Unpredictable Post breakfast highs

High all, been on the pump for 4 weeks now, Animas 2020 with Novorapid, and everything is fine except my post breakfast BG’s.
When was on MDI I never had a problem at all with my post breakfast BG levels and would never get a rise of more than 2mmol when I tested 1 hour, 1 hour 30 mins or 2 hours after I’d eaten. I also used to take my Novorpaid and eat straight away.
Now with my pump I have my fasting Basal set ok 24 hours a day and don’t get a rise in BG of more than about 1.5mmol right through the day or night.
So the only problem that I have is that some days post breakfast my BG level will go up by about 5 mmol 2 hours after eating and, while it does come down a bit it will remain high until I do a correction Bolus in the afternoon.
Initially I thought that my breakfast insulin:carb ratio was wrong but I don’t think it is because some days I can wake with a similar BG have exactly the same breakfast and take the same Insulin and my 2 hour post BG rise is only around 2mmol.

So has anyone got any ideas why, on some days, I get this problem with high BG readings after I’ve eaten and then on other days I don’t get any problems at all?

My initial thoughts are that I’m going low in the night and waking up insulin resistant or that I may not have my morning Basal set correctly (I get a rise in BG between 7 and 10 which I have to up my Basal for) or that I need to Bolus and eat straight away when I wake as I know when on MDI if I didn’t Bolus and eat first thing in the morning my BG would start to rise (I thought I’d got round this with the pump though by increasing my Basal rate in the morning).

Does anyone else have a similar problem and if so what is causing it, Is there anything I should be looking for with night time BG checks

Is there any difference in the time you bolus and then start eating?

I’m fairly insulin-resistant in the morning (despite a big basal increase starting at 4 a.m.) and find that I definitely need to wait at least 20 minutes before taking the first bite. [Here’s what happened this morning: fasting 113. one-hour later, 89 (my higher a.m. basal rate in effect). Took breakfast bolus, 25 minutes later I was 94–then I ate. Forgot to set dual-wave, was 154 1 hour after first bite … waiting to see what 2 hour post-prandial number tells me.]

You may want to look at the discussions about using dual-wave bolus (some bolus right away, the rest doled out over a certain number of hours), which can help with “matching” the glucose rise that comes from the non-carb portions of your breakfast. Let us know how it goes!

And I’m still wondering, did by blood sugar go up 6 points after the bolus because of the stress of driving to work? Was it simply meter variance? Does my left hand have better circulation than my right hand? Does it really matter? Who knows?!


What would you recommend for breakfast?

Kelly, I took my Bolus and started eating within 5 minutes of taking it.

Dave, I had porridge oats with semi skimmed milk for breakfast, I’m all to aware that cereal is generally a high GI and I avoid it but I have always found porridge to be ok, especially when it is unprocessed.
Also I’ve not been high when I wake up. This morning I was 4.7 when I took my Bolus and ate. An hour and a half later I was up to 10. Also, about four and a half hours after my Bolus I was back down to 5.3. In the past I would have expected to go from 4.7 to around 7 an hour and a half later and then back down to around 4.7 again after four hours or so.

…and this morning I had exactly the same to eat, at the same time, with almost the same waking BG and after an hour and a half I only went up by 1.2 mmol and after 2 hours my BG was the same as it was when I woke!!!