Trying out different breakfast, thoughts?

This is the brilliant thing about using a CGM, you can try different foods and see what the result is, personally I can't eat eggs on their own without insulin, in fact I can't eat anything without taking insulin, particularly in the morning my body is pretty efficient at converting the protein to glucose. I know your seeking reassurance but I think you've answered your own question here

shivles said:

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?

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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

shivles said:

From experience half a unit should knock her down to around 5, I've give her the dose now as CGM still hasn't moved and is trending flat.

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Remember that the bolus insulin will peak around 90 minutes post injection but may take a few hours to lower BG.

We can't do eggs without insulin. Freya has scrambled eggs as part of her breakfast every day, and we bolus 1 carb per egg plus half the protein, which is another 2g.x

Shivles I would suggest keeping a food diary whilst she's using the CGM to chart food/insulin doses/readings, whilst she may only require .36 as you can only administer .5 on your pen, she would still require the minimum dose to counter the BG rise. I know you've mentioned about resistance in looking at a pump however a major advantage is being able to administer smaller doses which would ultimately give much better control, something I know you are striving towards

Shivles, yes 6g for 2 eggs. We're also MDI so have the same issue of having to round up or down to each half unit of insulin. Do you have the expert metre? I'd have thought that would suggest giving a half unit for 6g at your ratio. We always give a few strawberries or blueberries (with insulin) for breakfast when dosing for protein, as a fast acting carb, because eggs wouldn't kick in for a little while. To prevent a hypo. Again the wonderful thing about the cgm is being able to see exactly what is going on, so you learn so much and can feel much more confident experimenting.