Hello,
I’m wondering how you deal with post-meal spikes? Lately, I’ve been having some substantial highs 2 hours after breakfast. I count carbs diligently and eat balanced meals. Plus, I usually have some flax seeds for fibre (which is supposed to help with reducing post-meal spikes). I’m not sure what else might be worth trying and I’m starting to get frustrated! Any suggestions?
Cheers,
Laura
Hi Laura,
I see you are type 1. Have you tried taking your insulin injections a little earlier?
Here is a discussion on early bolusing that offers some tips.
Low glycemic foods ( high fiber ) may work …high glycemic bananas ( for breakfast ) did this to me ; apples much kinder to my numbers. When do you deliver your bolus insulin , right at mealtime or better at about 15-20 minutes prior ??
Can you fit a short walk in after you have eaten ?? Are you a " regular " coffee drinker …it would spike my BG in the late afternoon , when I have a cappucino at 3 pm …changed to decaf …and result a lot better.
I am sure others can come up with great, tried out ideas …I am glad I was the first one to respond …but then , I live in your time zone 
Have you considered trying Symlin? It will eliminate the post-meal spike and smooth out the upward swing. I know it can cause hypoglycemia if not managed closely, but in my opinion it can reduce the incidence of low blood glucose by allowing you to bolus for meals using square boluses that do not spike down your blood glucose like a large single bolus can. Check out my blog here at tudiabetes, I have a guide to Symlin posted with a good discussion thanks to the members who have given their input.
Hi Laura:
I’m a non-medicated type 2… so I don’t know if this will help you much… so I’ll toss this out there and see what happens.
You don’t say what you are eating for breakfast. I had to completely change my morning diet to avoid the spikes. I normally eat eggs with some sort of meat with a milk or maybe some cheese. Then throughout the day I have some high fiber veggie snacks or fruit (berries) and finally in the evening I usually will put the fish, steak, chicken, taco meat (whatever hubby wants) on salad greens.
I avoid:
Breads, processed cereals, noodles, potatoes, corn and rice. (they all seem to give me long lasting spikes)
I also found that at first Cinnamon really helped me get my numbers down and it also helped me get past the need for something sweet. I put it in coffee, tea, and took the capsules.
Good luck
Hi Laura,
In case this helps (in addition to the other great suggestions), I’m very carb sensitive in the morning so eat very few carbs for breakfast. It’s the only thing that helped me. Something to consider is that often insulin needs change & you just may need a bit more than before.
if you want to eat your carbs for breakfast maybe you could take your insulin earlier like kristin implied or just take more insulin if you don’t have a problem with that. i know just how much insulin to take if i eat a bagel for breakfast to be perfect an hour and a half later. i’m all about being able to eat whatever i want so if you are too it might take some playing around with your insulin to figure out how much you need for certain foods. i agree it is frustrating but hang in there you will get it!!
Hi Laura,
A while back my endo suggested trying Fortamet (Metformin in extended release form) to help with my post meal highs and it has been great!
Its true this is normally a T2 drug but my endo found that it works very well in his T1’s so I decided to give it a try…He did prescribe it for twice daily and honestly, I only need one pill a day to give me good coverage for a full 24 hours. Not to say I don’t have highs sometimes but the Fortamet has really helped to keep them to a minimum.
Also, as far as coffee goes, if you are a coffee drinker…I found that for my morning cup I need to take for 10 carbs. It took a little experimenting to come up with that number bc from what I understand its less the carbs and more the caffeine that effects the BG but now that I take that insulin when I drink a cup I find my BG’s are much more stable.
Oh and I do try to take my insulin a little before eating also if my BG is over 130 or so.
Hope some of that helps 
I was having a post breakfast spike also a while back. It was my coffee. Do a search on this site for coffee if you have a cup with breakfast every morning. Others have to carb for coffee and I have found that I have to as well. Some have speculated that the caffine makes the normal glucose more potent.
i also count a cup of coffee for about 10 carbs
i think caffeine in general can be a factor :o. I don’t drink coffee or soda anymore.
i’ve cut back on caffeine big time and i feel wayyy better…but that’s off the subject
As Kristin wrote, dosing earlier can help.
You may also need a different insulin-to-carb ratio at breakfast. For years, I didn’t want to have to change my carb ratio (I don’t know why I stubbornly resisted, but I did). I learned I needed substantially more rapid-acting insulin to cover breakfast: 1 unit per 8 g carb vs. the 1 unit per 12-15 g carb I take at other times of day.
Also, exercise before breakfast really helps! Good luck.
Hi Jason,
I’ve read about Symlin but I live in Canada where it hasn’t been approved yet - we’re usually a ways behind the States when it comes to new drugs, etc. I’m planning on asking my endo about it when I see him next month. He’ll probably have an idea of its presence in Canada. Thank you!
Laura
Thank you for all the replies! I hadn’t heard about the coffee thing before. I don’t drink coffee everyday but I’m going to start watching my sugars closely when I do.
To answer a couple of your questions, I do try to take my insulin 15-20 minutes before my meals. Of course, this isn’t always feasible but I do it enough that I’m confident the spikes are caused by either the glycemic index of my food intake or by an inaccurate insulin:carb ratio. Thanks for your input in helping me come to this conclusion!
Most of my diabetes-life (nearly 16 years) I’ve had major dawn phenomenon issues and, therefore, would wake with high sugars (I’m not on the pump yet though I will be soon!). In the last year or so, I’ve started waking with better numbers…and started experiencing these post-breakfast spikes. There’s always something! I think I do need to do some experimentation with my morning insulin:carb ratio. Like some of you, I know I’m more sensitive to carbs in the morning. I took more of a bolus this morning…now I’m just waiting to do that post-prandial test.
Cheers,
Laura
Hope the numbers are happy ones.
Wanted to comment on the suggestion about exercising before breakfast. Different for everyone of course, but I was told by my endo not to exercise before breakfast, or in the morning at all. People with dawn phenonmenon (I have this also) can experience further spiking from increased liver dumping. What’s helped me is injecting & eating immediately when I get up & taking basal in two doses, one before bed & the other in the morning. Glad you’ve got yours under control. Awful starting out the day with high numbers.
I also have post breakfast spikes. With my doctor and CDE we adjusted my carb ratio a little higher for the morning. Generally it’s 12:1 but from 6 am to 10 a.m I use an 8:1 ratio. That helped a lot. (Oh, I see Kelly had the same experience!!)
I also avoid grains in the morning and substitute fruit. Yeah, I miss my toast (with cinnamon), but I’ve lowered the spikes.
Moving around in the morning helps, too. Stretching, a quick walk to the end of the block and back (real vigorous if you’re in your PJ’s and it’s still winter), walking the dogs.
Good luck,
Terry
don’t we all hate the dreaded dawn phenonmenon 