Category Archives: Diabetes

The pie story

Fruit pie has always been one of my favorite desserts.  It’s one of the first desserts I took the time to learn to make well when I started needing to cook for myself.  And yet I went without it for almost two years.

The problem with fruit pie is that when you cut into it, the filling pours out, so there’s no way to make sure that the 1/8 of the pie crust that you serve someone has almost exactly 1/8 of the filling.  With something as high carb as fruit pie, this means that there’s too much uncertainty as to the carb total to feed it to a small child with diabetes.  I didn’t want to thicken up the filling, because I don’t like pie fillings that are gelatinous or starchy.  For this reason, I did not make any fruit pie, and so did not eat any fruit pie, for almost two years after my daughter’s diagnosis with diabetes.  There were times when it seemed like I was crying because I wanted fruit pie, although of course I was really crying about diabetes in many ways.

Then, instead of making a birthday cake for myself, I tried to make individual blueberry pies in canning jars, following an idea in King Arthur Flour’s blog.  They were good, but they somehow didn’t qualify as fruit pie.  I think that the shape and the filling to topping ratio were just off a bit.  Also, the filling and crust were cooked separately.  The carb counting was OK, though, which was encouraging.

Then, about a month ago I remembered that I had mini pie pans in the cabinet.  They make about 1/4 of an 8″ pie.  I made apple pies with these, and gave my child with diabetes half of one.  This was OK, I can split something in half and eye how much of the escaped filling goes with it.  Now, I can make fruit pie occasionally.  I found myself in tears again that night after the rest of the family was in bed.  I had fought one more little piece of normal away from diabetes, and it was one that was important to me.

Before I could make fruit pie, I needed several things.  I needed the idea of making small pies so that the carb counting was reasonable.  Also, I needed the confidence to tackle a food with such a high carb total.  This experience reinforces my belief that there is no real food that my child cannot eat if I put enough thought and effort into it.


Ok, so all parents understand part of this frustration.  You work hard to make delicious, healthy food for your family,… and then one of the kids doesn’t like it, and lets you know this in no uncertain terms.  Maybe they even refuse to try it.  Positively maddening.

However, for those of us caring for small children with diabetes, this frustration can get even worse.  Not only  have we put in the time to cook a meal, but we’ve also spent the time and care to carb count it.  The cooking also benefits the rest of the family.  We even get to enjoy the food.  The carb counting is only for the sake of this one child.  And then they won’t eat the food.

I could suggest philosophical resignation… It’s good practice carb counting.  However, that doesn’t make me feel any better.  What does make me feel better is to remember that it’s my job to take care of this precious little one, and even if she won’t eat this food, I had to be prepared in case she did.  I’m glad to do what I must to take care of her.  This same determination (it’s not just an emotion) that gets me through the 3am alarm clock for a night check can get me through this frustration.

(I know some families would push harder than I do to require a child to eat what is provided.  I’m not willing to do that, because it’s hard enough for a child with type 1 diabetes to have a healthy food attitude without the added pressure.)

Why so careful?

To those who do not care for small children with type 1 diabetes, it may seem that I’m going overboard with the detail in my carb counting.  However, this is the level of detail that I find necessary.  I’m feeding a small child who sometimes eats meals as small as 15 grams of carbs.  To be off by three grams of carbs would mean an error of 20% in carb total, and so 20% in her insulin dose.

When we eat at restaurants, I obviously don’t have this degree of accuracy, because I’m not going to bring a scale and measuring cups with us.  I just estimate fractions by eye, and do my best.  I often will check blood sugar about 2 hours after insulin to check for a low just in case I was off by a lot.

Just like nutrition and parenting, in carb counting I do the best that I can and then try to let go of the things I can’t do quite right.  It’s the overall pattern that matters more than any specific instance.  Our wonderful diabetes team has set up a structure that will catch any errors before they can harm my wonderful child.

What is type 1 diabetes?

Type 1 diabetes (often abbreviated T1D) is a condition where a person’s body is no longer able to make its own insulin.  This leaves a person’s body unable to use the sugar in the bloodstream.

Type 2 diabetes is an entirely different disease.  Because so many more people have type 2 diabetes, when most people mention diabetes, they mean type 2.

The usual treatment for type 1 diabetes is insulin.  The insulin can be injected or come through an insulin pump.  The amount of insulin has to match with the number of carbohydrates (carbs) in the food eaten.  This is where carb counting comes in.  The person with diabetes (or a caretaker for a small child) adds up the carbs in food eaten at each meal.

The American Diabetes Association has an explanation of type 1 diabetes.

The JDRF is an organization very involved in raising funds for diabetes research.

For parents caring for children with type 1 diabetes, this community can be very supportive and helpful.  They have a forum for posting questions.