Going high in AM despite overbolusing

Thanks Marie!
Just did not know the abbreviations. Git both conditions most days!

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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!

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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.

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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!