I know morning spikes have been discussed in the past. We are struggling with the morning spike and cereal and the number of carbs is the root of the problem. But you pick your battles with a 12 y/o carb loving boy. We are having better luck, by prebolusing and doubling the amount of insulin he is getting in the am and he is not bottoming out. His am carb ratio was 1 unit to 40 carbs. And now is 1:20. We have adjusted his basal and when he sleeps in stays stable. I am so grateful for the CGM to work on spikes. It is amazing how high they can be with a growing preteen. I am wondering how much lower are kids AM ratios? I am sure this will change again as his insulin needs increase and we enjoy growth spurts. Thanks for any help.
My dd is 11. Her breakfast is 1:3, lunch 1:6, other times 1:10. She is on MDI do this may affect it; some of it might really be covering basal needs.
The spikes will be lower if the carbs are lower and they are less processed. The high postprandial spikes are a real problem when considering long term concerns. Best to lower the morning carbs - might be worth it in the long run.
I think what you are doing is a good plan, if he must eat cereal. Give lots of insulin upfront to counter the colossal rise in blood sugar. That is what the body does, so this is a good plan to better mimic a working pancreas.
First meal/snack of the day is 1:12 and the rest are 1:15-1:18 depending on how active I am. I think that is pretty typical for a relatively thin young female adult. During the worst of puberty it was 1:2 for breakfast I just wanted to suggest something my parents did which was move cereal to the evening. The deal they made with me was that if I would switch to something other than cereal for breakfast I could have sugary cereal after dinner. We would add the carbs into my dinner bolus and then about 30 minutes after I finished dinner I could have a small bowl of frosted flakes or something similar. The hefty prebolus and protein in dinner prevented a spike. I thought it was a pretty good deal for me because I had never been allowed to have sugary cereal before except for on vacation. That may not work for you or be a change you want to make but it is just a suggestion...
I would love if he had 45 carbs and good protein for breakfast with more snacks. We have done some fine tuning but somedays what he wants to eat could be better. I am not ready to ban all cereal from the house. I am also very concerned about the potential consequences of high spikes with even a good a1c. As parent we do have control of what our kids eat but if I micromanage his diet too much he revolts. And the reality is he is growing and needs a lot of calories daily. I just wished he liked eggs, mornings would go much better. We have been able to get the AM spike down to a reasonable range. I keep wondering how long it is going to last.
