Decided to just go with eggs for breakfast, it makes sense after all and pretty much all T1s struggle with carbs in the morning. On waking she was 4.2mmol and we had low alert from the CGM, I give a quarter of a rich tea just to give her a little boost and went ahead with scrambled eggs with butter which LO wolfed down. Now I didn't give her any insulin as I didn't really know what would happen, she's had a slow steady rise up to 9.2 over the course of an hour and a half and the CGM is reading flat, she's been hovering here for almost an hour. I reckon it's safe to give her half a unit now and just nudge her back down a few points? Or should I just wait and see what happens?
It's hard to say really.
If she normally has a breakfast containing carbs every morning, then you will never have really seen what her fasting BG is for the morning period. I don't have breakfast in the morning and when I wake up and start moving about, my BG rises about 4mmol/L - requiring a 2u bolus to compensate for this. This may be what LO is experiencing, basically her liver releasing glycogen stores to get her ready for the day. If she normally has a breakfast and bolus to go with it; you may not have noticed this happening.
Also, the body can convert protein into glucose... Crazy I know; as it's rarely mentioned by Dr's and dieticians. It's a process called glucogenesis and is a bodily response when carbohydrates are not available as an energy source. The proteins are broken down and turned into glucose and can often require a bolus of around half of that which you'd administer to cover the same weight of carbohydrates. I don't experience this and never bolus for protein, but some need to.
If I was to take a guess, I'd go with the first theory. Try a half unit and see where she ends up. The chances of a hypo in the morning should be slim as the body tends to be most insulin resistant at this time.
Grant
