Consistent highs after breakfast......

[beckybuckley]

For the last 2 weeks, Alyssa has been at 400 after her 2 hr post breakfast finger poke. I'm noticing that her blood sugar is rising from her 5:00 am check to her awake check, which is usually at 8:00 am. So I can only assume that she's starting to come out of her honeymoon. Seem reasonable? But it's never more than 2 or 3 days in a row so I've been very nervous about starting her on a basal during the early hours - it really varies a lot right now. I have her basal start at 9:00 am. Prior to these last few weeks she was always pretty consistent with low 100's --- oh do I miss those days!

I've heard some parents talking about insulin sensivity being lower in the morning, is this part of coming out of the honeymoon phase also? I've changed her ratio from 1:20 to 1:17 and she's still hitting 400's. Does it get more consistent once she's completely out of the honeymoon phase?

[Emmasmommy]

My Daughter needs A LOT more insulin in the am her higher basel starts at 6:30 and then an even higher on between 9 and 11. We also have a diffrent carb ratio in the am shes 1-14 and the rest of the day 1-20. Emma is 2 and found that she started needing more insulin in the am almost right away (i question if she ever had a honey moon). The other thing to look at with the high 2 hours post is that alot of the breakfast food we tend to feed our kids have a higher glicimic index then most. Ceral will make the sugar spike fast and then it seems to take longer for it to come down. I would try a new basel in the am or even start with changing breakfast foods to something that take longer to break down ie toast yogart and more complex carbs.
Another thing to look at is does she need a corection to bring her down or does she come down on her own after another hour or so?

Good luck hang in there!

[mom2a]

Our post breakfast numbers are the hardest to figure out. I know with Alana I start increasing her basal gradually starting at 5am and then a little more at 7am and again more at 9am. I believe I have heard growth hormones are more active around this time causing some to need an increase in insulin. And the fact that there is usually more sugar in the breakfast foods given. It is so hard to figure because we can go a couple of weeks and think we have figured it out and then something comes up. I guess that is all part of it. The nice thing is having the pump to make the chages. Good luck....

[Mojo's mommy]

Courtney is not on the pump yet, hopefully in the next 2 months tho. I had a horrible time with her morning sugars as of lately(Last 2 months). We are 2 years into this and still changing. I found she needed much more insulin in the AM just to get a good number for lunch and she almost always eats the same thing for breakie...

Not useful information I know, just wanted to add that it is very common to have the resistance to insulin in the morning

[BrendaK]

Carson needs a lot more insulin in the morning, too. We have to double his basal rate at 6am to help the post breakfast spike. His breakfast ratio is also 1 for 14 carbs and 1 for 25 the rest of the day.

Before pumping, his post breakfast numbers would ALWAYS be in the 300's and then crash to normal by lunch.

The pump really helps the spikes. But it's a little tricky on days he sleeps in. Since the basal rate is doubled at 6am, he has to eat by 8am otherwise he'll go low. That's not a problem on school days -- he eats at 7:15am. And on weekends, I never know if he'll sleep in or not, so I hesitate to change the basal rate to accomodate for that.

It sounds like your daughter may need to start a basal rate or something to keep those 400 numbers down after breakfast. What does your endo say?

[Kirsten]

Before pumping, his post breakfast numbers would ALWAYS be in the 300's and then crash to normal by lunch.

The pump really helps the spikes. But it's a little tricky on days he sleeps in. Since the basal rate is doubled at 6am, he has to eat by 8am otherwise he'll go low. That's not a problem on school days -- he eats at 7:15am. And on weekends, I never know if he'll sleep in or not, so I hesitate to change the basal rate to accomodate for that.

We're right there with you. Pre-pump we couldn't tame the spike, but it's well under control right now. He gets an hour of doubled basal right before breakfast with a 1:9 ratio for breakfast and a practically non-existant basal between breakfast and lunch.

We also have the same problem about sleeping in on weekends, so I have a second basal program for weekends. His increased basal kicks in an hour later than normal.

Kirsten

[Hoping4theCureinWV]

My 13 year old son has the same problem and he was dxd over 2 years ago. We work with the endo periodically to review those am readings and adjust the basal rates. When he combines a lower carb breakfast with some protein and a little fat he does the best with the post breakfast readings. Of course, being 13, he does not always follow the best morning routine....

[Bobbie]

I have the same problem with my 7 year old. Since she has been on the pump most of the adjustments that had to be made were in the AM. Her post breakfast numbers are high at times. She seems to need more insulin in the morning than the rest of the day.

I don't think consistancy is something I see in Emily's numbers. She can be good for a week or so and then go high or low for now apparent reason. I think it is just something that constantly needs to be looked at and adjusted to fit the need at the time.

[beckybuckley]

Thanks everyone. We're adjusting our bolus ratio for breakfast, I figured out how to set the pump for different times (yay). Will give it a few days to see how that works then try to figure out if we need to start the basal earlier in the AM.

Have I mentioned how much I couldn't do this without all of you!!!!!