I am too lazy to look into it right now, part of my 504 plan for my type 1's includes a few lines about having extra time to eat if necessary, and being able to make up any work missed if it becomes an issue. The extra time is offered in my office. They must eat, and for some reason the ones for whom food is medicine like to take exxxxxxtra looooooong to eat.

[BeckyESRN]

I'm with Mr.Nurse on this one-meal times and snack times are non-negotiable for a diabetic kiddo. The teachers may not realize just how important it is that meals/snack be on time, so make it clear to them that this child's medication will not work correctly if her meals are not timed properly and yes, 20 minutes can mess up the entire day.

As for the kiddo taking forever to eat; my son is now 5 and for a while I didn't think he'd ever finish a meal with the rest of the family! He would take for-freaking-ever to eat lunch/dinner. Setting a timer worked really well for him, maybe it could help this little too? Something that she can see while she's eating

[OldDude]

It doesn't matter what grade level it is. If she is scheduled to eat to a certain time she needs to eat at that time; especially a 4 year old. So, get that set with whoever. Like these guys said, she needs to eat all the carbs she has planned for that meal. I suspect the biggest reason she doesn't finish eating in 30 minutes is lunchroom distractions; that is an environment you can change. Just remember...her diabetes management plan trumps school schedules. A 504 likely isn't required at this point but will come into play in a few years. Hang in there and good luck!

[peaceful nurse, RN]

I am totally not one that wanted to say okay, your done... lets go!! but mom is struggling with numbers being too high or too low and insulin duration. it being too close to correct a high due to carbohydrate dose or being low and now wanting to give all the carb dose based on her dropping. I feel like I just don't understand and its frustrating to me. I want the child's life to be as normal as possible, eating the same food, same time. now we are considering making one snack lower carb. thanks for letting me rant. I agree that lunch distractions are a big deal... even just eating with me she constantly ask me to guess things and play with her. I did talk to the teachers about getting her to the table at the right time and starting to even thouth they said oh yeah we sit down as scheduled... she needs to be the first one to sit and start eating.

[Flare, ASN, BSN]

This has been where Nurse Flare really lives up to her name - messing with my T1D student's meals. I have gone to bat many times when I've learned that my student's with insulin on board were made to wait to get their lunches or rushed and not allowed to finish all their food. And by gone to bat I should really clarify and say bat S#!t crazy at the lunch aides giving them a hard time. My students right now are all older and i believe feel empowered enough to say something- but they know that all they have to so is say the word.

Same goes for access to snacks and a student having to leave if she feels low. Yes - believe it or not dear colleagues, this was an actual argument. The child ultimately was allowed to come to my office - her blood sugar was 56. I still get fired up when i think about it. I get and appreciate cutting down of frivolous visits to my office and interruptions in teaching but this teacher needed to have a different perspective.

[Flare, ASN, BSN]

also - wanted to add - agree with OD to the point that she does need to learn to eat within a suitable timeframe. Perhaos the parent can shed some light on if it takes her that long at home or if she is getting distracted. If not, then alterations will need to be made either to lunch, eating location, something... If she's just a slow eater, then i would think it's a discussion to have with her medical professional writes her orders for her T1D

[shark_nurse14, BSN, RN]

I find my little ones (and some teachers) do really well with reminders!

For one of my teachers, they explained they just get side tracked and don't necessarily remember Little One NEEDS to eat RIGHT NOW. We came up with a plan to have a reminder set on her (teachers) cellphone to play 5 minutes before snack. Even if they are in the middle of something, Little One knows her special ringtone (she got to pick it) and will go grab her snack herself.

For students that take too long to eat, I've bought countdown timers from the dollar store/discount stores and let them decorate it with stickers/ribbons...this way they can watch as time ticks away and can better manage finishing their lunch. I've also had parents label the foods in lunchboxes with "#1", "#2", "#3", so on....lunch item #1 is the item with the highest carbs, and the student is to eat that FIRST. Usually the last numbered item is the thing they REALLLYY want to eat, so the incentive is there to eat quick enough to get to that item, without a teacher/nurse having to be the bad guy.

[peaceful nurse, RN]

Head Start does Family Style Meals and lets the child choose how much to eat. Today I choose a lower carb snack with the correct serving size that will hopefully make a shorter snack time. She has a tendency to eat and eat and eat- Many serving of crackers for instance. I think hope she doesnot feel singled out. Am I doing the right thing? When parents provide food they provide the right serving.. You can't just let a child eat and eat and eat.

[peaceful nurse, RN]

here is an addendum question... How do you deal with Continuous glucose monitoring? what phone would you use and are you responsible for every five minutes it checks? I know that it does not replace accuchecks... I need some assistance. my type one is getting the dexcom;5 and manager thought it wouldn't be this year... well she has it. I am thrilled...but nervous

[kidzcare]

here is an addendum question... How do you deal with Continuous glucose monitoring? what phone would you use and are you responsible for every five minutes it checks? I know that it does not replace accuchecks... I need some assistance. my type one is getting the dexcom;5 and manager thought it wouldn't be this year... well she has it. I am thrilled...but nervous

To follow her, you will need a compatible device. I think that means an iDevice (iPhone, iPod, iPad) since I think the app is only available through iTunes. I think I remember reading that you can set the times that you are able to access (you don't need to know what her blood sugar is on Saturday afternoon and it could be considered a violation of privacy).

All the student's I've worked with who have Dexcom have been very independent and able to handle it all on their own. Sometimes I'd get a call from a parent who wanted to make sure their kid was in my office because their blood sugar was in the 50s.