- advertisement -

On the low carb meal topic

Discussion in 'Parents of Children with Type 1' started by nebby3, Jun 17, 2015.

  1. nebby3

    nebby3 Approved members

    Joined:
    Jun 5, 2007
    Messages:
    923
    DD chose low carb breakfast and lunch today. (Insert disclaimers that she's 13, she doesn't eat low carb all the time, it's her choice, yadda yadda yadda.) She finally ate more carbs just now for a PM snack (not even super high carb; no sugar added ice cream but it's higher carb than what she's had previously today). And now her bg which had been very straight all day for us is 217 and straight up. Anybody else find this? That if you do low carb for breakfast or even longer into the day that the first meal with carbs kind of acts like breakfast, ie has a big spike? We've seen this before. It kind of negates the value of a low carb breakfast, just puts the spike off till later in the day. I'm trying to attach a picture of her dexcom (never done that before) . . .
    dexcomgraph.jpg
     
  2. dpr

    dpr Approved members

    Joined:
    Dec 17, 2013
    Messages:
    399
    For us it doesn't seem to matter what meal is high or low carb. What time was the snack? My guess is she needs to pre bolus longer before eating. If my daughter is in the 150-160 range I like to see her drop to 110-120 before eating any carb, snack or regular meal. I tend to let Dex tell me when the pre bolus has been long enough and it's time to eat (when possible). How long did it take for her to come down after the spike? If not too long I might not worry about it. But if your consistently getting a spike like that, try a longer pre bolus.
     
  3. nebby3

    nebby3 Approved members

    Joined:
    Jun 5, 2007
    Messages:
    923
    We do prebolus but thanks. I guess what I am getting at is if you don't do carbs until later in the day does the "breakfast" spike really become the "first meal after a carb fast" spike? It seems like I read in Think like a Pancreas (or one of those books) that there is something that happens physiologically in the bodies of T1 people that makes them spike high first thing in the AM and I am wondering if this is because it is the AM or because they haven't had carbs in a while. I am not sure from my dd if this is a real trend or just what happened today; I'd need for evidence on that. I do think that if she eats lower carb for a period of time that the "bad" meals (pasta, pizza etc) tend to affect her even more. But this could be because we have adjusted basals and they are no longer compensating for some of the meal bolus.
     
  4. njswede

    njswede Approved members

    Joined:
    Feb 9, 2015
    Messages:
    385
    We see the exact opposite. After a low carb breakfast, it becomes easier to control the numbers the rest of the day. It probably has nothing to do with carb absorption in our case. It's just easier to control if you don't have a big swing to begin with.

    DISCLAIMER: May not apply to your kid, since we're still at the tail end of the honeymoon. But we DO see 200-250 spikes after carb-rich breakfast if we don't aggressively pre-bolus.
     
  5. Mimikins

    Mimikins Approved members

    Joined:
    Jun 22, 2014
    Messages:
    203
    I've also been experimenting with low-carb meals. I wanted to have a pasta-and-cheesecake-fest for my birthday dinner a few nights ago and ate lower in carbs the rest of the day to compensate (my net carbs was around 17g, which is a bit over a unit of insulin for me). Shockingly, my meal spikes with the low-carb meals were nonexistant, but as soon as I had the carb fest, I rapidly went up to 230. I ended up chalking it up to the fact that I had to do a WAG bolus for dinner (there were no posted carb counts) plus a possible low rebound (I was at 71 right before eating).
    Birthday BG.png

    I thought breakfasts were difficult to manage because of insulin resistance associated with the Dawn Phenomenon. When looking at your CGM data, it only looks like it was a 60-70mg/dL spike. It might look like a super bad high because she started out at 150-ish (when the spike might have gone to 150-160 if she started out at 100).
     
  6. Theo's dad Joe

    Theo's dad Joe Approved members

    Joined:
    Jun 7, 2015
    Messages:
    802
    I think that going very low carb for half the day is going to make you temporarily insulin resistant. You start to get some ketones which reduce sensitivity and your body tries to work to save all of your blood sugar for the brain. People will fail glucose tolerance tests if they eat less than 30% carbs over the 3 days prior to the test (which is not so bad if you always eat 30% carbs because you will not be eating glucose tolerance test levels of glucose at meals).

    One of the reasons for the dawn phenomenon is that you haven't eaten for a long time and the liver is low on glucagon, but the body has started to use other pathways to raise blood sugar.
    So basically compensating with low carbs at breakfast may be OK but compensating until 6:53 pm may not be.
     
  7. Theo's dad Joe

    Theo's dad Joe Approved members

    Joined:
    Jun 7, 2015
    Messages:
    802
    What and how much did she eat for breakfast? Again as mentioned below if you go into a carb meal off of a 12+ hour low carb period then you may have already gone into mild (mild for non diabetics) temporary insulin resistance. Eating more protein for breakfast on the low carb might be able to prevent this because the protein will slowly get processed into liver glycogen and meet the brain needs for glucose.

    Here's the thing. The brain needs about 5 grams an hour of glucose whether you eat it or not. And it doesn't need insulin to use it. If you don't give the brain 5 grams an hour more or less it will start to make glucose from body proteins, and food proteins and also make the muscles less sensitive to insulin so that the brain is not at risk of getting starved. The dawn phenomenon is particularly a problem through early morning because of increased morning stress hormones that get you going, like cortisol, adrenaline, and glucagon, so you want to start getting your brain carbs in-delaying longer and longer may backfire-but you may benefit from avoiding them during the stress hormone surge of the early morning.
     
  8. Theo's dad Joe

    Theo's dad Joe Approved members

    Joined:
    Jun 7, 2015
    Messages:
    802
  9. swellman

    swellman Approved members

    Joined:
    Jul 30, 2008
    Messages:
    3,544
    It could be possible you just haven't dialed in the best IC ratios.
     
  10. Sarah Maddie's Mom

    Sarah Maddie's Mom Approved members

    Joined:
    Sep 23, 2007
    Messages:
    12,521
    Looks to me like you simply ate a high fat, high carb restaurant meal and got the bolus amount and timing wrong.
     

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