Newly diagnosed and high after breakfast numbers and afternoon lows


I’m new here! I was diagnosed with type 1 diabetes about 4 weeks ago, and I have been home from the hospital for about three weeks. I haven’t seen my regular endocrinologist yet (I’ll see him in a week), only the endocrinologist in the hospital (and the diabetes educator). I’m taking lantus before bed and using homolog for my bolus, and carb counting. But I must be doing something wrong, because my numbers are all over the place.

For example, two nights before bed my blood sugar was 5.0 mmol/L (90 mg/dl). I took my prescribed dose of 10 units of lantus yesterday when I woke up my blood sugar was 4.7mmol/L (84.6 mg/dl). I boluses 1 unit of homolog and had breakfast (2 eggs scrambled with 1 stalk of celery, half a tomato, 1/4 green pepper, bit of onion, one piece of whole grain toast with butter = 20g of carb). 2 hours later my blood sugar was 14.1 mmol/L (253.8 mg/dl). So I bolused 2 units for correction.

Then before lunch, my blood sugar was 5.8 mmol/L (104.4 mg/dl). I bolused 2 units of humalog and had lunch (2 pieces of bread, a slice of havarti cheese, half a tablespoon of branston pickle, 2 lettuce leaves = 43 carbs).

2 hours later and my blood sugar was 6.3 mmol/L (113.4 mg/dl). I decided to have a snack so I had an apple with 1 tablespoon of natural peanut butter, and one seashell chocolate = 28 carbs). I bolused 1 unit.

An hour and a half later, I felt really shaky and dizzy. I took my blood sugar, and it was 3.7 mmol/L (66.6 mg/dl). I decided to have 6oz of blackberries and a glucose tablet (20g of carb). Within half an hour, all was well at 5.3mmol/L (95.4 mg/dl).

About an hour later, it was dinner time. I checked my sugar again, and it was 5.8 mmol/L (104.4 mg/dl). I decided to make myself a stirfry (1/2 cup of rice, a half package of firm tofu, 11 pea pods, 1 cup of broccoli, a half a red pepper, a half cup of napa cabbage, half a carrot, tablespoon of soy sauce, tablespoon of rice vinegar, tablespoon of rice wine, tablespoon of honey, tsp of sesame oil = 66 carbs). I bolused 3 units.

Before bed my blood sugar was 5.9 mmol/L (106.2 mg/dl). I took my ten unit of lantus and went to bed.

I woke up this morning, and my blood sugar was 5.3 mmol/L (95.4 mg/dl). I had 1 cup of special k with a half cup of 2% milk, and a container of sugar free yogurt (38 grams of carbs_. I bolused two units. 2 hours later, my blood sugar was 11.7 mmol/L (210.6 mg/dl). I corrected with 1 unit of humalog.

This pattern has been going on the whole 3 weeks since I have been home from the hospital, where the endo told me that I should try not to have numbers over 10 mmol/L (180 mg/dl). I don’t know what I am doing wrong!!! Any advice would be greatly appreciated!

edited: I’m 24 years old, female :slight_smile:


Welcome to TuDiabetes! I have to tell you, you actually seem to be doing great. Even if your blood sugar numbers are not where you want them to be that doesn’t mean you are doing something wrong. It can be very for us to separate the crazy things that diabetes does to us from our efforts to manage our diabetes.

So first, many of have blood sugar rises in the morning due to what is called Dawn Phenomenon. I call it Darn Phenomenon. My blood sugar starts to rise in the morning the moment my feet hit the floor. In fact, before my current (better tuned) insulin my blood sugar would rise at 3-4am in anticipation of my arising. I deal with it by taking some extra insulin in the morning. That might be something to talk with your doctor about.

It is also important to realize that you may have very different insulin sensitivities at different times of the day. Part of getting better at diabetes is making these observations. Many people find it helpful to log the date/time, their blood sugar, what they eat and the timing/size of the insulin dose. If you see repeated problems, such as going low after lunch then you can make some adjustments (such as slight reductions in the insulin you take at lunch). Again, having a log book and going over this with your doctor can be helpful.

While seeing a doctor is important, many of us have also realized that we have to learn to take care of ourselves, a doctor can follow us around every minute. Two books many find helpful are “Think Like a Pancreas” by Gary Scheiner and “Using Insulin” by John Walsh (although this on is a bit date at this point).


I have to agree, I think you’re doing great! Breakfast is a notoriously difficult meal to treat correctly (and I find bread, rice, and other similar carbs to be nearly impossible to have good post-prandials for), without very aggressive pre-bolusing and other trial and error type tweaking.

Otherwise, though, most of your bgs are absolutely within range and your corrections seems to be working well. Not to mention, you food choices seem to be on the smart/healthy side. So overall, stay in touch and keep it up!


Hey VikaPlume

Welcome to Tudiabetes. Everyone here can relate to what you’re going through. We’ve all been there, and we understand. You’ll find lots of practical help here, and lots of empathy anytime you need to vent. You’re going to be ok. If there’s one thing I’ve learned, its that people with diabetes can do everything other people can do…it just takes a little planning.

I was diagnosed as T1 5 years ago, in my 40’s, and have learned to keep my glucose levels at non-diabetic levels most of the time. The biggest variable impacting your glucose levels is what you eat. Based on what you write, it seems like you’re still in a honeymoon phase (where you’re still producing some insulin) which is great and will make management easier. You are also making a lot of good food choices, but your spikes are directly related to the higher-glycemic foods like, bread, rice, honey and breakfast cereal. These are difficult to dose for, but I’ve seen some on this forum do it successfully. If I were to eat these, I’d be in the 200-300’s in no time.

No two people are alike, so you need to go through some trial and error. The methodology that’s served me best is to establish a baseline, and then change one variable at a time. Consider this in the beginning phase: remove all sugars, starches and fast acting carbs for all your meals in the beginning: Breakfast - eggs and meat (bacon/sausage), Lunch/Dinner: Protein and grilled/steamed green vegetables only (i.e., burger, no bun, steak, chicken, fish, broccoli, asparagus, etc.), Snacks - almonds, lunchmeats, avocados.

These types of meals will have a very slow and predictable impact on your blood sugar for which you will be able to find optimal and low doses very quickly. Along with your honeymooning, I’d imagine you will quickly be able to manage relatively flat glucose levels. Any under/over dosing will be easy to correct.

Once you’ve stabilized the variability, then begin to test higher glycemic additions one at a time. What impact does a slice of bread have, some fruit, a glass of milk, etc.? You’ll quickly see what you can best tolerate, and what you can’t tolerate at all.

As I said earlier, everyone’s metabolism is different, but through this process I learned that the higher-glycemic treats for which I can reliably dose and still maintain normal levels are strawberries, high-fat premium ice cream (Haagen Dazs, Ben and Jerry’s, etc.), high-fat premium, unsweetened yoghurt. Bread throws me into the stratosphere no matter what I do, by comparison.

Find a good way to log everything you do in the beginning. This way you will develop your own personal database of cause and effect. There are many ways to do this. Some prefer pen and paper, others prefer using smartphone apps - and there are plenty good ones out there. I use OneDrop - available on iOS and Android. After a while, you’ll begin to automatically know what you can and cannot eat, and what your dosing needs to be. I can now eyball a plate of food and very reliably estimate the correct dose to keep my levels flat.

You’ll do great, and don’t hesitate to reach out to this wonderful community for any advice and support you may need.



Welcome to TuD, @VikaPlume! You are already doing well with adjusting to your diabetes. You are conscious about what you are eating, checking your blood sugar levels, and taking your insulin. I agree with all the advice you’ve already been given.

If I were you, I would spend time educating yourself about how insulin works for you. Keeping a log is a great way to learn what different foods do to your blood glucose. Some foods you will learn that drive your blood sugar so high that it’s not worth it to you. You may decide to avoid those foods or maybe just cut down on the portion size.

I encourage you to buy a scale so that you may calculate carbohydrate content accurately. There are many electronic scales available on Amazon that will display the weight in grams. You can then look up that weight in grams of your food in an app like Calorie King. It will then display in a standard food label format, the nutritional components of your food, including carbohydrates.

You don’t have to do this everyday forever. Most people tend to eat about 10 meals for about 90% of the time. Once you figure out the insulin doses that work well for you for those meals, your life will get simpler and you’ll enjoy better blood glucose levels.

The log you keep (you won’t have to do this forever) will be useful to your doctor but is much more valuable to you. You will find, if you pay attention, that your knowledge of your diabetes will quickly outrun your doctor’s. A log is part of your education about how your metabolism works. We’re all a little different, so using a scale and keeping a log on your favorite meals will give you great, actionable, and customized data.

You can live a long, healthy, and productive life with diabetes. None of us would volunteer for this and we would trade it away in a heartbeat, but we don’t have those options. Understand that a diabetes diagnosis raises emotional issues and you likely have been experiencing stages of grief. Go easy on yourself. Acknowledge the emotion and maybe write about it. It will help you in the long run. Seeing a talk therapist is a great idea, too.

As you can see, there are a lot of facets to living well with diabetes. Don’t be overwhelmed by the volume of information that you’ll need to learn. You have your whole life to learn how to deal well with your diabetes. It can be done and the community here is ready to help 24/7/365. Good luck!

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My advice is to learn HOW to deal with your Type 1. Which is what you’re doing. Type 1 is not easily controllable because Type 1 is a mean, arbitrary bastard. I can have a near perfect day yesterday and do all the same things today and have my numbers be totally different.

So, the only thing you can do is your best. You know what I call a bad blood glucose day? Tuesday. Monday. Thursday. Your inability to have stable numbers also has a name: Type 1 diabetes. You also probably have SOME insulin production left and it will be intermittent. That will change your BG numbers, too.

You are doing nothing wrong. Concentrate on being flexible in your thinking and actions when things go sideways. Things will go sideways. Sideways is not a reflection on your effort, competence or worth as a person.

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Welcome. The people here have a wealth of knowledge and are happy to help. Use the forum search function liberally and always ask when you need to!

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Echoing what everyone else has said, you’re doing a very good job for someone this early in the process. And 4 weeks is very, VERY early. As someone here once said, “Diabetes is a marathon, not a sprint.” You’re at the start of a long road and you’ve taken oh, perhaps 3 steps so far.

Managing diabetes is something you’ll be doing for the rest of your life and it’s a complicated beast with a lot of knobs, switches, and levers. It takes time to get good at it, and you will; a great many people have been down that road ahead of you, know the route, and are eager to share what they’ve learned the hard way. This community is full of them.

Don’t try to learn it all at once. You can’t, anyway; the brain will absorb only so much before it gets saturated and demands some R&R. Learn one or two new things a day. You’ll be surprised how soon it starts to come into sharp focus.

Now, to the specifics of your BG swings. A key to successful management is matching insulin to the carbs consumed. You were probably given some general guidelines in the hospital, but those numbers are just averages at best. The individual variation from person to person can be quite great, even extreme. You need to learn exactly how sensitive you are to carbs and insulin. If you haven’t already, you’ll run into a couple of common terms: I:C ratio and ISF.

The I:C ratio is your insulin-to-carb ratio. In other words, how many carbs will one unit of insulin counteract? ISF stands for Insulin Sensitivity Factor; meaning, how many points on the scale will one unit of insulin lower your BG? Once you’re armed with those numbers, you can learn to do a pretty effective job of matching food to medication. The only way to find out what those numbers are for you is to do some controlled testing. Your endo or diabetes educator can probably help with that, and the books mentioned below definitely can.

But aside from simple lack of experience, there are a great many things that can affect your BG and produce the kind of erratic swings that have you concerned. Some have been mentioned in the previous posts, but they are way, way too numerous to describe here; I’d have to write another 500 or 1000 words just to make a conscientious start. I’ll just mention one: people diagnosed with diabetes as adults sometimes have a form of it called LADA (Latent Autoimmune Diabetes of Adults). This may or may not describe you, but one of its characteristics is erratic BG behavior during the early stages, before things settle down. Don’t take that too seriously, it’s only one possibility. But you see what I mean about there being a lot of possible explanations.

There are some really excellent books that can teach you the ins and outs of this stuff. Two of the very best ones are listed below:

Gary Scheiner, Think Like A Pancreas (Boston: Da Capo Press, 2011)

Richard K. Bernstein, Dr. Bernstein’s Diabetes Solution, 4th. ed. (New York: Little, Brown and Company, 2011)

To reiterate, you’re doing an excellent job for someone this new to diabetes. You’ve got time to figure this out. Take a deep breath, relax and move forward a step at a time.

Oh, and you’ve found a superb community full of people who want to help. We’re glad you found us! Welcome to the family. :sunglasses:


Welcome. I agree you are doing quite well after diagnosis. Bravo!

Diabetes changes day to day, hour to hour. Just the way it is. Don’t freak.

Get a nutrition app to help with carb counting. Find a support group. NO ONE will understand your needs better.

Christmas 2017 will be my 55 year anniversary of Type1 diagnosis

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Hugs to you - so sorry for your diagnosis. :frowning: Hang in there - all this new information gets a little bit easier and more comfortable each week that passes. Honest. :wink:
Two specific things that have been TREMENDOUSLY helpful for my new T1 son’s adjustment are his Dexcom and the book Sugar Surfing, by Dr. Steven Ponder. Game changers.
Both came HIGHLY recommended via multiple sources/friends immediately after he was diagnosed. We are soooo thankful for the suggestions.

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Thank-you all so much for the encouragement and suggestions!!!

I’m already using a kitchen scale and an app called MyNetDiary for carb counting (because I was using them pre-diagnosis… to avoid weight gain since half of my family has type 2… meanwhile I did everything right and ended up diabetic anyways… grrr). I also started suing an app called MySugr to track my glucose levels on the advice of the diabetes educator at the hospital.

I ordered Think Like A Pancreas on amazon, should be here tuesday! Thanks for the suggestion @David_dns and @Brian_BSC

@Christopher5 I think you are right about those higher glycemic foods! I had pasta for supper yesterday, and even though I weighed the pasta dosed the right amount of insulin according to the hospital (1 unit per 20g of carb) my 2 hours post meal blood sugar was 15.8 mmol/L (284.4 mg/dl)! Oops… At least that is still lower than the 24.2 mmol/L (435.6 mg/dl) it was at diagnosis? I’ve been a vegetarian since I was 14 so today I tried to eat mostly just eggs, cheese, sugar free yogourt, tofu, vegetables, berries and avocado and no morning spikes! Over the course of the week, I’ll try some tempeh, seitan, nuts and chickpeas to see how those are too.

@Terry4 that’s good idea to build a regular repertoire of meals which affect my blood sugar in predictable ways that I can use most of the time.

@Sue27 That’s a very long time that you have had type 1! Have you had any complications? My grandfather has been a type 2 diabetic for around 20 years and recently lost a three of his toes because of it… I’m rather fond of my toes, and being in my 20s means that I’m likely to have diabetes a lot longer than 20 years…

On a side note, my diabetes educator said that anything under 4.0 mmol/L (72 mg/dl) is hypoglycaemia, and should be corrected. But I start to feel the symptoms of hypoglycaemia at around 5.0 mmol/L (90 mg/dl). Does anyone else have that problem?


Hypoglycemia thresholds vary from person to person. Sometimes hypo symptoms can occur just due to quickness of glucose descent. People whose bodies are used to higher blood glucose levels due to delayed diagnosis and treatment will often feel low at normal levels. It is the relative glucose fall that can bring on feelings of hypoglycemia.

For you, hypoglycemia is the level at which your body decides it needs sugar now. 4 mmol/L (72 mg/dL) is a nice round number and is reasonably near where most people start to feel symptoms. I don’t usually feel low until I sink below 65 mg/dL (3.6 mmol/L). I’ve spent extended hours in the 65-70 mg/dL range and have felt fine.

Always take note of what level of blood glucose you feel symptomatic. That set-point may change.

I’m glad you found some useful ideas here for you to try. Your good attitude bodes well for your prognosis. It’s great that you have a diabetes educator to turn to.


Perfectly true as far as it goes, however . . . everything about this insane disease varies from person to person. So much so that we have an acronym for it: YDMV (Your Diabetes May Vary). So yes, hypoglycemia thesholds are as invididual as everything else. The bottom line is, what works for you may or may not work for the next person; but it’s what works for you that matters. You’ll find this to be true of just about every aspect of diabetes. The silver lining is that with time, more and more pieces of your own individual puzzle will fall into place.

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It looks like you’re making excellent progress and you’re doing all the right things. Remember, there are very few absolutes in this disease. It’s all about testing and logging, especially in the beginning, and developing your own personal repertoire of cause and effect. Anyone who tells you that you can continue eating like a person without diabetes and all you need to do is dose accordingly to maintain “normal” glucose levels is either naive or just flat out lying to you. As you can see, there are some foods that are much more of a challenge than others. Numbers don’t lie, and with time and trial and error you will develop a delicious menu of options for yourself that also meet your blood sugar goals.

Your diabetes educator’s definition of hypoglycemia sounds a little arbitrary. As others have stated, everyone is different. The symptoms you feel are related to where your historical averages have been, so it’s no surprise that you’re feeling symptoms at 90, as your average numbers have been elevated. As you start to bring them more under control and as you minimize the variability (you’re doing a great job, by the way), you’ll start to see this threshold lower. In my case I feel symptoms at about 55. One thing I learned long ago is never try to address a low using food. I’ll almost always get it wrong and over-correct. Rather, get yourself glucose tablets and establish how much each one will raise your levels.

You’ve gotten great reading recommendations from everyone. One I would add as a quick and easy resource that helped me answer so many of my early questions post diagnosis is

Keep up the great work!

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Welcome. @VikaPlume!

Your bgs sounds fantastic! You make it sounds easy!

I haven’t read through all the comments, but seeing who has responded, I’m sure you’ve received great advice and this has already been mentioned: the afternoon low after snack might be bc you still had insulin working from lunch when you bolused for the snack. As far as breakfast, it could be that you just need more insulin for breakfast carbs. My son has type 1, diagnosed 10 years ago. Breakfast has always been the most unpredictable meal to handle and has always needed the most insulin. As the day goes on his body becomes more efficient at using insulin due to his normal activity. After laying in bed all night, his body is a little less efficient first thing in the am.

My best to you!


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