Anyone else out there having or have had trouble with breakfast? My 6 year old daughter wakes up in her range, I count the carbs, inject pre-meal and she goes high about an hour after she eats and stays that way until I correct with her pre-lunch insulin. It's the only meal I have this problem with and it seems to happen no matter what I feed her. The breakfast ratio is 1:20 while every other meal is currently 1:30.
We've only been at this since the end of April so any suggestions would be appreciated.
I had the same issue with my 6 year old daughter. At the beginning of the school year her ratios were the same all day long but then she was having crazy highs at lunch even though she was waking up in the low 100’s. I spoke with her endo and now her breakfast ratio is 1:10, lunch 1:20 and dinner 1:15. Also our sliding scale got adjusted slightly. This corrected our issues - for now anyway
Good luck!
Melissa
Hello - my daughter is 12 and was dx at 2. I assume you are on MDI (basal bolus)? We've learned over the years that on waking you are very resistant to insulin, hence the increased carb ratio compared to the rest of the day, and also it takes longer for the insulin to work. So you end up with sugar being released into the blood before the insulin gets there. So, we do the insulin 15 - 20 minutes prior to eating (you can experiment with timing) and this nearly always eliminates that post breakfast spike. Gary Scheiner (Think Like A Pancreas) always teaches this and it works! The other thing to do is always include some protein in the meal, ideally first, such as yogurt, egg, or meat etc. That also slows the release of sugar into the bloodstream. If you can't figure out the exact carbs 15 minutes beforehand, as she may change her mind, do a reasonable number (we do 50) and then adjust it when you have assembled the meal. Check out Gary's website at integrateddiabetes.com - he's my hero. I hope this helps.
My daughter is 13, diagnosed 3 years ago. She is very carb resistant in the morning. Her breakfast ratio is 1:9, yet her dinner ratio is 1:18. I agree that you need to have protein with breakfast (she has peanut butter and a glass of milk) and also fiber is important. She has a handful of berries every morning with breakfast. We too give her the insulin about 20 minutes before she starts eating. She starts around 100 and she usually peaks about 90 minutes later with a blood sugar around 140. By lunch time she is around 90-100 again. Hope this helps, good luck!
I agree with Marnie, fibre is good too, the lower the GI of the meal the better. The worst thing to eat is most breakfast cereal which is very high GI - Cornflakes have higher GI than coke. (Cornflakes 84, Cheerios 74, Coke 63. Go figure!) But it's tricky as we've all been brainwashed into eating cereal for years - so if you have to eat it, try to combine it with low GI stuff and protein.
Agree with what everyone has said regarding food choices and breakfast. I'll add a quick, informative story about the challenges of breakfast that I heard at a Children With Diabetes conference.
The speaker's husband is T1. He loves Pop Tarts and eats them every morning for breakfast. Obviously, eating a Pop Tart is going to spike your blood sugar like crazy. So every morning, he walks into the kitchen, gives himself his bolus for the Pop Tart and sets the kitchen time for 45 minutes. When the timer goes off, he eats the Pop Tart.
Now, I totally not suggesting you do that with your daughter. But the point is that breakfast is a real challenge because insulin resistance is so common in the morning and popular breakfast foods are super spike-y. Good luck.
My son, currently 11, diagnosed at the age of 3, has always needed a significantly greater amount of insulin for breakfast than other meals. Because of inactivity overnight, his body isn’t able to use insulin as efficiently in the morning as it is later in the day. His sensitivity increases as the day goes on and his meal ratios are each different.
If it’s a consistent pattern of highs that need to be corrected, I would consider changing the breakfast IC ratio.
Talk to endo about this pattern. They will probably give her more insulin for breakfast. That is very common; I think most use more insulin for breakfast. Also watch the type of carbs given for breakfast. Cold cereal this time of day can be a disaster; best saved for an after-school snack. We also give less carbs at breakfast than other times of day, but that is optional, depends on how hungry she is at breakfast. I would do french toast instead of pancakes, yogurt, fruit (not too much fruit), eggs, bacon, etc. You could make your own egg mcmuffin sandwich with ham, eggs, cheese. I would just avoid the sugary cereals, make sure there is good source of protein in the meal, use high-quality carbs.
We had a very similar issue with our 10 year old up until recently. The best thing we have come up with to help has been to change his breakfast. I didn't feel the post breakfast highs were down to insulin resistance as much as the speed of his carb absorption being very high. With an empty tummy in the morning and just eating cereals we felt he was just absorbing carbs at a much quicker rate. When we upped his insulin (to counter a higher insulin resistance) we found he was tending to go low about about 2 1/2 hours after breakfast. We tried different ways of cooking eggs so that he could choose what suited best. At the moment he is happy to have an ommlette with some ham which he eats before the cereal. It also meant he did not have so much cereal which also helped out. I think its help to balance the carb absorption rate with the insulin bolus release. so far so good
Thanks to everyone who responded for sharing your ideas and experience. We ended up changing the breakfast ratio to 1:12 and giving it to her 20 minutes before she eats. This combination seems to work pretty well. My daughter was already eating eggs and some type of meat for breakfast with fruit on the side so cereal is a non-issue for us, but I have found that bread makes her bg sky rocket. I thought the fruit might be the culprit, but her bg spike from bread is far, far worse.
