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Breakfast issues

Discussion in 'Parents of Children with Type 1' started by JNBryant, Apr 16, 2013.

  1. JNBryant

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    DS just got over his croup about a week ago, and during the time he had it we battled crazy numbers. Everything seems to have returned to normal dosing wise, but his after breakfast numbers are just driving me nuts! His I:C ratios for lunch and dinner are back to normal (1:25), but I've had to keep reducing his breakfast ratio and it doesn't seem to be helping at all. We've gone from 1:25 down to 1:15, and nothing seems to change. His usual breakfast is either waffles or cereal (dry) with a glass of almond milk and a scrambled egg. In short, he's not consuming any more than 35g of carbs and even a dose of 2u didn't scratch it. I'm wondering if this is just the aftermath of the illness he had and his body's in the process of trying to normalize itself again, or if something else is going on. I know that the obvious answers are to either reduce the carbs and give him something else for breakfast, or to keep reducing the I:C ratio until we get somewhere, but I'd really hate to tell the little guy that cereal and waffles are 'no go' foods.

    As an example, I checked his glucose two hours post breakfast today and he was sitting at 301. I have no issues with dropping his I:C ratios even more than I already have, but I've just never had to drop him this much before. It seems like in order to get anywhere with that after breakfast number, I'd have to reduce his I:C ratio down to at least 1:8 or 1:10 just to get it to do anything, and that just seems awfully low to me. Any ideas??:confused:
     
  2. danismom79

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    Is he coming back into range 3-4 hours after breakfast? If so, I wouldn't change the ratio. At 2 hours, the insulin is still working. Do you prebolus at all?
     
  3. JNBryant

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    Everything was fine before he got sick. He would go high at the 2 hour mark, but would come right down back into range well before the 4 hour mark was up. Now, the only way he comes back into range at the 4 hr mark is if I give him a correction. The first two days I let the high ride just to see if it was a spike we were dealing with that would come back down, but it never did. I try to prebolus at least 15 minutes before he starts eating. I've tried pushing the prebolus to 30 minutes before the start of breakfast, but I wasn't seeing any difference in his numbers. It's almost as if he's got some sort of resistance going on in the morning which confuses me because I always heard that insulin resistance is common when you're sick. We had no issues with insulin not working while he was sick, but now that he's fine and dandy, breakfast seems to be the 'nightmare' meal of the day.
     
  4. Jennifer126

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    This might be a silly suggestion but I know Joseph was sick a few weeks ago and now he has grown dramatically... I haven't measured him yet but it seems like an inch! He has also been really high after breakfast.... even more than he used to be. Maybe it's growth hormones? I have heard that can mess with numbers.
     
  5. SandiT

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    Kira has a sensitivity to wheat, and we just can NOT cover cereal for breakfast. We can cover whole wheat for lunch, but any of it for breakfast, and forget it.

    I wonder if he was on antibiotics? Did you have him taking probiotics while on the antibiotics? Probiotics make a huge difference to the ability of the intestines to digest a lot of foods, according to my research (just learning from the internet and reading studies, not personally doing studies). Lack of beneficial flora in the gut (such as right after a course of antibiotics) can mimic an intolerance to some foods.

    Just what I've learned, as I say, and may have nothing at all to do with it. :)
     
  6. danismom79

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    Breakfast has always been our nightmare meal of the day. There are hormones at play when one wakes up. My daughter's breakfast ratio is the highest, as is her basal rate at that time, and she gets a 45 minute prebolus. I probably wouldn't be so bold with a 3-year-old. Are you seeing any rise in the time before he wakes up until breakfast?
     
  7. JNBryant

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    His pediatrician did have him on an antibiotic while he had croup mainly due to the fact that he said it looked like DS was coming close to having an ear infection. He was on Augmentin for about 10 days, but no probiotic (shame on me!). He's been on antibiotics before, and we've never had an issue with the medicine itself having any impact on numbers. At first I always thought it was the meds, but his numbers would return to normal while he was still on the antibiotics. It's the one sure way I always know that he's over whatever he came down with, even if he's still on amox or whatever the doctor puts him on.

    His numbers have been absolutely beautiful when he wakes up. We may have the occasional 80 or 85 here and there, but for the most part he's always between 100 and 110. I'm not seeing any increase in BS that would indicate dawn phenomenon, and if I did I'd go back to giving him a split dose of Lantus to cover it. I guess this is one of those things where we just have to ride it out to see what happens. I'm just not comfortable with him going so incredibly high after breakfast because I know it's not good for him. I guess at this point I could always cut out the majority of the carbs by giving him some strawberries, a diabetic yogurt and some eggs for breakfast to see what happens. He's just incredibly picky when it comes to eating breakfast and it makes it all the more difficult!
     
  8. SandiT

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    Well, as I said, it may have nothing at all to do with it, so no shame. :) Remember, you didn't cause this. It's not about you doing something wrong, just a thought I had that might help NOW. :)

    I mention it only because of my reading that mentions the immune response being connected slightly to gut bacteria. If he's just having a hyperactive immune response this time, it might help.

    But I find that diabetes so far (we're new to it) is just very unpredictable, and often times trying to figure it out is less about "why" and more about "where do we go from here?".

    Probiotics probably won't hurt, but it might not really do much, either. It was just something that I thought of because of it happening right after a course of antibiotics.

    But diabetes is so unpredictable from what I can tell that I wouldn't go too far in trying to figure out "why" as much as "where from here".
     
  9. kirsteng

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    How long before breakfast do you give him his dose?

    My son is the same age (will be 4 in May) and it's really important that I give him his insulin much earlier than he eats. Even if his wake up number is in the 6's (100-110) like it always is, I still wait at least 30 minutes before he gets his breakfast. Otherwise we see some huge spikes. Dry cereal and frozen waffles are the 2 worst.. their glycemic indexes are worse than eating a spoonful of straight table sugar. We've switched to kashi cereal and granola, which thankfully our little guy likes, especially with yogurt. We do still allow the odd bowl of his favourites, but do try to keep them more for occasions now instead of being an everyday thing... ironically, I think the glycemic index of fruit loops is actually better than plain cheerios or rice krispies, due to the coating that keeps them crunchy in milk! Might be why you're seeing such big spikes...
     
  10. pianoplayer4

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    Breakfast is my nighmare meal too=/ If I eat I spike to the 300-400s... if I don't eat, or eat less than 20 carbs I spike to the 300-400s... and it doesn't matter when I'm getting up (I'm home-schooled so it changes each day) =/ By a string of luck right now I'm not doing too bad, but don't feel bad mornings are just hard!
     
  11. JNBryant

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    Thanks for the suggestions! Breakfast has always been a challenge mainly due to DS being picky, and his favorite cereal happens to be fruit loops. I found that plain cheerios were a little easier on him, but of course they still caused him to spike. We managed to get breakfast nailed down well before he got sick so we were able to avoid those nasty spikes, but every time he gets sick with whatever the case may be, once it's over with his ratios change slightly. I've just never seen a change this drastic. I'll try to change things up a little. I don't mind pushing back his breakfast prebolus from 30 minutes to 45 minutes to see if it helps any. I'll just have to keep a close eye on things to make sure he doesn't drop too low before the carbs have a chance to kick in. One other thing I'd like to get my hands on is some kind of GI scale so I can get a better idea of what foods will throw him for a loop. I typically just run to the computer and look things up real fast, but if I had some sort of book or a list similar to the calorie king book it would make things a lot easier.
     
  12. TheLegoRef

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    Have you tried a very low carb meal like an omelet, veggies, and sausage, to see what happens?
     
  13. JNBryant

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    The smallest breakfast he had was while he was sick. He didn't have much of an appetite, so whenever he did feel like eating, we gave him low to no carb meals like salmon, salad with chicken, or things like that. For breakfast he usually had a diabetic yogurt which has 3g of carbs for a small 4oz cup, and his numbers still seemed to spike, just not as high. I have noticed that 1g of carbs brings him up more than the 10 points that it used to, but I attributed that to him being sick. Tomorrow morning I'm going to make him a scrambled egg with half a cup of strawberries and some breakfast sausage to see what happens. I just have to be careful with him because he's really fat sensitive. At the most, he'll be having around 6g of carbs from the strawberries which is a far cry from what he usually eats, so I'll have to see what happens with his numbers.
     
  14. mmgirls

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    do youn have a nutrition scale? so you can see carbs compared to fat/protein and fiber
     
  15. SandiT

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    Mine hasn't arrived yet so I don't know how good it is, but Beach Bum recommended this one to me: http://www.amazon.com/The-G-I-Handbook-Glycemic-Index/dp/0764131605

    GI scale book. I figured I'd pass on the recommendation, since it seems like Beach Bum (username here) has a pretty good handle on things.

    :)
     

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