High blood sugar after low GI breakfast

[lollerhaylz]

Hi!
New to the forums, I'm Type 1 and injecting Novorapid for meals and Lantus in the evening. I'm trying to tackle my high sugars in the mornings. I recently saw a diabetes dietician and she suggested I make a switch from my usual breakfast bars of about 30g of carbs to something with low GI. For the past 2 days I have been having a pot of natural greek style yogurt with 50g of mixed nuts and raisins thrown in. Overall carbs is now 15g.
I thought this was going to be great because it seems like a healthier breakfast and it is keeping me full until lunch. However my post-meal readings are now way worse than they ever were with the breakfast bars and I feel so frustrated.
I take 3 units of Novorapid as soon as I get up at 7am because my blood sugar starts rising rapidly. By 8am my sugar will have risen by 1 or 2 even with the 3 units. I then have my breakfast at 9:30am at work and my ratio is 1 unit:5g, so I have been taking 3 units for the yogurt and nuts, injected about 10 mins before I eat.
Yesterday I had a pre-meal reading of 11 which rose up to 19.6 after 2 hrs! It then dipped down to 15.5 after another hour.
Today I took 4 units for the same breakfast, my pre-meal reading was 7.3 and it has risen up to 18 after 2 hrs! I don't want to feel as rubbish as I did yesterday so I've taken a correction dose of 2 units to get this down.
I can't understand why this is happening because I was under the impression that low GI foods should level my blood sugars out? I'm wondering whether I should just go back to the breakfast bars, or is there something I can do such as splitting the novorapid dose?

 

[karen8967]

Hi!
New to the forums, I'm Type 1 and injecting Novorapid for meals and Lantus in the evening. I'm trying to tackle my high sugars in the mornings. I recently saw a diabetes dietician and she suggested I make a switch from my usual breakfast bars of about 30g of carbs to something with low GI. For the past 2 days I have been having a pot of natural greek style yogurt with 50g of mixed nuts and raisins thrown in. Overall carbs is now 15g.
I thought this was going to be great because it seems like a healthier breakfast and it is keeping me full until lunch. However my post-meal readings are now way worse than they ever were with the breakfast bars and I feel so frustrated.
I take 3 units of Novorapid as soon as I get up at 7am because my blood sugar starts rising rapidly. By 8am my sugar will have risen by 1 or 2 even with the 3 units. I then have my breakfast at 9:30am at work and my ratio is 1 unit:5g, so I have been taking 3 units for the yogurt and nuts, injected about 10 mins before I eat.
Yesterday I had a pre-meal reading of 11 which rose up to 19.6 after 2 hrs! It then dipped down to 15.5 after another hour.
Today I took 4 units for the same breakfast, my pre-meal reading was 7.3 and it has risen up to 18 after 2 hrs! I don't want to feel as rubbish as I did yesterday so I've taken a correction dose of 2 units to get this down.
I can't understand why this is happening because I was under the impression that low GI foods should level my blood sugars out? I'm wondering whether I should just go back to the breakfast bars, or is there something I can do such as splitting the novorapid dose?

hi lollerhaylz i have 4 buttered ryvita with cheese for my breakfast most mornings which keeps my levels pretty even maybe a rise of 1to 2mmol i find if i have some brown toast levels sky rocket about 6/7mmol im not saying this will work for you but worth a try also speak to dsn regarding basal insulin maybe that might need adjusting hope you get sorted x

 

[becca59]

Try leaving the sultanas out or having some raspberries/other berries. Trying to get it to 10 carbs rather than 15. One other thing, you say you wake at 7am but do not eat until 9:30am. You may find your levels stop rising if you eat a lot earlier. It helps your body to know you are not going to starve it. I too have bad mornings and have found delaying eating just exacerbates the problem. Good luck!

 

[lollerhaylz]

Thank you both! There is definitely a learning curve here and I think my ratio may not be quite right. I'm keeping a food diary and going back to the dietician in a couple of weeks so hopefully she can provide some insight. Today I'm eating the same but seeing if splitting the novorapid dose will help.
becca59, eating earlier sounds like a good idea, I will give that a go tomorrow

 

[Colin of Kent]

Hello and welcome, @lollerhaylz

My take on this is that the GI only affects how quickly or slowly the carbs are absorbed, not necessarily the total effect you will see on your BG levels. Any injected insulin works slower than that produced by a healthy pancreas, so for us T1's, it's about trying to match the action of the glucose coming from the food with the action curve of the insulin.

The lower GI breakfast you have may well match the action profile of your Novorapid better than cereal bars - at least to begin with - but if you're having readings that high after two hours, it may be time to think about increasing the bolus dose.

By the way, have you checked that the yogurt is 100% plain and full fat? If it's low-fat or has added sugar, it will be higher in carbs and have a higher GI too, probably. Also, dried fruit on its own is high GI (I think), and certainly high in carbs, so you could try leaving that out next time.

 

[lollerhaylz]

By the way, have you checked that the yogurt is 100% plain and full fat? If it's low-fat or has added sugar, it will be higher in carbs and have a higher GI too, probably. Also, dried fruit on its own is high GI (I think), and certainly high in carbs, so you could try leaving that out next time.

The yogurt is fat free but not sure about added sugar. The carb content of one pot is 5.3g. Is this a problem? I don't really fancy switching to a full fat one, thought this would be a healthier option.
I have however been counting the carbs for the mixed nuts & raisins wrong! I had it in my mind that it was 10g but turns out the portion I've been having is 14.4g. So overall I've been having around 20g of carbs for breakfast so I should have been taking more insulin.
Just to clarify, the nuts and raisins come pre-mixed in a bag so it would be a pain to pick the raisins out, plus they are the best part for me. I trust the label should account for the sugar in the raisins. I think the reason the dietitian recommended nuts is because the high protein is supposed to slow the carb absorption. So far this switch has just been a bit of a hassle.

 

[Colin of Kent]

The carb content of one pot is 5.3g. Is this a problem?

I wouldn't have thought so, no. It's my own view that low-fat foods aren't necessarily healthier, and in many cases actually worse. But it's worth reading around the subject for yourself. The nuts should certainly help slow things down a bit with their fat and fibre content.

 

[Fairygodmother]

Becca’s advice to eat earlier works well for me too. If it’s easier to eat later then some say that a bite of cheese or a spoon of yoghurt helps reduce the Dawn Phenomenon when blood sugars rise to give you power for the day.
I too would avoid the full on sugar content of dried fruit. Could you buy the nuts separately? Lidl, for instance, does reasonably priced bags of walnuts, almonds, mixed nuts etc.

 

[becca59]

Full fat yoghurt will slow down absorption of the carbs. Don’t fall for the low fat message. More up to date medical research is showing that lower fat produced products are worse for our health than first thought. To make products more palatable they up the sugar in them.

 

[lollerhaylz]

Very interesting, thank you all. I’ve been diabetic for almost 9 years and I’m only just discovering how protein and fat also factor into BG control and it’s all a little overwhelming. I will look at full fat yogurts next time I shop and cut out the raisins.
For now, I think it’s clear that I haven’t found the right ratio yet and need to increase my bolus dose. Fingers crossed tomorrow will bring better readings!

 

[kitedoc]

HI @lollerhaylz, Perhaps buy nuts without the raisins or other dried fruit next time. The sweet taste of the raisins is not worth it.
Somethings food companies do not ist all ther carbs in a food product because they are exempt from having to do so. There will some lactose, milk sugar in yoghurt that does not need to be declared because it is not dextrose or glucose. In fat-reduced yoghutrs some sugars might be added , as others have said but the fact may not be in evidence on the labelling.
Just because something is low GI does not mean that it will pack a punch. The quantity of it and the concentration of carbs, not just the declared carbs (called the Glycaemic Load. all come into it.
Added to all this is that the resultant BSLs from such foods is influenced by the particuylr bugs in our bowel, so there can be a individual response which will not neceesarily match the published GI figutre.
If you look at mendosa.com and definitions for GI and GL and Glyceamic Values, you can see that a food can have a range of its GI value, not necessarily a single value. In the end it may be a guide but testing is the best way. A
As you say, your insulin to carb ratio may need adjustment.
I know mine is different between morning and evening, always less carb g per unit in the morning (= larger insulin dose /carb g).
Good luck with sorting it.
Perhaps also ask your dietitian how to obtain Vitamin C from vegetables so that you do not need to rely on fruit.
There are low carb ways of enhancing taste also.

 

[evilclive]

I'm pretty sure lactose gets declared on nutritional information in the UK as a sugar. Look at eg milk.

If sugar is added to yoghurt, it'll be on the label in the UK.

 

[kitedoc]

Thanks @Evilcloive, I think it varies between countries but I did not have the info on the UK, so thank you !!

 

[lollerhaylz]

Well I'm just about pulling my hair out at this point. Tried increasing the bolus dose this morning and still got a reading of 18.5 two hours after eating. In comparison, when I used to have some sort of breakfast bar (typically 30g carbs) with the same ratio, I found my sugars would go back to pre-meal level, in fact it would usually be lower by lunch time. I can't see why this would be the case? I tried splitting the novorapid dose, that made no difference. I know it's usual to need different insulin:carbs ratios for different times of the day, but is it possible to need a different ratio depending on what you are eating? I wonder if slow carbs in the morning is just a bad idea for me.

 

[Colin of Kent]

I feel your frustration! Sometimes, there is no rhyme or reason. It's just about finding out what works for you, and what your body can tolerate in terms of insulin requirements and glycaemic response. Trial and error is often the only way, in my experience.

 

[kitedoc]

Hi @lollerhaylz, perhaps ask your dieitian about swapping back to your usual breakfast.
If it is the yoghurt causing the high BSLs at least you can stop that.
Also if you BSLs settle down down at least you will know it is not something to do with your insulin being out of date, leaking etc. (although it should show up as a problem after other meals).
Also do you have a particular site you tend to use for the morning Novorapid? as opposed to other times and is that site rotated so that you do not go near it for some weeks at least.?
If you have the brand name of the yoghurt to give us maybe more can be found out about it.
Also check goodtoknow.co.uk - Yogurts: best and worst for your diet revealed 1 Jan, 2019.

 

[Lynne C J]

Hi!
New to the forums, I'm Type 1 and injecting Novorapid for meals and Lantus in the evening. I'm trying to tackle my high sugars in the mornings. I recently saw a diabetes dietician and she suggested I make a switch from my usual breakfast bars of about 30g of carbs to something with low GI. For the past 2 days I have been having a pot of natural greek style yogurt with 50g of mixed nuts and raisins thrown in. Overall carbs is now 15g.
I thought this was going to be great because it seems like a healthier breakfast and it is keeping me full until lunch. However my post-meal readings are now way worse than they ever were with the breakfast bars and I feel so frustrated.
I take 3 units of Novorapid as soon as I get up at 7am because my blood sugar starts rising rapidly. By 8am my sugar will have risen by 1 or 2 even with the 3 units. I then have my breakfast at 9:30am at work and my ratio is 1 unit:5g, so I have been taking 3 units for the yogurt and nuts, injected about 10 mins before I eat.
Yesterday I had a pre-meal reading of 11 which rose up to 19.6 after 2 hrs! It then dipped down to 15.5 after another hour.
Today I took 4 units for the same breakfast, my pre-meal reading was 7.3 and it has risen up to 18 after 2 hrs! I don't want to feel as rubbish as I did yesterday so I've taken a correction dose of 2 units to get this down.
I can't understand why this is happening because I was under the impression that low GI foods should level my blood sugars out? I'm wondering whether I should just go back to the breakfast bars, or is there something I can do such as splitting the novorapid dose?

 

[Lynne C J]

Have you tried having porridge for breakfast or is that not possible at work? Have you tried having breakfast before you leave for work so any activity getting to work will help to keep your BG down?

 

[kitedoc]

Hi @lollerhaylz, perhaps ask your dieitian about swapping back to your usual breakfast.
If it is the yoghurt causing the high BSLs at least you can stop that.
Also if you BSLs settle down down at least you will know it is not something to do with your insulin being out of date, leaking etc. (although it should show up as a problem after other meals).
Also do you have a particular site you tend to use for the morning Novorapid? as opposed to other times and is that site rotated so that you do not go near it for some weeks at least.?
If you have the brand name of the yoghurt to give us maybe more can be found out about it.
Also check goodtoknow.co.uk - Yogurts: best and worst for your diet revealed 1 Jan, 2019.

The other thing, as a general principle, is to discuss with your doctor or DSN, delaying your breakfast for ? 30 ? 40 minutes after injecting your Novorapid. Give the insulin more time to build up and better match whatever peak in BSL.
Plus as mentioned above, early breakfast earlier.

 

[VivD]

Cream has no carbs and fills you up add some berries and nibble a few nuts and you have a healthy sustaining breakfast. Butter cheese and cream are a diabetics friend and full of nutrients too. I often have a piece of cheese a small apple and some nuts too. I used to get confused about rising bs in the morning too when all I'd had was tea - it was the milk in the tea - so I learnt to account for it. You really have to be fastidious about counting the carbs - they can be very sneaky - ignore calories low GI helps a bit but not a lot. Dieticians still stick to the low fat mantra but there is lots of evidence to show that a diet high in healthy fats and protein is actually beneficial + lots of low carb veg. Look at some of the low carb high fat videos on you tube. You could also see if some HIT helps too.