I’m starting to really fine tune the way I deliver boluses to try to avoid highs 1-2 hours after eating. My blood sugars are usually in range before eating and return to range within 3-4 hours. I’m continuing to have challenges with breakfasts hitting my system before my insulin is peaking and it appears to be a rush of sugar all at once. I always bolus 30 minutes before a meal because insulin doesn’t start working in my system until then. My breakfast always consists of 1 cup of Kashi Go Lean Crunch and 1/2 cup of organic banilla yogurt. It’s a total of 45 grams and the cereal has a fair amount of protein. Does anyone have any suggestions? My thoughts are that I might need to bolus earlier than 30 minutes before eating with breakfasts, add more protein/fat before eating my cereal, or slowing down my eating with breakfast.
Some people find that they are more insulin resistant in the morning and have to use a different I:C ratio for breakfast. Just a thought.
I’m completely unable to eat any cereal at all, healthy or not without spiking. Also 45 grams of carbs would be too much for me for breakfast which I keep around 30 and stick to eggs. I’ve heard others say the same. I don’t know about bolusing more than 30 minutes ahead; that could be risky. I tried and tried with cereals and finally gave up.
Well if it has a lot of protein in the cereal, you may need to account for that and add 1-2 units extra and set that on a dual wave bolus for about 1.5 hours. So that way its delivering more units over a set time frame, and will help to counter that around the 2 hour mark. You don’t want to go much past that if your normal BG are there at the 3-4 hr mark.
Also the suggestion for lowering your I:C ratio a point or 2 is a good one. I have a lower I:C ratio in the morning than I do at night. Give it a try and see how it goes. I would do one or the other though, not both, or you might be having some unnecessary lows as a result.
I have a similar struggle. One of my conclusions is that the insulin absorption is slower with a pump because we are pumping insulin into the same spot for 3 days (I think Dr. Bernstein talks about this). Have you ever tried giving the same bolus by injection? Be careful as you may drop faster than 30 minutes.
Thanks for the info guys! I’ve decided to take a break from my usual breakfast and try something lower in carbs - 30 grams. Today I had a piece of whole wheat toast, an egg with some cheese, and a chicken sausage. I started out at 90, then went up to 99 1 hour post, 96 2 hours post, and 103 at lunch. It felt great to see that my CGMS didn’t have double arrows going up. I’ve decided to cut my carbs at lunch down to 30 grams and the same pattern resulted with not much of a climb in blood sugar. Great ideas everyone!