hi bg after breakfast

[andybee]

Having been diagnosed with type 1 in January this year at the age of 43 I have been avidly asimilating all of the excellent information available in this forum, so thanks to all who post with their experience and expertise.

Being qiute new to this I am testing my bg quite often (approx 10 times per day) and whilst I am getting pretty good control (average 7) I am having high spikes after breakfast ie it can still be 12 plus, 2 to 3 hours after eating. If I skip breakfast the same thing happens after lunch. After 4 hours it will have returned to normal.

The realy strange thing is that even a single 10 gram yogart can rasie my bg 6 points for 3 hours! If I skip breakfast then my bg will steadily rise by about 0.5 point per hour even though my levemir (10 units at nigh and 10 units in the morning) keeps me steady during the night and would seem to be at the correct dose.

I think that I have some amount of early morning effect as I go go to bed at 6 I will wake up at 6 but if I go to deb any lower I will wake up higher than 6.

Other meals seem to go off fine; 1 until (novorapid) per 10 grams will see me back to less than 9 after 2 hours and back to normal (4-6) after 3-4 hours.

At the moment the only thing that seems to bring some measure of control to the after breakfast spikes is some fairly energetic exercise; at least 30 mins, which is becoming more difficult with pressure from work.

Would be very grateful if anyone has had a similar experience or any advise.

 

[Luckystar96]

A lot of people need quite a lot more insulin in the morning than at lunch or tea. I need a ratio of 1unit (novo rapid) to 7-8g carb at breakfast but for the rest of the day 1 unit per 12g. ( until late evening when I need much less-about 1 unit per 18g) it's trial and error really. My fluctuating insulin requirements have meant I have been given a pump which is great and I have much better control now.

 

[Juicyj]

Hi Andybee,

I was diagnosed last Jan at the age of 39, so still learning as I go !

I've also found I get high bg readings for a while after breakfast, mine have been down to what i've eaten, so if it's porridge I have to be careful as takes a while to come back down, so some mornings it's an omelette with courgette and feta cheese (no carbs), also exercise, mega stress = good readings :crazy: otherwise i'm adjusting insulin 2-3 hours later. I'm reading Dr Bernsteins book at the moment to help change my diet and to manage after meal spikes, as it's these highs and lows which then affect my mood and I can get quite low. It's all trial and error and if anyone asks I always say 'it's work in progress' !

Good luck.

 

[n-g]

This is quite common. I was actually speaking to a leading diabetologist last about this at a meeting.

Essentially, every almost type 1 will be 'insulin resistant' in the morning. Current research indicates that this because of something called the 'dawn phenomenon', but the evidence is not conclusive.

In any case, practically what you have to do is take some extra insulin in the morning.

You have to do this even if you don't eat. This is because you are 'insulin resistant' to your background/basal insulin as well as any rapid acting insulin. However, if you don't eat a meal, you will probably become hypo. Therefore, current recommendations for type 1 diabetics (except those on pumps) is to always eat breakfast and take some extra insulin.

To remedy this situation you can either increase you insulin:carb ratio, or you can take a 'boost', or both.

As Luckystar mentions, this is all trial and error. I always recommend you make one change only at a time.

For instance, for me all day I take 1 unit of NovoRapid for 10g carbs. But at breakfast I take 2 units of NovoRapid for 10g carbs, and I also take an extra 3 units of NovoRapid regardless of the amount of carbs I have eaten.

Hope this helps.

Best, NG

 

[n-g]

Also, about waking up higher than 6 if you go to bed less than 6. How much higher are you talking about? If it's a lot, then you may want to consider that you're experiencing night-time hypos. Google 'somogyi rebound' for details.

 

[Luckystar96]

Good point about possible nighttime hypos n-g. I was always told to not go to bed lower than 7. It might be a good idea for andybee to set their alarm to wake up and test a couple of times during the night just to see what is happening.

 

[andybee]

Thanks everyone for the advise.

It seems as though I should start experimenting with a lower ratio; its suprising that it could take upto twice as much insulin.

I didn't know about not going to bed lower than 7. I have tested in the middle of the night quite a few times and generaly I am the same as when I went to bed. I have also recently had to get up unusaly early for work recently (4-5 oclock) and my sugars are always normal then so a dawn phenomenon would seem to explain that by my normal waking time (7.45) I can be higher