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.
Carbs are really difficult for me in the mornings. I usually stick to protein and avoid the carbs as much as possible.
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.
what is DP abnd FOTF
DP = dawn phenomenon
FOTF = feet on the floor
There is a list of acronyms here:
Moderators, can you please add FOTF?
try the breakfast with egg whites and no cheese to see if fat is doing the increase
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.
Just did not know the abbreviations. Git both conditions most days!
There’s no such thing as “overbolusing”. One thing I’ve learned about T1, especially since getting a CGM, is that you need the amount of insulin you need at a given moment, and it’s never consistent. There are a trillion variables, most that you can’t account for, that affect blood sugar. The morning is even worse because of feet on the floor/dawn phenomenon, as others have talked about. It’s really about using a CGM or Libre to monitor how BG is affected after eating and correct as necessary, as the closed loop pumps do automatically. There are no real carb ratios that will get you sailing towards a perfect BG every day, these are just starting points and all we really had to go by before CGMs and the other advancements that are coming.
100% agree. My endo likes to term this as “always trying to hit a moving target” and thinks it’s pointless to try to nail down the “right” or “perfect” I/C ratio or basal since things vary so much day to day, and there are so many factors. My time in range for the last month is 71% so I guess I’m not doing too bad.
It’s also harder for me now that I’m working from home and don’t get to bike to an office in the mornings—I’d probably take half the insulin if that were the case since otherwise I’d go low on my way to work! I might try to work in some post-breakfast exercise instead of doing it before lunch, which has been my pandemic routine. Heck, I could even “commute” by doing a 20 minute ride before I sit down to start working!
You may also want to try one of the new ultra-rapid insulins, Fiasp or the one by Lilly I can’t spell. Fiasp has made a huge difference for me in the morning, I can eat very carby things without spiking most days, which was near-impossible using NovoRapid (Novolog) no matter how early I pre-bolused.
Fiasp is weird for me. If I just use it every once in a while, it works great. But the minute I try to use it more than once a day it slows down significantly. When I first got some to try, I tried it a couple of different days and great!!! So one day I decided to try it for the whole day and I kept giving myself more and more insulin and wondering what the heck and then I remembered some people complaining it stopped working for them. I can’t use it more than once a day and it seems that even if I try to use it 2 days in a row , that second day it doesn’t work as well.
But at least I have something for those days where you need that faster boost. I am looking forward to trying the new Lilly one to see if it performs better.
The last 3 days I have been doing temporary reductions in my insulin every morning. Today I have been giving myself extra insulin every hour…par for the course as this is the no pattern, pattern I have been having.
Try sticking with it, even if it slows down a bit. It’s definitely not as fast as when I first tried it, but it’s significantly faster than NovoRapid for me. I probably have to take more of it for whatever reason than I would with NovoRapid, but it definitely allows me to eat more carby things with less of a spike and to correct or stop a spike quicker.
I use Humalog in my pump and I just got the fiasp to deal with an unpredicted spike off and on. It’s weird how it stops working well on some people. I actually don’t need to use it often so it works well for the reason I got it.
If it’s your usual breakfast and it makes you happy starting your day with it, than let the experimentation start!!! Just keep eating the same thing and try all the different suggestions. Take one of the suggestions and try it for a couple days and see what happens. If it doesn’t help, move on to the next one. You may end up using variations of multiple suggestions.
And here is my one suggestion, timing of your prebolus maybe the simple key. Many people have to prebolus much earlier in the morning than for any other meal. Some people have to wait 30-45 minutes. Again, experiment and see. I am a firm believer in if you like it, figure out how to make it work. Sometimes it is a lot of work and many of us just don’t want the extra headache, as diabetes has so many, but I do feel food is a very personal thing and everyone needs to do what makes them happy!
So enjoy whatever you like for breakfast, just take some time to make it work. I do find sometimes talking with someone on my medical team can help with different ideas as they see so many people who have tried so many different things. Good luck with your breakfast experiment!