My blood sugar always seems to sky rocket after meals into the 290s and 300s before (sometimes) coming back down.
Could someone give some examples of meals they eat which do not do this to your blood sugar.
I’m newly pregnant and I really need to keep my numbers low.
Any advice or meal ideas would be appreciated!
I am sure that you will get a lot of replies along the lines that you cut out nearly all carbs or avoid anything with a GI higher than sawdust.
Anticipating this, it is possible to eat at least a moderate carb diet and avoid signficant spikes. The first rule of thumb is that with any meal with a reasonable number of carbs you will need to pre-bolus. Rapid analog insulins just don’t act quickly enough so you need to bolus well in advance. Some people go for as much as 30 mins before eating, but I would start with 15 mins. Are you using a pump or CGM? If not, would you qualify for them on the grounds of your preganancy? If you are often returning to a reasonable number, it may be that just getting the insulin acting a bit sooner will do the trick.
If you are in Japan, does your present diet include lots of rice and/or noodles. These offer opposite problems. Plain boiled rice is high GI - prebolusing may work. Noodles or pasta tend to be low GI (which might work for you) but can result in an initial fall in BG followed several hours later by a rise. Pump users tend to employ extended boluses for these (e.g. 50% upfront and the remainder over 2-3 hours.
I am sure you want to eat a nutrionally healthy diet. Start by trying prebolusing.
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Nicely stated @jjim335. It was basically the message I was going to write myself, before you beat me to it!
The combination of low carb and pre-bolus should do the trick. If you are looking for specific recipes, I would look on YouTube and search for ketogenic diets. I’m not suggesting such a diet would be appropriate, but some of those recipes would help give you a variety of foods that are tasty and low-carb.
But there is another aspect to consider. There are likely nutritional needs to consider for pregnancy that go beyond what might be appropriate for a teen-age boy or a senior citizen like myself. Make sure your maternity medical team is providing input about your unique needs!
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45 minutes pre-bolus of Humalog for fast-acting carbs at breakfast time works for us. Wearing a CGM helps so pre-bolus can be cut short if the graph shows a dip occurring sooner then expected.
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I try to test my BG an hour before a meal, so if it is unusually high, I can pre-bolus longer before the meal. Yes, if the meal is high GI and my BG is higher than 150, I actually am best off to pre-bolus up to a full hour ahead, since fast-acting insulin is not very fast in my body. You’d need to do some experimentation to see how far ahead is most appropriate in your body with different levels of BG and types of food.
I’m on MDI, so don’t have the same options of extended bolus that pumpers do. But if I want more carbs than my body can handle at one time without going too high after meals, I super bolus for both the main meal and a later snack before the meal. Then I hold part of the meal, like fruit or higher carb salad, for a couple of hours later. That way my BG has come down close to or below 100 mg/dl (5.6 mmol/l) before I send it back up again with the snack. In doing it this way, the BG never reaches the level it would if the food is eaten all at once.
I’ retired, so I can do this any day, but for most employed individuals, it would likely only be an option on days off. But you might give it a try when you can.
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There used to be a guy on here named Dave, who was really well read and battled this issue with a lot of tenacity. Anyone see him around anymore?
I had problems with ‘postpranials’ for years, on and off. What I ate did very little to control things. There’s a limit to what you can do by adjusting your eating. I find that basal insulin adjustments have had the biggest impact on bringing those numbers down.
I’m a vegetarian and have been all my life, so I eat a relatively high carbohydrate diet. While a pump has helped me bring my postpranials down to normal, I was never able to do this on injections. Certain carbs will result in high post meal numbers, but many do not. It depends. Mostly, it depends on having adequate basal, I think. I dose according to recent experience, differently at different times of day. Eating the same foods might help, in the short run.
Here’s a video on one of the many complicating factors: https://www.eurekalert.org/pub_releases/2015-11/cp-fd111215.php
Do you use a pump or injection therapy? If you are on a pump, using a Super Bolus can help significantly with post meal spikes.
Thank you so much! I’ve never heard of a super bolus, but I just read the article you linked, and I’m intrigued. I can’t believe I’m finding solutions! Thanks to ya’ll!
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Wow! I’ve never heard of prebolus before! I’m amazed!
I also never considered the GI in the foods I was eating. I do eat lost of rice and noodles in Japan, so I will experiment with the prebolus.
I do wear a pump and just started the CGM since becoming pregnant.
Putting all this together, and adding a high dose of will power, I’m hoping for success.
Thanks again, this was tremendously more helpful than anything I’ve heard from my doctors in Japan.
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Have you read “Pumping Insulin” by John Walsh (available from Amazon)? He goes over all these tricks.
All good advice on making the most of the flexibility a pump gives you, but do also remember that during pregnancy you will need to adjust both your basals and your bolus I:C ratios frequently. (The postprandials are a real challenge for a number of reasons, one of which is because the increase in the hormone relaxin slows down your digestive system. Basically I think of it as my body behaving as if I have a mild form of gastroparesis for a bit.)
I am now at 30 weeks and have probably had to make over 10 adjustments over the past six months (not something that ever happened to me pre-pregnancy when my insulin needs were extremely stable). Are you comfortable making your own adjustments? If so, I would advise you not to wait longer than 48 hours of persistent problems to change something (though I would recommend changing one thing at a time only; i.e., first basals, then bolus, not both at once, so that you can see how each factor is affecting you).
(Especially) if you are not comfortable doing your own adjustments, are you seeing an endo or a high-risk OBGYN? They should also be able to assist if you call or email them with your challenging BG results.
If you want to chat specifically about pregnancy adjustments, look through the threads on that topic and feel free to send me a personal message.
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hi, during pregnancy my carb tolerance drps dramstically. so i focus on eating eggs, mests, nits and vegetables. i am most carb i toletsnt in the mornings… so my breakfast is ususlly some variation of eggs. lunch is meat plus salad, veges. dinner i am least carb resistant, so i eat a bit more.
I take Symlin with the meal as well as insulin. You will never go high within 2 hours. But at 1 1/2 hours the symlin wears off and then I bolus more (pump) depending on what I ate.
jim335 offers great ade. I also prebolus, considering it an art when done well. If my BG starts climbing after eating even if I prebolus, I’ll sometimes take a short walk. I have to be careful especially if I have active insulin on board. When I say short I mean no more than 5 maybe 10 minutes.
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All great suggestions here. I also agree pre-bolus can help control most post meal rises. I am not a low carb person but still do ok eating what I want but that pre-bolus is key. Depending on what my blood sugar is before, will help me decide how long to wait. And a CGM is great for this. Just watch for the “bend” and than you can eat. Good luck and keep asking questions. Knowledge is power!
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I’ve seen research saying that the complexity of carbohydrates has little effect of how much they affect diabetes. The types of links between the simple sugars have much more effect, since the digestive enzymes can break links almost anywhere in the chain, not just at the ends. For example cellulose (the main carbohydrate in wood) has a type of links for which no humans or multi-cell animals have a suitable digestive enzyme, so the few animals that can digest cellulose do so by containing colonies of bacteria that do produce a suitable enzyme. Such animals include termites, rabbits, and cattle.
Do you mean the “bend” when the blood sugar starts to drop?
I’m assuming that’s what she means by the bend, and that’s what I was going to add here too. I pre-bolus and watch on my CGM until I see the line begin to “bend” or dip down, which tells me the bolus has actually started to take effect.
If I have time, I’ll continue to wait until my number is in a range I prefer, around 100 or lower ideally, or I can eat and know that at least my insulin is actually working. The amount of time can vary quite a bit depending on time of day, etc. There’s a book called “Sugar Surfing” which goes into this in more detail, but you’ve already got plenty of info to start from here! Best wishes!
I’ve been T1 43 years and found the best diet that works for me is vegan, low carb, sugar free. I’m MDI and use about 17u Toujeo and between 4 and 6u Humalog once a day. The diet is very restrictive and keeps BG average of about 90. I do have on/off days once in a while although A1C has been in the mid 5s (5.7, 5.5, etc). I’m not strict with carb counting since my intake is so low. When I do ingest carbs, they are usually high fiber included (such as black beans, almonds, chia seeds or seed based crackers, etc). The reason I can skip the Humalog most of the day is because lunch will only consists of veggies/salad using yellow mustard and red wine vinegar as dressing (no meat or cheese). Breakfast is usually about a cup of almond milk, coffee and sometimes the addition of one scoop VeganSmart Nutritional shake. Dinners are usually 4 servings of riced cauliflower and some kind of small addition like vegan protein (Beyond Meat) or crushed tomatoes and enchilada sauce. As a treat, I will sometimes indulge in fresh almond butter or “rollers” (rice snacks - mid carbs/sugars to bring BGs up or stabilize overnight), or vegan crackers. This works for me and may not be good for others. The trick is to find what works specifically for you. In regards to pregnancy, I would think lots of fresh or raw options would be helpful from a nutrient perspective or even something like the VeganSmart shake mix. Might take a little practice 
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