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How to deal with cereal spikes?

Discussion in 'Parents of Children with Type 1' started by Ginagbaby1, Jun 22, 2010.

  1. Ginagbaby1

    Ginagbaby1 Approved members

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    We just finished our IPRO study and it revealed that cereal has a big impact on David, sending him to 400+ within a little while. I knew that cereal was one of those problem foods for most type 1's but I had no idea how big the impact was. He usually eats breakfast by 6:30 and has a snack by 9:30 where we would check him again. At 9:30 he'd usually be in the low 200 range so we'd never see that 400 number. He usually had honey nut cheerios. He likes Life too which has about how the sugar that the cheerios has so we're doing that today. I've tried pre-bolusing and adding protein but hasn't helped much. The problem is that he loves cereal...
     
  2. Mom264

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    So here is what worked for me I changed the pre-bolus for breakfast.

    (I pre-bolus according the the morning BG number) Less than 90 I bolus as she is eating (and will use a dual wave) over 130 I will wait 15 minutes, Over 200 I will have her wait 25. (Obviously I am attentive to the timer, which I always set.) And of course I cleared with the endo team on amount of time to wait.

    One suggestion is to give protein and fat with the meal. I know you've tried protein, I think the fat helps slow things down, though.

    Another suggestion would be to give him cereal at lunch time, and try a different breakfast, sausage and egg with a piece of toast or similar. I find breakfast can spike her like no other meal, probably because her stomach is empty and the food starts processing right away.

    What insulin are you using? Dd uses Apidra and IME it begins working faster than Novolog or Humalog.

    Hope that gives you some ideas!
     
  3. Ginagbaby1

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    He eats the cereal with milk so that would count as fat right?
    We are on Novolog. We haven't pre-bolused for as long as 15
    minutes but I will try that. (usually 5-10 minutes).

    Thanks!
     
  4. VinceysMom

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    My DS loves cereal as well...and loves it for a bedtime snack... I finally figured out that if he has 2 pb crackers along with his cereal, he will not spike so high! And, we use skim milk which has no fat, so I'm sure that doesnt help with numbers either... But, the PB crackers do seem to totally help keep the spike down. Then again, remember, YDMV.
     
  5. hawkeyegirl

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    We generally have to prebolus 20-30 minutes in the morning. Milk has fat in it, but it typically doesn't help with a cereal spike. You're going to want to add an egg, or maybe sausage or bacon to help slow that spike down.

    Cereal is a disaster for many type 1 kids. It's one of the few foods I simply do not buy.
     
  6. ecs1516

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    We pre bolus but no too long ahead if in range(low 100's) If we pre bolus too long we will have a low. We try to pick cereals with a lower GI index. Such as Frosted Flakes or cereals with coating on the outside. Never rice krispies or plain cherrios. Also, they have a piece of wheat toast with marg. on it. If they are not in range(more than 160's) then high BG's are hard to avoid. Have also used a piece of cheese for protein but not very often.

    I have noticed Life cereal works horrible for us. I think it has a higher GI index. I find the amount of sugar in the cereal has no relation to how fast the breakdown of sugar in the blood is.
    There are books and websites on GI index lists.
     
  7. Nancy in VA

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    Have you considered a super-bolus - pre-bolusing the next 3 hours worth of basal - helps combat the spikes.

    Cereal is just evil. Its such a high glycemic index.

    Milk fat won't slow it down - so milk isn't enough. You need protein with fat - eggs and sausage, eggs and bacon, etc. Dairy protein/fat doesn't slow it down enough.

    For us, she has it once in a blue moon because its evil
     
  8. Ginagbaby1

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    I've been checking his bs every hour since he ate to see how it's going.

    6:30 before breakfast: 150
    7:00 wanted more so I gave a tiny bit more. 3 onces
    7:30: 246
    8:30 289

    I'm going to check at 9:30 since this is the time for usual am snack. Would a lower carb ratio help? Right now he is at 1:36 grams. Maybe 1:30? Our correction factor is set to high on the pump too so that's not helping. It's at 400 so maybe lowering that will also help with the am snack bolus? I just don't believe in denying him any one type of food. Moderation yes but not denying, you know?
     
  9. Heather(CA)

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    If he's still in the 200 at the 3 hour mark, he needs more insulin for breakfast. That will make the spike lower too:cwds:
     
  10. hawkeyegirl

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    I get this. If Jack was really into cereal, I would probably treat it like doughnuts, which are also evil on BG. I'd let him have it on Saturday mornings when I was around to experiment with taming the spike, but I wouldn't give it to him every day.

    I also agree with Heather that if he's in the 200s 3 hours later, he needs more insulin in his food bolus.
     
  11. Jen_in_NH

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    We've been having a rough time with this lately. Cheerios with fruit seem to be fine. Frosted Mini Wheats are the breakfast from hell. Within 2 hours, he's well over 500 :eek: Of course, we found this out on a morning my dad was babysitting. Scared the poop out of Grandpa, I tell you:cwds:
     
  12. Flutterby

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    To help with the spike we prebolus.. I took cereal away for a bit, but the endo didn't want me to do that since she is so limited in her food already. Its one of those things that just happen and its near impossible to get rid of.
     
  13. Darryl

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    We've consistently found this to be true (we've seen every breakfast spike for the past 3 years on a CGM) - On those days when the bolus is not enough to cover the carbs, the spike is much higher, and the 2-hour BG does not return to baseline. So adjusting IC ratio is a good place to start, with the goal of achieving baseline BG at the 3-hour mark.

    Pre-bolusing helps somewhat, you just always have to be careful to not forget to eat. Superbolusing works for some people but is even riskier.

    Bottom line is that T1's do not have a first phase insulin response to react to high glycemic foods, and foods that cause spikes should be eliminated (at least from breakfast) order to avoid health impact down the road. If you try different things, you may find foods that are enjoyed just as much as those that cause problems.
     

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