It might be a variation on the "dawn phenomenon" theme -- morning stress hormones making you insulin resistant. I do not have diabetes but was told by a nutritionist that focusing on protein in the a.m. was a way of meeting my body's energy needs without messing up my blood glucose/insulin response, and d'you know what? When I started eating that way, I found myself having fewer sugar cravings midday and much more energy. So your "stubbornness" might not only be counterproductive with respect to your diabetes control, it may also be contrary to what your body actually needs. I guess what I'm saying is, don't get so set on "eating normally" that you eat in a way that's not helpful to your body, just to prove you can.
I see you have a bowl of cereal and a bagel for breakfast. Why don' t you try those really thin bagels that are just about 15 gr of CHO. Maybe substituting that and still having what you like will help bring your BG down. If that doesn't help look at the quantity of cereal or the type of cereal you are eating. If nothing like that helps you may have to look into sub'ing other options instead of the two high carbs for breakfast.
Breakfast cereals have sugar in them and more than 1 cup is too much. A bagel with peanut butter is probably 300+ calories. No wonder your b glucose readings are 300+.
Change your eating habits and see a dietician.
Maybe I missed it, but has anyone mentioned your insulin timing? The need to bolus 30 min prior to eating is even more important to me in the am. Also, because of dawn phenomenon, my sensitivity is lower. Take your bolus/shot 30 min before you eat, and take 1/3 more than you would the rest of the day.
Also, of course, eat less carbs like everyone else is saying.
I eat high calorie on purpose. I'm a personal trainer i know a bit about nutrition.
And yes i have 600 calories at breakfast. Calories don't=blood sugar. I can have 600 calories of protein and my sugar won't spike at all.
It happens when I take my insulin 15 min before breakfast
I upped my basal rates and it seems to be helping some.
And I do eat the thin bagels- and low glycemic cereal- all bran..
Re the personal trainer= more carbs, I have found that at the moderate level I exercise at most of the time, I have a lot of my best runs when I'm more moderate w/ "carb loading" sticking with 15ish G before I "blast off" with some IOB and then have 7-10G of carbs every 3 miles, it seems to keep my BG about where it's supposed to be and that seems to help me feel strong throughout the run. MrsAcidRock gets "Fitness" magazine that had a pre-marathon "loading" diet that was a shade over 500G of carbs/ day, I was like "I don't think I can eat that much?"
If all I am eating is Prot/Fat, I take the prot+fat number, multiply it by .3 and use that number as a carb number to calculate insulin, and I take it as an extended bonus over an hour or two.
But, it took a long time and a lot of testing to come up with that formula for me, and it is probably different for everyone.
What I have found is that if you are eating a low carb meal (15 g or less), the protein and fat will affect blood sugar, just not as fast or as much as carbs.
If I don't take some insulin with that low carb meal, my bGL will be high two or three hours later.
-M
If you don't want to spike read Dr.R Bernstein Diabetes solutions
Ideas: try taking usual dose of insulin before breakfast, and take another dose of rapid acting insulin (of however much you would usually use to lower a 300 blood sugar down to normal range) before your blood sugar starts spiking again (guestimation, experiment). Try playing with different doses in small incriments. The insulin:carb ratio might be higher for breakfast too due to the dawn phenomenon.
If i know im going to be eating alot of carbs i usually go ahead and bolus for half and wait like 15-20 minutes before i actually eat. That way your already getting insulin for some of what you eat and that way its already starting to kick in
I hear we can't do that because of "insulin stacking". Though it doesn't make sense to me. That's what i'd rather do.
Bolusing 15-20 minutes before eating isn't stacking, Tom. It's a good policy, whatever you're going to eat, because it enables the insulin to start working before the carbs hit! Insulin stacking is if you take more insulin when you already have insulin on board. Even that isn't an absolute no-no as long as you keep track of the insulin on board and take it into your calculations. If you're responding to greenclouds post, though, I do agree that it's pretty risky to take insulin to correct a high that hasn't happened yet!
But yes, Anthony has the most practical suggestion, echoing what others have said: eat less carbs and you will spike less and need less insulin!
I regularly bolus my Humalog 15 minutes before the meal. But if I don't control the food (like in a restaurant), I don't bolus till I see my pile of mush. It can also be pretty risky to bolus for a meal that may not happen (or it least won't happen promptly).
You can try it for longer than 15 too. Personally I cannot do this. I go low very quickly. I have to introduce the two elements together and adjust as is needed, and then I'm fine for the rest of the day.
Your predicament also sounds like a good case for a square wave bolus to me.
Gives you a smack of the good stuff straight away and then trails the rest of the delivery out over the time you specify.
It's useful for sluggish times like the one you're describing where your body or the food or both outlive the insulin usefulness in some way and then send you skyrocketing.
I use it for pizza for example, or chinese food...The kinds of instances where the fat content ruins the insulin activity and so you need to prolongue it by amount and duration.
what are your sugars when u wake up ? i usually wake up with it in the low hundreds then i eat my bread and eggs befoe workout no insulin and i take in 20 to 30 carbs before i start . if it is say 130 when i start i only take in 10 carbs ck it about 15 min and see what its doing . if it is coming down then i take in another 15 carbs and keep going ! if u r high in the morning u probly need to adjust the evening dose .. im on lantus not the pump. also watch the fat u take in fat doesnt spike sugar levels right away but does later .
i meant bolus for like half my meal at first before i eat then bolus for the rest when i finished.
if I cannot eat first because I don’t have time to wait a hour and a half before I can start working out . What I do is start with protein then start working out as sugar levels come down I take in carbs like anywhere from 13 carbs to 30 depends onhow hard you are exercising . I use a heart rate monitor to help me. If I’m training in my upper zones know I using a lot of glucose so I need more carbs. Plus my levels I the morning are at 115 to start. So I can take in 15 args before I begin
Holy cow. I think if I removed diabetes from my decision-making processes I'd be paralyzed with indecision! I've always lived by the opposite motto: factor my diabetes into every decision. It sounds kind of awful, written so starkly, but I've done it my whole life (which is not to say that I don't ever consider the diabetes-related consequences of a decision and decide I don't care). Luckily, it usually means making a generally more healthy decision than I might otherwise :)
I think I'll try making 2 decisions for a while: with diabetes and without diabetes, and see how much they differ.
Eeerily, I think that many of the decisions I'd have made without diabetes would have had *more* negative long-term consequences than the ones I made with diabetes.