So we’ve just starting to use a Dexcom and it’s becoming very clear which foods give my daughter huge spikes. Things like sugar cereal - which we rarely eat but it was a birthday treat for her younger sister - and others like raisin bread or just plain ole bad for you carb laden processed foods… haha.
So just curious, are there foods that people here avoid because of how they make you spike? Or do you just eat them less often and deal with it? Or does prebolusing help? Prebolusing is a new concept for us… we’ve gotten lazy and have often bolused after meals, but the Dexcom has shown that that is a huge no-no.
I don’t mind staying away from processed foods as much as possible, but I would rather not say ‘never’ about certain foods to a 10 year old for when she’s a friend’s birthday party or we want to indulge on special occasions.
Just curious as to what the rest of you are doing!
Different opinions on this, but I for one avoid foods which make me spike. Which is, more or less, almost any food with digestible carbohydrate. As a consequence, I eat very low-carb (not quite to nutritional ketogenic levels), and have thus flatlined my BG (for the most part).
I don’t say “never” about foods either. On special occasions (anniversary, wife’s birthday, etc.), I eat (small portions) of restaurant food as well, and try to exercise on that day (before I eat). Helps to seriously blunt the impact. But cereal…that’s pretty much a de facto never for me
I’m not starting insulin for another month (very slow onset LADA T1), so I can’t weigh in on the pre-bolus from experience, although from reading here and elsewhere it seems a necessity for tight control when eating carbs.
Pre-bolusing helps a lot; however, it’s still a tricky thing to figure since there are a lot of factors in the mix (timing, dosage etc). Sometimes it works really well, sometimes not so much (like I get a spike that then comes down effectively). My strategy is to try to limit my intake of spike-causing foods when I can and then to prebolus when I do have them, so that if I do get it wrong, it’s at least not happening often.
The goal, of course, is to mimic the body’s normal response as well as you’re able to: a gentle rise and peak instead of a sharp spike that must then come back down.
I had done quite a lot of reading and self-study before I started insulin, so I pre-bolused right from the beginning. I’ve always found that it makes a dramatic difference—not always perfect, but light years better than waiting. The ideal scenario is for the insulin to begin working just as the food hits the blood stream. To do that you need to know how long the insulin takes to begin working, and that’s different for each type of insulin for each person. For me, for instance, Apidra starts to kick in at about 15 minutes and R at about 40. The only way to know what those numbers are for you is to do some controlled testing and watch your meter. Armed with that knowledge, you can prebolus with fair accuracy most of the time.
As the the question of “which foods”, that’s also a very individual thing, as you’ve already observed with your daughter. The only real help for this is time. As you gain experience, you will get steadily better at gauging the insulin (and timing) that give the best results. It would be lovely if there were a simple shortcut to that learning curve, but there really isn’t. The good news is that you have the time: “Diabetes is a marathon, not a sprint.” It’s not going anywhere, and neither are you.
Further on that question, there are foods that I avoid, not so much because of timing and spikes, but simply because I try to minimize the amount of carbohydrate in my diet. So I just steer clear of white things and things full of sugar, really just to minimize the amount of carb I eat and the amount of insulin required to deal with it. (Of course, there is the occasional “vacation” or treat, but they are the exception, not the rule.)
I’ve had my Dexcom for about a month now, and I find there’s no one fix for me. Fine-tuning the timing of a pre-bolus helps a lot, but as @cardamom says, it can be hit and miss. I experiment with superbolusing for those rare meals that are high-carb or high-carb/high-fat, but again, sometimes it works, sometimes it just delays the spike.
Now that I’m able to witness what things like white rice, potatoes, and oatmeal do to my sugars, I’ve definitely reduced both how often I eat them and how much of them I eat at a time. But I’m not in the right place to outright eliminate these foods from my diet now. I pretty much avoid processed foods anyway, and cook almost everything from scratch, including the breads and baked goods we enjoy in our house, which makes it easier to reduce or modify the carb content.
But I practice a bit more moderation now. I figure whether or not I can successfully wrangle the spike from Sunday morning blueberry pancakes with maple syrup – or, like your daughter, some cake at a party – having them once every few months isn’t going to kill me. Because there’s this thing in life called enjoyment.
I occasionally will have tiny bit mixed into yogurt or a little handful for a snack if I’m staying at someone’s house who buys it, but yeah… if my diabetes were ever cured, I’m pretty sure I’d gain like 5 lbs from bingeing on cereal the first week. (I could live with that!)
Anything that comes from a grain(including corn its a grain not veg) is off limits for me. Potatoes are a once a week item. Anything with sugar (including fruits)or any of its 20+ variants except for Peanut butter that has cane sugar thats my weak spot. I thought of making my own and adding stevia to it instead but i don’t eat it that much.
If you’re looking for peanut butter… Most stores sell a “natural” brand which is just ground peanuts and salt. It’s pretty easy to sprinkle some stevia or erythritol on top and boom. It can be tough to eat without something to sweeten it up, though, I’ll give you that.
Since we’re talking about a 10-year-old girl, as someone who grew up with all kinds of hangups myself about eating, I’d say letting her choose to eat the spikey foods in moderation and pre-bolusing when possible is probably the best way to avoid creating psychological issues around food. Girls can be very prone to eating issues and of course T1s have the added benefit of being required to think about what they eat almost 24/7. I think giving kids as much choice as possible within reason empowers them around their eating and helps them be more natural eaters.
When I was first diagnosed with T1 as an adult, I imposed all kinds of rules on myself around my eating. It was easy for me to do since I had an eating disorder as a young woman. However, over the last few years, I’ve loosened the rules, which lets me put diabetes and food a bit more on the back burner. I eat what I want a great deal of the time and pre-bolus when possible. My A1C is usually around 6.5, which I find acceptable because I think I’d be more obsessed with food and my T1 if I tried to get it lower.
EDIT to add I didn’t mean to sound too preachy. Just sharing my thoughts given my own personal history.
Wow… didn’t realize so many of you found it easier just to avoid certain things. Of course it makes senses because I know so many are doing well low or no carb.
Thanks for this Shadow2 - not at all preachy, just good advice. I certainly don’t want my daughter to develop any eating issues so I will tread very carefully. There are some things that will be easy to avoid because I just won’t buy them for the whole family! ha! But for right now we will just have to get better at prebolusing and let her be a normal kid. Because I have three other kids I don’t feel right about restricting only her, don’t want to set her up to resent her diabetes more or me for that matter. Thanks again.
I completely agree with this! As T1s we are encouraged to take an attitude towards food that in a non-diabetic person would be regarded as diagnostic of an eating disorder. Remember that your objective should be to achieve “good enough” blood glucose levels. IMO perfection is not necessary or necessarily achievable without an unacceptable cost.
I go along with the prebolusing advice, it makes a huge difference. Also, I have just started to use Fiasp (Novo-Norkdisk’s latest ultra-rapid acting insulin analog) and I find that it dramatically reduces spikes. Fiasp has been approved in Europe, and I should imagine it will be available in the US shortly.
A wholewheat Eggo waffle has 12g of carb and is tasty enough when slathered with butter that I enjoy them, but not so great that they make me lose control. The butter helps make the ice crystals more palatable.
The finest Sunday brunch we ever found had, among many other goodies, a waffle station where they were made to order with a choice of two batters (regular, or hazelnut). Unbelievably good.
I think it’s a great point re: kids needing some freedom. I’m admittedly always kind of concerned when I hear about parents implementing very strict/Type 1 grit-type diets for kids. I was diagnosed at age 10, went on the old exchange diet system (which had carbs, but was very strict in terms of amounts/timing of food), and we would measure and count everything I ate, and I had to have so much at any given time whether I was hungry or not. I know I’m not the only person to develop serious difficulties with eating from that that it took me decades to sort out and those problems contributed to my having much worse control as a young adult. My parents and I all now agree that it would have been preferable to have had a little higher A1cs as a kid/teen and to prevented those problems. I suspect paradoxically I’d have fewer diabetes complications today, due to having then had much better control in my 20s.
