Thursday, February 13, 2014

Breakfast Hates Me . . . .

Lately I’m seeing a huge post-breakfast spike every day.

BreakfastHatesMe
I can eat foods that never spiked me before, and still I spike.  I can pre-bolus earlier than I ever have before, and I still spike.  I can eat less than I usually do, and still I spike.  It’s getting really aggravating.  So I’m looking for your best breakfast tips!  What do you eat for breakfast?  What is your breakfast bolus strategy?  Have your breakfast blood sugars suddenly changed for no obvious reason, and what did you do to fix it?  Help!!

11 comments:

  1. Hmmmm, tricky!! Based on your bolus indicated, it looks like you are already doing a dual wave (or is that just two back to back?). What about a superbolus? I tried that with my morning oatmeal and after some tweaking with what percent of my morning basal worked best, I got my spike to smooth out a bit. Good luck! Breakfast is always the cruelest meal of the day for me too...

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  2. Breakfast is a difficult dance for me - If I have a lot of physical activity to do in the morning - it's easier - if I'm sitting at my computer screen - Not easy at all.

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  3. I have been seeing the same problem on and off, and now I'm getting a huge spike but dropping low 3.5-4 hours later (which may be a basal problem, not sure!). I have no advice, but just wanted to commiserate! My doctor keeps suggesting high protein, low carb breakfasts to me, but I am a habitual cereal eater in the morning.

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  4. I don't like to eat right away in the morning. What has been working for me lately is to take 0.5 units plus any needed correction right when I get up. My TDD is quite low, and I think that Dr. Bernstein recommends that some of his patients take 1.0 unit upon arising. That usually gives me the freedom to read the paper, answer emails, start laundry, etc before having breakfast an hour or so later. If I wake up low, I postpone this "booster" or sometimes eliminate it.

    When I bolus for breakfast, I usually still take my full breakfast Bolus and ignore the IOB. Other times I reduce my bolus by 1/2 of the IOB. Remember insulin dosing is an art, not science....

    My favorite breakfast recently is 1/2 cup Greek yogurt (I eat full-fat Greek Gods brand or 2% Fage) with 70 grams by weight of cut-up apple or berries. I bolus for 15-18 grams of carb depending on which brand of yogurt and which fruit I use. It's not a very big breakfast, but it actually keeps me satisfied most of the morning. I try to eat low carb most of the time, but find I do better with this breakfast that has some carbs rather than just having eggs and vegetables.

    I also am usually able to walk the dog right after breakfast and that helps prevent a post-breakfast spike.

    I do think that the insulin I take immediately when I get up serves to help prevent the common rise in BG that many Type 1's experience first thing in the morning. (It's not really dawn phenomenon because it doesn't start until I get up.) And it gives me a head start on my breakfast bolus because it is close to peaking when I eat. I do watch my CGM to make sure that I don't go low before eating. If it's trending too far down, I eat my breakfast sooner rather than later.

    So a long explanation of what I do. This is working now and for the most part I don't mind eating the same thing every morning. Occasionally I'll have other things, but in general I've found out that a breakfast with about 15g of carb works best for me.

    Good luck with your science experiment of figuring out your breakfast!

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  5. Long time reader, first time commenter! This post caught my eye because I have recently had some issues not only with breakfast but with basal rates in general. I have started working out, although I would say so far it has been sporadic at best, usually in the evening and varying in intensity from weight lifting to running/walking to cycling. To make my life easy I generally eat the same thing for breakfast every weekday morning - a make-it-yourself slimfast shake with a little extra milk than it calls for. But recently I have been going low before lunch, so today I tried adjusting my insulin-to-carb ratio and is seems better so far. It just blows my mind how exercise can affect blood sugars throughout the day, not just near the time of the exertion. Sorry I don't have a great idea for your breakfast problem, but I suggest sporadic exercising if you want a Diabetes surprise everyday...haha ;-) Kind of.

    Keep up the good work on the blog, I love how "real-people" it is.

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  6. Funny this is your post. I came back from my endo yesterday with good waking sugars, good through the next couple hours, then big spike into upper 200s.
    I love a big breakfast but it's a very low carb high protein.
    SO, dual wave over 1.5 hours PLUS 20 carbs or less seems to be the best thing.
    I've been able to get this to almost work even on days I cave and eat a hollowed-out bagel with cream cheese. Aggressive up front and dual wave the rest. 1.5 hours... roughly.
    Started today at 138, spiked at 211, coming back down.
    25 carbs, 25 protein, 2 units over 1.5 hours.

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  7. Have you tried limiting carbs the night before. Sometimes this helps me with the following morning spike. Good luck.

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  8. What about doing a basal assessment and adjusting your basal if it seems to be a persistent problem?

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  9. A few things that seem to help me when I actually follow them:

    I pre-bolus for breakfast by a ridiculous amount of time - like at least 30 minutes.
    Eating a low carb breakfast (remember those egg cups?) but with a few carbs (a handful of crackers or so). I find that no carbs doesn't reset the dawn phenomenon so I continue to rise.

    Sometimes it's just not possible to do, but when I take those two steps I usually have a positive result.

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  10. We pre-bolus longer than any other meal (usually about 20 mins) and have found success with essentially splitting the meal (a la Gary Scheiner's Strike the Spike) by bolusing upfront for breakfast PLUS an extra 15 or so g of carbs - then eat those extra carbs as a mid-morning snack about 1.5 - 2 hours later (when the insulin is really gaining steam). Good luck with reducing the aggravation!

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  11. Sometimes I wear my son's old CGM to see what happens to me through the day. Remember this is with only a slightly malfunctioning pancreas. I usually wake up 110 - 125. Pretty deluxe, I know.

    When I eat nothing, my BG goes up to maybe 130 by 10am.

    When I eat berries and Greek yogurt [probably a whole cup of berries], my BG goes up to about 170 within an hour of eating.

    When I eat banana bread with peanut butter, fire shoots out of the top of my head and I speak in tongues, my BG goes up over 200 for a moment and then crashes.

    Would any of those plans be good for you? : )

    I love Laddie's description of how she does it. Even though everyone is different, and food effects each of us differently, isn't it so helpful to have precise ideas to use as starting points---or just for the knowledge bank? I never get tired of reading about what people eat and how they bolus.

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