No longer spiking after coffee; an update

I’d think this would be pretty common, and is probably why a lot of people choose to go on a low carbohydrate diet.

For me, I find pre-bolusing prior to eating is important, and combine it with a regular bolus to cover the food (adding on more insulin as needed). I’ve never found the extended bolus to be all that useful. If I spread a bolus out, I end up spiking hugely because the food hits way before the insulin does. I’ve heard it’s helpful for people who have gastroparesis, though. I’d say I have the opposite problem, where foods hits my system before the insulin does, which is why I have to pre-bolus before eating almost everything.

Jen, i would have to admit that i will spike terribly if i do not pre-bolus, and for that and other reasons, i only would eat something like and English Muffin for a special occasions. it’s just too much (chemistry) trouble to bother. however, i do not want to deny myself something yummy all the time.

MarieB,
thanks a lot. i am still trying to navigate my way around this forum. i will try exactly what you have suggested for next time.

Daisy Mae

Jen, do you drink coffee? and, if yes, do you have the spiking problem as i do? and, how long do you have to wait after pre-bolusing for your meals?

[quote]Jen, do you drink coffee? and, if yes, do you have the spiking problem
as i do? and, how long do you have to wait after pre-bolusing for your meals?[/quote]

No coffee here. I typically pre-bolus by 30-45 minutes before eating. Even with that, I still have a rise in my blood sugar, even with moderate to low-GI foods that I try to stick to. If I do this and exercise a bit each day (nothing too intense), that’s when I can sometimes flatline after meals. If my blood sugar is on the lower end of my target range, then I can’t pre-bolus by more than 10-20 minutes without ending up low (and if I’m borderline low, then I bolus and eat at the same time).

Jen, what do you mean by pre-bolus and then combine it with a regular bolus to cover the food? I am also struggling with insulin timing. I also have to pre-bolus or I will spike badly. Hwr, I often go quite low, 40s, before I level out, usually less than140, which is my goal. I’m now trying to rectify the lows. I’ve tried taking 2/3 the insulin for the pre-bolus then the last 1/3 insulin a half hour after eating. This causes me to go a bit high and then once again, still go low before leveling out. I’m using the dexcom cgm which of course has a 20 minute lag so timing is difficult. I’ve been on it since March this year, and the omnipod pump since June. Both have helped greatly. Before I never really analysed anything.

I believe the link below is to your previous thread about this.

thanks John. you found it. much appreciated,
Daisy Mae

[quote]Jen, what do you mean by pre-bolus and then combine it with a regular
bolus to cover the food? I am also struggling with insulin timing.[/quote]

I just mean that I pre-bolus and then use a regular/normal bolus to cover my food, rather than any type of combo/extended bolus. The timing is tricky. I’ve pretty much decided that staying under 7.8 mmol/L (140 mg/dl) is impossible because I don’t eat a low-carbohdyrate diet. So my goal is less than 9-10 mmol/L (160-180 mg/dl) at peak and then levelling out close to my target which is 6.0 mmol/L (108 mg/dl). If I bolus too far in advance, then I find I go low before or during (or shortly after) eating, which is why I’ve figured out that the pre-bolus timing depends on what my blood sugar is before I’m eating. I don’t have a perfect system worked out yet, if a perfect system exists, but am slowly getting there. Today I did Experiment #6 of my cereal (keeping all variables the same except for insulin dose), and I thought I had it worked out but it turns out I didn’t (I had to eat to avoid going low).

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Oh, I see. Yes, timing is the most difficult. It is all new to me so I’m doing experiments, too, knowing what works today may not work tomorrow, of course:(

you are an incredible navigator. i am forever bewildered. hopefully sometime soon, i will be expert regarding the ins and the outs of this TuD website. thank you.

i am a VERY slow learner. often i do not want to take the advice of others, which is forever my loss. but after all the encouragement from TuD members, i began experimenting, trying not to be so afraid of messing up my BGs. this issue w/ coffee has been long in coming, so i was very glad to report some progress.

Yes, me, too! In fact, I didn’t even know I could pre-bolus before coming to TuD! I had asked my CDE about it but she told me that she did NOT advise it for me! Incredible!:frowning: I so appreciate all of the help that members have provided. I know we are all different when it comes to D but at least knowing what others do or try gives me the confidence to try, too. I’m glad you are making progress w/ the coffee. That one is difficult! We all love our coffee in the morning! Keep up the good work!

Congratulations on your coffee!

I know exactly what you mean about taking advice; once I finally got something that (sort of) worked, I was highly reluctant to alter it, even a bit. Glad to know I’m not alone!

And thinking about advice, it occurs to me that no one can tell me the road I ought to take. Heck, I don’t know what road I ought to take! All we can do for each other is share the road we did take, and describe where we are. And that’s quite something.

Sometimes I feel like one of the six blind men trying to describe an elephant, LOL!

So, @Daisy_Mae, let me see if I understand the bigger picture a bit better. You are eating breakfast where you pre-bolus/bolus ‘x’ amount of insulin, then some short period after breakfast, you have coffee with a large amount of cream and 6 packets of Splenda. You bolus ‘y’ amount of insulin to cover the coffee. Is that correct?

yes. i pre-bolus for coffee covering 25 units of coffee w/ splenda and cream. this seemed to work so-so yesterday, but i actually think i need to cover a few more gms of carbs. either that or discontinue the Splenda. does that help answer your question?

PS: i actually do one bolus together at breakfast time, but if i should want a cup of coffee in the afternoon (which is rare), i will bolus again to cover that coffee as well.

I am just wondering if you have eliminated enough of the variables? I ask this because first of all, I’m not a coffee drinker, second, the only carbs you are consuming are the ones in the cream.

Did you try drinking a cup (Yes, I know it would be bitter) without the Splenda? Or with only 3 packets? Or with only 1?

What would happen if you eliminated the cream and the Splenda, or just the cream?

Could there be a caffeine effect on your digestion of the food and/or the amount of glucose released by your liver?

I also wonder about what happens if you don’t have the coffee at all (over multiple days?

often, i don’t bother having the coffee for this very reason. i don’t have any desire to drink it black, and the only thing i would be willing to eliminate is the Splenda. i can’t imagine having coffee w/out the cream. its kind of like ice cream for me; i would rather not bother having ice cream b/c its just too troubling to bolus for. pizza, for example is another impossible food which i would only save for a vacation situation or a special occasion.

everything boils down to one thing: experimentation.

just to keep you posted and up to date:

i stopped drinking coffee and am finding i don’t miss it at all. and, to top it off, i am using considerably less insulin. Yay.

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