Over the last 3-4 weeks, I’ve been going high after breakfast despite bolusing for the correct amount of carbs—and in some cases, overbolusing! I’ve tried changing my I/C ratio in the mornings from 15 down to 11 without success, as well as adjusting basal upwards.
I’m just worried something else might be causing this. Most breakfasts for me are an omelet (3 eggs, cheese) with 1-2 tortillas (21g carbs) and a glass of kombucha (15g carbs) and coffee. I know some folks bolus for coffee, but even if I overbolus, e.g. for 45g of carbs instead of 35, I’m at 180 2 hours later and often take a correction bolus of 1U. Any suggestions or tips?
That’s a bit of a poser. You say adjusting your basal didn’t alleviate it, but have you experimented with fasting and watching what your BG does with zero food and zero bolus? If it still goes up, you could be developing a more acute DP or Feet-on-the-floor phenom than you’ve noticed before. Stuff like that changes with time and you just have to adjust to it. It may be a question of increasing your basal more and starting the increase sooner than you tried. OTOH if you do stay flat, then something else is involved, but I’d want to eliminate that first and the only way to do it is with a fasting test.
I experience the same kind of trend after breakfast. For example, this morning I bolused for 56 carbs and around 10:00 my BGs hit 235. I took no action but at 1:00 my BGs were down to 62 and I had to take a glucose tab which brought me back to 94 by 1:30. I usually then register a straight line until dinner. This seems to be a regular pattern I go through most days.
Good call, I might try just having coffee and waiting an hour or two to see what happens in the AM. BTW I was Dx’d 3 years ago so I’m expecting things to change. Wonder if I’m less sensitive in the AM than I was originally.
Would a super bolus help in your situation? Bolus for the basal amount up front and reduce the basal to 0 afterwards for a duration. This was something another poster suggested to me recently.
Same. And it’s amazing the difference in I:C ratio between morning and later in the day (for me, anyway).
I agree with other posters about reducing some of the morning carbs until you figure it out @A.A.Ron. That does sound like a pretty tasty breakfast though! I miss those days.
I had the same breakfast as usual without tortillas/high fiber wrap. I stayed around 110 all AM. I would like to add some fiber, though, in the AM—how do folks here do that without much carbs? (No veggies or chia seeds please even though I know I should eat more of them!)
Great! That’s a tall order (high fiber, no/low carb & no veggies) but some slow-digesting / lo-GI things like nuts or avocado could do it (I love avo with omelets). They’re not low carb, you’d just have to add insulin to cover over several hours instead of the faster peak with tortillas. (Isn’t strong coffee high fiber? ). Oh yeah, and if you can work it in: bran.
I have DP and FOTF to some extent each day. I have a slightly higher basal before I get up and then one about an hour after I get up. My carb ratio is double for the am if I try to eat something.
But really the easiest thing for me was to skip eating if I can in the morning. It’s just too hard to control and I was never avid about eating breakfast anyways.
Example, say I am trending low, I am at 75-80 so I eat 4 carbs, I will end up between 130-160 in 20-40 minutes. So it’s easier to try to just skip the food. Although I do respond well with the then high to getting on my exercise bike for 10-15 minutes.
Mornings are typically a guessing game as to where BG will go after breakfast. Other mealtimes not so much. My “solution” has been to stretch the typical food (carb) intake over an hour or more, while watching the CGM. Not convenient for working people, but is good for me since I have (mostly) retired.
When I go for a walk after breakfast, it’s almost never an issue. When I go first to my desk it’s usually bad news, unless I have compensated by eating a half breakfast. If everything goes well, eating more is a pleasure.
DP is dawn phenomenon and FOTF is foot on the floor as @Tapestry has said. DP causes a hormone release before you awaken and hence you have higher than normal blood sugar when you first wake up. FOTF causes it once you get out of bed or fairly soon after.
Hopefully the moderators will ad Foot On the Floor to the Diabetes Terminology Glossary.
). Oh yeah, and if you can work it in: bran.