Whatcha think..?

#1

ok people, i need some inputs/suggestions about my morning BG…i have noticed for the past 3 or 4 days, that after breakfast, my BG spikes up to near 200’s, my prebreakfast BG is within my target, and this is very unusual for me coz i never have this problem since i adjusted my carb ratio, i thought i had this fixed… anyways, i also observed that this high post breakfast BG levels happened after episodes of lows early morning, between 3 or 4 am… i know that after a hypoglycemia, especially when you overtreat it, BG levels bounce back usually to an unexpected highs…but this morning, i had a hypo and i just sipped an apple juice to make it back to within my target, when i woke up, it was 120, so i was happy…during breakfast, i adjusted my 8am basal a lil bit higher than usual, but still i got this 190’s BG and i bolus enough for my breakfast… im starting to get confused… do y’all think i need to adjust my carb ratio in the morning or just adjust lil bit more for my am basal…?also, does this mean i had this dawn pehenomenon that bad…?

i need your comments…please…

thank y’all…

#2

Could be the carb ratio. I had similar results - my bg would keep spiking after breakfast even though I was SURE I’d bolused correctly. Since I raised my ratio for the morning my control has been a lot better.

You might also consider whether morning stress (traffic, work) is a factor.

YMMV

#3

Many people need a different carb ratio in the morning due, I think, to the fact that even normal people have a little insulin resistance in the morning. If you look at this study: http://www.diabetes-symposium.org/index.php?menu=view&chart=34&id=322
You’ll notice that regular folks had their highest post meal BG after breakfast and their lowest after lunch.

#4

i was thinking about changing my ratio in the morning but i was hesitant coz i dont really eat heavy for my breakfast… usually just crackers with coffee or cheese sandwich, usually total carb for breakfast is usually 25-30 grams…

but anyways, im gonna try to check on that…

thank you …

#5

1st I’d look at my basal…skip breakfast and see if are going to rise at that time even without food.

2nd does your BG come back into range again or do you have to take a correction?
If you have to take a correction then I’d look at my carb factor.
If your BG comes back into range on its own after a few hours I’d try taking my bolus little in advance of eating breakfast. I try to bolus 30mins or so before eating if my BG is in a good range. If its a little higher I’ll try to bolus even further in advance…I might not know the exact carbs but I can normally guess, even if the number is a little lower and I have to take another bolus when I figure out the exact carbs its still helpful to get that first on on board a while before I put that first bite in my mouth.

#6

thanks stacey…

my BG comes back to normal after adjusting my basals, i didnt do any correction coz i adjusted my basal lil bit higher and maybe in about an hour im goin down, so what i did was adjust my basal again to what it used to be…

#7

Marvin,

If you adjust your basal it needs to be adjusted 2 hours before you want the effect to take place. In other words if your BG is high at 8am you need the increase to be at 6am. Also do you drink coffee? I drink one cup when I first get up in the morning I put 21 carbs into my pump so that I don’t spike. Granted there aren’t 21 carbs between the sugar and the coffee but the caffeine is part of what causes the bg increase. Hope this helps.

Dave

#8

yeah, i do drink coffee everytime i came in for work, that is one of my routine, but im just wondering coz this doesnt happen before, ive been drinking coffee for years now…at first i thought that coffee does this too, but ive talked to my CDE, she said NO, it must not be the coffee…so i dunno…

yeah i programmed a new basal starting at 6a,. lets see how this works…

Thanks Dave…

by the way, ive tried wearing my CGM for 6 consecutive days, and ive noticed that the longer it was on me, the more it gets closer to my fingerstick BG readings…

#9

Coffee can definitely affect BG’s…I did a lot of testing to figure out exactly what I need to take for my standard morning cup.
Exactly 10 carbs.

The box (I have a Tassimo that uses pods) says 3 carbs per serving…so I started there and experimented till I found that 10 is the perfect amount per cup.

#10

I love my Espresso machine as well!! If I drank my regular coffee black I might bolus a lot less, but after the sugar milk and the caffeine it spikes up a bit. I used to use the fake sweeteners but I gave that up. I like my tsp of real sugar!

#11

I find my CGM to be more accurate the longer I leave it in. So far I have had it in for as long as 14 days!!

#12

COFFEE- I glad I am not the only one. If I drink black coffee and don’t bolus for it I will hit 300. But I can drink black tea and be fine (almost the same amount of caffeine)

I do find that if I have been hypo - correct and then eat - my liver will kick in and add more sugar to the mix and I go high. I have yet to find the point in where my liver will start “helping” me some days it is 60 others it is 90.

#13

Wow 14 days. I have stopped using my CGM :(, but while I was on it I saw the same thing happenig, I would wake up with a normal bgs and go sky high about an hour later. I did not want to mess with my basal, because on the weekends I would sleep in and I would only go high after I woke up. So I believe this is a dawn phenomenon thing happening. What has worked for me, and of course nothing is consistent, is that I add 1.5 units of bolus to what ever I was using to cover my carbs. It works most days, but like everything with diabetes, everyday is different and it is not an exact science.