An observation with a question

[Jonathan_R]

I have noticed that after breakfast my blood sugars spike considerably. This is probably cause the Lantus has worn off. I am thinking I should eat a lower carb breakfast, or break up the Lantus to twice daily.

Here is my most recent log. diabetes log (http://spreadsheets.google.com/pub?key=t9VUzhpoAfLnAwtjFOSgFIA&output=html)

I'm noticing that I'm spiking in the 300's 4 hours after breakfast. Breakfast is a bowl of cereal of 60 carbs or less. But you'll see all this in the log.

So what should I do.

[shiftzor]

I get spikes in the morning due to Dawn Phenomenon, I have increased my basal dramatically at around 2 am but I still get spikes. I can't eat over 20gs of carbs in the morning. Not sure there really is an answer here it might be your Lantus but it's probably more likely to be DP. Try eating low carb in the morning and splitting your Lantus dose taking one in the AM and PM. You could over bolus in the morning and then eating a small snack later in the morning that works for some people.

[e||ement]

Hi Johnathan
I'm certainly not an expert, but what I would suggest is to change the type of carbs you are eating, and limit them if you can.

Also keep in mind that your I:C ratio may be different at different times of the day.

Have you done basal testing to see if your basal dosage is right for you? A spike 4 hours after breakfast (with no snack in between?) indicates to me that your basal dosage is off. I'm not familiar with how Lantus works but I'm sure someone else will be able to guide you on your idea to split the dose.

I'm not judging your diet by any stretch (I enjoy my indulgences now and then too!) but if you are looking for better control I'd start by cutting out the candy bars, blizzards and starchy "white" foods (raman noodles, potatoes, etc.) first.

Once you get your levels back to where you want them, then reintroduce them slowly and monitor for spikes, etc. to see how you tolerate them.

I would suggest starting your day with a low carb breakfast, as an experiment, to see how that 4 hour pp reading is.

Good luck!!!
Ashley

[Jonathan_R]

I have never done basal testing. I am seriously affraid of that, of any testing involving fasting because of my tendancy to crash, and the results crashing gives me.Namely, seizures. This last seizure was vicious. A six centemeter gash in my head with about 6 staples and one stitch.

How would I figure out different bolus ratios? I have never done that before.

I agree with doing lower carbs and splitting up the lantus. I would like to do a basal test to see how close I am. I'm just scared. If I'm going to do it, it needs to be soon, and not tomorrow.

shiftzor, sounds like you and I are on the same page. I have heard about the dawn phenomenon before. From here, and only a couple days ago, but I am aware of it.

btw, I wish I could upload my log. It's got a lot more than what Google docs allow.

[e||ement]

Johnathan...go out and buy Think Like a Pancreas. It is my BIBLE! It leads you through the steps of basal testing and determining your I:C in an easy-to-read format.

From what I understand, an ideal basal dose should keep your blood sugar fairly steady without eating.

Personally, I can easily skip a meal, or eat low carb and not bolus, and my blood sugar remains quite steady.

However, my I:C is 1:30, so I can probably get away with eating more carbs/no bolus than someone with an I:C of 1:10, for example.

Go get that book!

[yannah]

nevermind, I am not sure what I am talking about here.

[Jonathan_R]

I appreciate all the feedback. I'll try and keep you updated as to what is going on.

I do have a question though. Do you really eat 5-6 times a day? If so, how do you do that at work? How do you do that, and keep a low carb diet?