Apologies for the vague title, I’m really not sure how to describe my issue in a small description.
I’m curious how you guys plan your morning with insulin dosing so that you can have your breakfast and out the door by a certain time.
I’m finding it very difficult to control the time I leave for work. I’ve ascertained that I have FOTF in the morning so the first thing I do when my eyes are open is to bolus for that and wait in bed for about 10 mins. I get up then prebolus for breakfast with the intention of having it in 20-25mins time. If all goes well, my sugar starts dropping after 20 mins. I eat and that’s the end of it. I’m out the door.
But there have been many occasions where my FOTF just keeps rising (not always but many) and the 20-25 mins prebolus turn into 1 hour + before I see my sugar start to trend down. Now this is annoying because it means I can’t leave for work on time. I don’t have the option of not eating or eating at work because I’ve already bolused for breakfast.
Any tips on how to manage the timing better? I haven’t been able to establish a pattern with the FOTF rise, sometimes it’s just 18mg, sometimes it’s 36mg and sometimes it even goes beyond that.
Mornings are often hectic and routine can change on a moment’s notice so I have also found that skipping breakfast did wonders for keeping my number flatlined until lunch with minimal insulin. I am OMAD, only eat 1 meal a day at lunch. Sometimes I will eat a small snack in the evening, but then end up regretting it because it becomes a chore to flatline in the evening and through the night as well as it brings on DP (dawn phenomenon) which I don’t get at all when skipping food in the evening.
I would skip breakfast if I could but I feel lousy on an empty stomach and just thought it’s not worth it as I don’t get productive. I skipped dinner yesterday to basal test and couldn’t sleep all night because I was so hungry.
Even with this you need to bolus right? But you make a good point here because if it’s just protein, the prebolus doesn’t have to be long. The only problem is I would need to stick to a protein meal everyday, if I had bolused for a carb meal, I can’t suddenly switch to a protein meal if my FOTF continue to rise.
I’m like you in that my spike varies for FOTF. Hwr, I usually take 1U when I get out of bed and that helps though I still may spike into the low 100s. Like others, I usually don’t eat breakfast especially if I plan to run in the morning. It just takes too long to get back to zero IOB if I eat. When I do eat though, I pre bolus when I get up. I usually eat a 1/4 cup each of Greek yoghurt, seeds (flax, chia, hemp), berries/fruit. It is very filling and does not usually cause a spike for me. It has about 30g carbs.
How do you exercise in the morning without food. I find that I will go low 10-15 mins into it.
At the moment I bolus 0.5 for the FOTF, perhaps I should bolus 1 like you and just terminate the extended bolus early if I find that the FOTF isn’t too bad. The only thing is by then, most of the extended bolus may have already been dispensed.
Oh, sorry, I should have been more specific. I do take in carbs during my run. Usually a 21g gel within the first 20 minutes or sometimes even before I start. Then I will take more carbs as needed if I am trending down. I rely on my Dexcom which seems to be pretty accurate even while running.
Oh, are you using an extended bolus for FOTF? I suppose that is because you aren’t sure if you will actually have the spike? Yes, you could terminate the extended bolus or even suspend your basal for an equivalent amount of time corresponding to the over bolused amount. Or eat something as part of your breakfast.
I don’t use extended boluses. Actually I’m on Loop so Loop will auto bolus additional insulin if my predicted BG is higher than my target. Usually the 1U that I bolus is sufficient but sometimes it is too much, then Loop will reduce or suspend my basal.
No, unfortunately, pretty random for me, too. Now that I take insulin for it with Loop, I’m not sure how high I would go. But even with insulin I could still go from 60 to 120! I have noticed that if I’ve gotten up throughout the night abd hence, already experienced FOTF and had to take corrections, then when I finally get up for the morning, my spike is usually much lower. I suppose that is because I have stacked insulin on board.
For me and many others, eggs can spike your BG as much as a carb rich meal and require as much insulin.
Eggs have a high relative Leucine and Arginine content.
In 1967, it was identified that Leucine causes an increased insulin reaction and associated with hypoglycemic symptoms. Proteins, including eggs stimulate glucagon release in the absence of carbs which will also raise your BG. (http://press.endocrine.org/doi/abs/10.1210/endo-116-3-1168).
L-Arginine and L-Glutamine (also present in relatively high proportion in eggs) also induce Glucagon secretion
In addition, Egg Yolks contain a lot of Oleic and Palmitic Acid, which account for 70% of the fatty acids in egg yolks.These are also known to induce glucagon secretion.
Finally, cellular uptake of amino acids requires insulin, so to avoid a low blood glucose level when protein is ingested, the body normally produces glucagon - again raising BGs unless you have IOB.
So, I’d experiment before going all in on the egg thing in the morning.
Interesting @Steve_Mann . I always wondered why at breakfast my sugar kept spiking despite prebolusing. I thought it was the half cup of milk I was consuming so I stopped it and it seemed to not peak so high. It could also be the egg too based on what you said.
It never occurred to me to take out the egg. The reason I kept the egg what some posters told me to eat protein with my carb to slow down the rise. I don’t like eating meat in the morning so I use egg as my protein source.
@tedos yes it is. I was having this problem… i ate only eggs for breakfast and my BG would fly hi… I started bolusing 25 minutes AFTER the meal and that took care of it.
