- advertisement -

I want to try a little expirement

Discussion in 'Parents of Children with Type 1' started by lohmggcjr, Mar 1, 2015.

  1. lohmggcjr

    lohmggcjr Approved members

    Joined:
    Jun 17, 2014
    Messages:
    59
    I'm sure you all know about the dreaded breakfast spike, right? Over the last two years I have tried it all to combat the spikes, but have failed. It is just something that we deal with. I do notice that weekends we dont have this problem, and if there is a spike it is much less. The only thing I can think of is the timing of breakfast. During the week breakfast is at 0800, on weekends it is about 930-1000.

    I want to try, at least for a few days, what would happen if she ate the same breakfast at 1000 at school vs. the 0800 she has been doing. I just want to see if there is the same spike or if she would be more in range? The only thing is getting the school on board to do it.

    I think with a pump, in theory you should be able to eat at whatever time you want, but if this helps from being over 200 for more than four hours a day, if feel like it will be all worth it.

    any thoughts?
     
  2. Nancy in VA

    Nancy in VA Approved members

    Joined:
    Jul 16, 2007
    Messages:
    7,308
    You might see a different result because many people / kids are insulin resistant in the AM. Emma has a lower I:C for breakfast than for lunch so if she ate the same meal later in the day, she would see different results.

    We superbolus every breakfast now and the spike is staying around the 200-225 mark instead of the 350 mark like it used to!
     
  3. lohmggcjr

    lohmggcjr Approved members

    Joined:
    Jun 17, 2014
    Messages:
    59
    what do you mean by superbolus and how do you reach that number? I tried doing dual wave boluses and they fail because she will be high and then crash. or crash and then go high. There has been a lot of trial and error, without much improvement. Her breakfast carb ratio is 1:14 and 1:12 is too much by the time hour 4 rolls around even on a duall wave if you can believe it.
     
  4. Nancy in VA

    Nancy in VA Approved members

    Joined:
    Jul 16, 2007
    Messages:
    7,308
    You don't want to dual wave and spread out the insulin, you want to front load. There have been a lot of discussions about super boluses recently - if you search, some should come up. I'm on my phone so not in a good place to type details.
     
  5. kiwikid

    kiwikid Approved members

    Joined:
    Dec 29, 2005
    Messages:
    3,011
    Does your basal rate change between 8am and 10am? Do you have a longer prebolus for the later breakfast? Do you prebolus breakfast during the week? Is it the first bolus in the weekend?
     
  6. KHS22

    KHS22 Approved members

    Joined:
    Oct 17, 2013
    Messages:
    353
    Seconding Nancy. The ONLY thing that has helped with breakfast spikes is the super blousing!!


    Normal bolus Screen Shot 2015-02-28 at 12.51.58 PM.png
    Super Bolus
    Screen Shot 2015-02-28 at 12.54.53 PM.png
     
  7. wilf

    wilf Approved members

    Joined:
    Aug 27, 2007
    Messages:
    9,652
    I wouldn't shift the timing of breakfast, that's the tail wagging the dog.

    Your job is to find a way to reduce the spike. A combination of increased basals, prebolusing and superbolusing should help.
     
  8. RomeoEcho

    RomeoEcho Approved members

    Joined:
    Dec 22, 2008
    Messages:
    483
    Superbolusing involves giving more insulin than you know you need for food, and then reducing or eliminating basal for a period of time afterwards to compensate. The idea is that the food will be hitting faster and harder than the insulin, and you are increasing the amount of insulin so that the peak of the insulin matches the food spike. The problem is that the insulin will continue to act longer than the food. So using easy numbers, lets say 4 units of insulin normally treats 40 grams of carbs over 4 hours. But for breakfast, those 40 grams will skyrocket you into insulin resistant range in the first hour and those next three hours of insulin are now useless. So you give 6 units for the food and then do a zero basal for the next two hours, while the tail of the bolus covers the last of the breakfast carbs *and* the next two to three hours of basal. These are example numbers only, pulled out of nowhere, do not use this. I don't remember if there is a real formula for this (it's not as simple as just adding the basal to the bolus) and mine was a decent amount of trial and error. CGM has made this much easier, but I first started superbolusing long before CGM existed. You can do this for corrections of stubborn highs too, since the theory is the same.
     
  9. quiltinmom

    quiltinmom Approved members

    Joined:
    Jun 24, 2010
    Messages:
    1,189
    Would she feel like it's worth it? Eating in front of everyone every day, I mean. My Ds would NEVER go for that. It would be too embarrassing.

    Spring break might be a good time to experiment. :). I think it might be too disruptive to her school day to be eating breakfast in the middle of whatever she's doing at 10:00. I doubt the school would cooperate. Not to mention how hungry she would be. It would be interesting variable to test, for sure.

    I wonder if there might be other things that contribute to what's happening, in addition to the timing. I'm thinking things like stress of school day vs. weekend, amount of sleep, etc. I not saying these things matter for sure, just to perhaps suggest thinking outside the "diabetes box" for things that might be answers to the puzzle.
     
  10. aprilodell

    aprilodell Approved members

    Joined:
    Dec 28, 2014
    Messages:
    100
    Gary Scheiner talks about this Think Like a Pancreas as one of the options to lower your post meal spike. Another option is to look at lower GI foofs on school days
     

Share This Page

- advertisement -

  1. This site uses cookies to help personalise content, tailor your experience and to keep you logged in if you register.
    By continuing to use this site, you are consenting to our use of cookies.
    Dismiss Notice