[kid_fears99]

I have a question about morning BGLs - any help you guys can give me would be greatly appreciated! In the morning, after breakfats, my BGLs drop extremely rapidly. However, first they go up sky-high. So two hours after breakfast, I can be anywhere from 250-400 (so I spend these two hours feeling horrible). But then, they fall extremely rapidly - sometimes as much as 150 points in 45 minutes. By 11:00 a.m., I end up having to eat a snack to prevent/correct a low. I take Lantus in the morning (15 units). My basal rate is correct, as my fasting BGLs are between 100-120. Each morning I eat a bagel with cream cheese (60 grams carbs), and my carb ratio is usually about 1:15. I have DP, so I wake up high - but even so I usually only take 4 units of Humalog with breakfast. I can't figure out why this is happening, or how to correct it. If I take less Humalog, my BGLs get dangerously high in the first two hours after breakfast. If I take more, I get hypo even earlier. Has anyone experienced anything like this, or does anyone have any ideas of what I can do?

[Lynne1]

I'm having similar problem. My levels don't spike quite as high but they spike when I eat cereal for breakfast. I'm going to test some other foods and see what happens. I'll let you know what works for me.

[Simon]

I've had this type of thing too. I think that the DP causes insulin to become inhibited so you need more then the DP wares off and all that extra insulin kicks in hard. I deal with it by getting up earlier and having breakfast asap, if my fasting bg was high I'll take an extra unit of novorapid then snack about 3 hours later if needed.

[jen_slc]

I would suggest trying something less carb-heavy for breakfast and see if that helps? A bagel is certainly hefty! I try to minimize carbs as much as I can when I know my bg is going to run on the high side. Not always easy, but if you know your bg is going to spike anyway, why add to the problem by ingesting a large amount of carbs?

[poodlebone]

I agree with jen, try something with less carbs for breakfast, like eggs/egg beaters, cottage cheese or something with more protein. Have you tried taking Lantus at night? When I was on Lantus I had to take it twice a day because if I took it all at night I'd wake up too low the next morning and by early evening I'd be high. I never tried taking it all in the morning, because then I'd most likely wake up too high the next day. It only seemed to last around 18 hours for me, which is why I split it.

[kidvid]

I had basically thie same thing when I was on MDI. No matter what I ate I spiked, even if carbs were down around 25-35. My spikes were 200-300 range. I took my Lantus in the evening, but that probably didn't have much bearing on things...but I went on Symlin to control spikes. I gotta say it worked great. I'm T1 and skinny and it didn't hinder my appetite, nor make me nauseus. Spikes smoothed out in a week. I halved my bolus to begin with, but had to work back up to my old carb ratio. I stayed on it for 3 months till I went on a pump. Now I still fight spikes, but keep carbs for breakfast low, and bolus twice per meal if needed.

Joe

[Cyborg]

How about going back on Symlin. Several of us on the forum are pumpers and taking Symlin.

[Cinnabon]

Sounds like a bit of trial and error to try and nip this. Give all this wonderful advise a try. The waking up earlier, have breakfast and all that. Also, try not to have so many high carb foods. You got to give this all a try and test much more so you will be able to get a better idea. how about your before bed snack, what does is it like?

[vrocco1]

Bagels are the bomb as far as carbs are concerned.

[corwin]

The way it seems to me is that your spike in BG just happens earlier then the spike in insulin. Why not just take the insulin earlier? If you take it right before you eat, try 10 minutes before that. It's especially easy if you eat your bagel every day, figure it out once and you are good forever. I find that for certain type of food I need to inject after I eat and for others about 10 minutes before, it all depends on the carb type and the individual way your system process the food and insulin.

I wouldn't go for the "low carb" option. I refuse to let the disease control me more then I have to and I think that adjusting the insulin to whatever you want is better then adjusting what you eat. Maybe it's just me.

Goodluck fixing this.

[Ailsa]

I think this sounds a bit like what I have been having up until recently.
I would wake up at 4.5(81) 2 hours later I would be 10.5(189) & then hypo by 11.30. Is this what you mean?
I think what is happening in my case, is that the Lantus is only lasting 20 hours. It's fine when I get up, but then I'm short until the next shot kicks in around 11.00-11.30.
I have found if I skip breakfast my BG rises.
The last 2 days I've taken an extra 2 units of Novo to cover that gap. I've tested 2 hours later & got a good reading & had a snack about 10.30. That has prevented the hypo & given me pretty good results up to lunch.
That could be worth a try.
Also I tend to eat lowish carb, so the max carbs I would have is 40, but often less. I think that helps

[dnamertz]

Originally Posted by kid_fears99

I have a question about morning BGLs - any help you guys can give me would be greatly appreciated! In the morning, after breakfats, my BGLs drop extremely rapidly. However, first they go up sky-high. So two hours after breakfast, I can be anywhere from 250-400 (so I spend these two hours feeling horrible). But then, they fall extremely rapidly - sometimes as much as 150 points in 45 minutes. By 11:00 a.m., I end up having to eat a snack to prevent/correct a low. I take Lantus in the morning (15 units). My basal rate is correct, as my fasting BGLs are between 100-120. Each morning I eat a bagel with cream cheese (60 grams carbs), and my carb ratio is usually about 1:15. I have DP, so I wake up high - but even so I usually only take 4 units of Humalog with breakfast. I can't figure out why this is happening, or how to correct it. If I take less Humalog, my BGLs get dangerously high in the first two hours after breakfast. If I take more, I get hypo even earlier. Has anyone experienced anything like this, or does anyone have any ideas of what I can do?

I agree with Corwin that you might want to take the shot a little earlier. I also had this problem, but not as extreme as you. My blood sugars would fall about 150 points between 2 and 4 hours after injection/breakfast. In order to be normal by lunch I would have needed to be over 200 two hours after breakfast. So, what I do now is eat less for breakfast and then 2 to 3 hours later eat a snack. I'm basically eating the same amount of carbs I was eating a breakfast, but now they're spread out over breakfast and a snack.

Shifting more of your breakfast carbs into your snack is something you might want to consider. Maybe eat half the bagel for breakfast, then test you blood two hours later and hopefully you'll be in more of a normal range, then eat a snack (probably bigger than you eat currently) to counter that extreme drop in blood sugar thats about to come.