Jump to content
Diabetes forums
  • Welcome To Diabetes Forums!

    Registration is fast, simple and absolutely free so please, join our community today to contribute and support the site.

Archived

This topic is now archived and is closed to further replies.

mom24grlz

bolusing for oatmeal

Recommended Posts

mom24grlz

This post is mainly for type 1s and type 2s who take meal time insulin. But anyone is welcome to give suggestions. :)

 

Ashleigh likes oatmeal, but due to bolusing problems she doesn't eat it a lot. What normally happens is she eats breakfast at 7:00AM. between 8:30-9:00AM she spikes close to 300. Then without fail around 10AM she drops below 70. She's gone as low as 35 after oatmeal. We are using the same ratio (1:7) that has worked for every other breakfast meal, but it does not seem to work for oatmeal. Here are suggestions other parents of type 1s have given me and the results.

Suggestion #1 Prebolus. This works well for the spike.  We have tried different prebolus times. Everywhere from 10min-40min ahead of time. It pretty much eliminates the spike but she still drops low 3 hours later.

Suggestion #2 give less insulin (change I:C ratio): we did try a 1:8 and she still dropped low, so perhaps even less than 1:8 the difference would be 10 units vs 8.5 units

Suggestion #3 subtract fiber. We were taught to only subtract 1/2 fiber if there is 5g or more per serving.  This oatmeal has 3g per serving

suggestion #4 have protein with it. She does drink a glass of milk every morning with breakfast. So that includes 9g protein. but perhaps more is needed.

Today she had oatmeal. We subtracted the fiber and added in 3 sausage links. Which gave her a total of 20g protein (9 with her milk + 11 with sausage).  Hoping it works out, but she had to correct a high, so i'm afraid that's going to be our downfall.  

Any other suggestions on what to try?  It's mainly the low that's driving us crazy.

Share this post


Link to post
Share on other sites
GrammaBear

On the rare occasions that I do have oatmeal, I do an extended bolus like I do for pizza (30/70 split over 3 hours).  Sometimes I still struggle with 200-300s and then I will drop low like Ashleigh.  Let us know how your experiments go as I like oatmeal too, but because of the high numbers I don't have it very often.

Share this post


Link to post
Share on other sites
Gladtobehere

For unusual situations like you describe where the low happens I usually take 1/2 the initial bolus and use corrections for the spike. 

 

Avoiding the low is the higher priority in my opinion.

 

For me I can avoid the situation if I choose too.   So avoiding oatmeal is likely the simplest long term solution.  But you know that already.

Share this post


Link to post
Share on other sites
NoraWI

Like GrammaBear, I use an extended bolus. Since Ashleigh is no longer using a pump, then I would follow both John's and Gladtobehere's methods... prebolus using a smaller initial bolus, then do small frequent corrections. Sounds like way more trouble than "liking oatmeal" justifies to me. I would then do like GrammaBear and avoid eating it. :D

Share this post


Link to post
Share on other sites
mom24grlz

ok it did not work :( She dropped to 58.  My next idea was to pre bolus 1/2 the amount 20-30 minutes ahead of time and 1/2 the amount after she's done eating.  Not sure how high she spiked, because her CGM fell off and she forgot to put a sensor back on before school started. 

 

I'd do a combination of #1 and #2

 We have done this combo before, and it didn't work. she still dropped low. But again perhaps trying even less of a ratio would work. going from 1:7 to 1:8 did not work. 

 

On the rare occasions that I do have oatmeal, I do an extended bolus like I do for pizza (30/70 split over 3 hours).  Sometimes I still struggle with 200-300s and then I will drop low like Ashleigh.  Let us know how your experiments go as I like oatmeal too, but because of the high numbers I don't have it very often.

 

yes this was suggested to us, but not sure it's possible to do this on MDI. This is a time i miss the pump.

 

For unusual situations like you describe where the low happens I usually take 1/2 the initial bolus and use corrections for the spike. 

 

Avoiding the low is the higher priority in my opinion.

 

For me I can avoid the situation if I choose too.   So avoiding oatmeal is likely the simplest long term solution.  But you know that already.

that may be what we end up having to do..

Share this post


Link to post
Share on other sites
Crizal

Have you tried different oatmeals?  The popular instant/quick oats don't have as much fiber as steel cut oats--which are less processed and take longer to cook.  I don't use insulin but switching to steel cut made a difference in by levels.  But as with this wonderful adventure has shown us, everyone's different.

Share this post


Link to post
Share on other sites
mom24grlz

Have you tried different oatmeals?  The popular instant/quick oats don't have as much fiber as steel cut oats--which are less processed and take longer to cook.  I don't use insulin but switching to steel cut made a difference in by levels.  But as with this wonderful adventure has shown us, everyone's different.

 

No we haven't. I like the instant oatmeal for school days, because it doesn't take long to make. Plus she doesn't like plain oatmeal. Her favorite flavor is maple and brown sugar.

Share this post


Link to post
Share on other sites
Gladtobehere

Whole grain rolled oats (with oat bran), sugar, soy grits, oat hull fibre, soy protein concentrate, inulin, natural and artificial flavours, salt, guar gum, calcium carbonate (thickener), caramel colour blend (soy), sucralose (8 mg per 38 g serving).Vitamins and minerals: iron (coated with hydrogenated soybean oil), niacinamide, thiamine mononitrate, calcium pantothenate, pyridoxine hydrochloride (vitamin B6), folic acid.

 

My grand kids like the Quaker instant oatmeal and it sure is quick and easy for school day breakfast.   But they are not diabetic.  Even so, they usually have eggs with toast for breakfast most mornings.  Albiet the toast usually has jam. Sometimes a little fruit.

 

Sugar is the second item on the list of ingredients which certainly explains the early spike and the sugar is gone before the last 1/2 of the bolus is used up. Hence the low.  (Ingredients are listed in the order of quantity, so it is never good when sugar is #1 or # 2 on the list.)  Also the sucralose only complicates the bodily response.

 

I was going to ask if you had tried doctoring the oatmeal?    Like use 1/2 the packet and to restore the volume add in ground flax or protein powder , etc... (I am sure there are better ideas, but those items come to mind. )

 

Sorry, I can't be more creative for you.   Diabetics have enough problems but I can't begin to imagine the stress of a parent with a diabetic child.   Maybe, you just gotta make those omelettes   more appealing than the oatmeal?

Share this post


Link to post
Share on other sites
mom24grlz

We actually do eggs and cream cheese waffles a lot. The oatmeal she probably only has once every 2 weeks or so. As for the spike, that happens after every breakfast, no matter what she eats. probably the milk that she drinks every morning. I do have flaxseed here. Never thought about adding some of it to the oatmeal. I also have plain rolled oats sf maple syrup and splenda brown sugar. That would probably reduce carbs, but figuring out how to bolus and stop the low is the main thing.

Share this post


Link to post
Share on other sites
Gladtobehere

Do 1/2 the bolus and correct at 3 hours using glucose tabs if heading low. If still high then correct and try a 60% bolus next time.    I find the DEX 4 glucose tabs are quite accurate for raising my BG number in a hurry.  With no risk of going over.     So maybe adding the glucose tabs at the right time will help to manage the inevitable low when eating a sugary meal.   If I feel really low I will even take 1 or 2 DEX tabs prior to checking my BG.

 

With those great A!c numbers you will always tread a fine line of too many lows.    You know what they say about cake?     ;)    Unfortunately for diabetics the "eating it" part is usually true. 

Share this post


Link to post
Share on other sites
mom24grlz

That method would work on a weekend. But I know she doesn't like to give herself a shot during class time. If she needs to correct she always waits until lunch time, and takes the correction with her lunch bolus. On a pump she had no issues correcting in class, it was less noticeable I guess.

Share this post


Link to post
Share on other sites
Moonpie

I like Glads suggestion of adding in a low carb & using only half the oatmeal. ground almond flour or flax meal would work. Good luck, I think she is doing great. Her age is not an easy one to live through.

Share this post


Link to post
Share on other sites
mom24grlz

I like Glads suggestion of adding in a low carb & using only half the oatmeal. ground almond flour or flax meal would work. Good luck, I think she is doing great. Her age is not an easy one to live through.

 

never thought about almond flour. I have that too!  I have flax seed, almond flour, and coconut flour here.

Share this post


Link to post
Share on other sites
Gladtobehere

:)   Proceed with caution.    Adding flour may turn the oatmeal into concrete.     I was thinking ground flax seed or wheat germ or some other similar non powdered ingredient might add a little bulk.    I also wonder about something like ground or flaked or slivered nuts similar in size to the oatmeal.  In an attempt to maintain the texture.

 

But I am just guessing.   

Share this post


Link to post
Share on other sites

×

Important Information

By using this site, you agree to our Terms of Use.