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jazzcat

Super High Blood Sugar after Breakfast!

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jazzcat

Hi,

 

I have been posting on the IVF and type 1 diabetes thread but I need to ask a question and no one has gotten back to me.

 

I am on a pump and sometimes, often I wake up quite high( i think i tangle it and stop it from working) , if I go up even a little in basal I go low, but mostly no matter what I eat and even if i just have coffee, after breakfast I go super high.... I then correct and go very low, I dont know what to do. My specialist said to give insulin half an hour earlier, doesnt help, tried super bolus, went low, dont eat but still eventually it creeps up.

 

If anyone has any suggestions that would be great.

 

I am thinking maybe I should do a large bolus and then reduce pump and eat around 11, but I am trying to watch weight and reducing carbs so this is tricky.

 

Rachel

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jazzcat

by the way, I only eat carbs during the day mostly except when eating out and I eat either two pieces of wholegrain toast with Vegemite or Peanut butter or a bowl of low Gi natural muesli... Its not like i am eating pancakes and maple syrup.

Thanks

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Subby

You're on the pump, so you are definitely carb counting, right? How many carbs are you having with that breakfast? Sounds like a decent whack. Being "low GI" on the packet or wholemeal for the bread, doesn't give any guarantee at all that the carbs actually work slowly for your body. We tend to react differently to food.

 

What I'm getting at here is 1) you're still eating a pretty high carb breakfast and 2) there's no guarantee that the reasons we are given for carbs to spike slowly are what is going to occur.

 

I'm not saying you should eat low carb or only certain things. Just trying to clear up why there might be issues. We need to ultimately go by our tester as to whether a carb spikes us badly. You've got the evidence here already that you do have decent spikes to contend with, who cares what the claims are on the packet.

 

Dealing with it: if you are geared towards reducing carbs for BG and weight, then I'd do so and cut out some of the carbs. That really should help dealing with it with a bolus. Cereal, can be especially problematic. Note the "can". It really seems different for all how much and what types, of carbs can be dealt with.

 

In the superbolus scenario where you went low but slowly crept up, my thought is that you need slightly less of a superbolus (you could try half the future basal instead). You could also experiment with a superbolus and a dual wave bolus in one, to cover both the front and tail end issue.

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dex123

I have a similar phenomenon in that i need about 3x the insulin for breakfast compared to what i would normally bolus for the carbs, i think its an insulin need due to waking up or something, im 18 so it may be a teenage hormone type thing when waking. Could you increase your basal an hour before breakfast/ waking and do a more ordinary bolus perhaps? sorry if i rambled a little :/

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jazzcat

Thanks so much for the ideas... It is causing me a lot of grief.

My bread for two slices is 24 grams of carbs and my cereal is around 22 grams. I have lots of problems with cereals and muesli...

My doctor believes I may be having lows during the night, thats why I wake high and go higher but and here is the But, I can wake with a really good bs and eat and then it go through the roof, does a night time low do this?

My basal rate is set lower after 10am to stop the lunchtime lows and higher around 4am, thats all covered.

I have been on the pump for only a few months and do not know what a dual wave bolus is.??????????

Rachel

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Subby

Your doc's explanation doesn't sound convincing to me, for what that is worth. When I've had lows followed by highs I see the results on waking, not after the next meal. I get the feeling that explanation is just avoiding the problem of the food. Another thing that might help to consider is that people can be more insulin resistant at different times of the day, meaning that they need more, or that insulin doesn't work as well and/or as fast. That might be playing a part for you. Carefully prebolusing is another tactic that may be worth using.

 

With the breakfast, especially adding in some milk (you eat your cereal with milk?) you are likely pushing past 50g carbs. To me, that sounds pretty high carb. How are you assessing your carb intake, do you have daily goals? If you look on your pump, you should be able to find daily totals of what you bolus for.

 

Dual waves and square waves are types of bolus that release the insulin over a period of time, chosen by you. So instead of getting your bolus all at once over a minute or so, you choose the time length and the pump delivers it evenly over that time period. Examples: you could opt for a square wave of an hour, or a dual wave which delivers 50% straight up, and 50% over the next 2 hours.

 

These options mean that you may be able to match the insulin action with certain foods better. I use these all the time, I consider them a major feature of the pump in getting it to work with different foods, though often they are left til later or ignored in pump education. You may need to unlock the features on your pump. I can only suggest you either see a DE or doc who will fully educate you on pump operation, or get learning on your own steam. The book "Pumping Insulin" by John Walsh is a great reference for that. And, in the first instance, the pump manual can answer some questions.

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jazzcat

Okay well thanks.

Thats great information and will definately look into it.

I dont have a set carb goal but I do try to keep breakfast and lunch under 30grams and dinner I try to keep as low as possible.

I dont believe that my educator is right also. I do have the dawn phenomena and my blood sugar does go very high at around 4 or 5 am. I have been asked to test a few more nights at 3 am.

I will look into the dual wave bolus. I think maybe I should eat breakfast and then go for a run, that brings me right down!

Thanks again

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