Food diary - first morning

[ChrisR]

God I hate diabetes - never the same results, even after 20 odd years

Breakfast time bg - 7.7

Insulin - 6u Novorapid

Food - 1 muffin (27.9g) plus jam and peanut butter (extra 5?)


10:30 bg - 9.4

Im pretty sure that usually that would be far lower....

 

[Tumble]

Is this a normal breakfast for you?

Maybe your ratio for your morning meal has changed. I was on a 1.5:1 ratio until last week and now I am on 1:1 for breakfast.

 

[ChrisR]

Relatively normal - some days it will be an almond croissant in the cafe, other days will have yoghurt/cereal etc

Most days recently though its been this, but that just seems like quite a high ratio to normal. I can guarantee another day, that Id be low as anything by now on that mix

 

[Robster65]

Hi CHris.

There are so many variables.

How long between waking and eatign breakfast (BG usually rises until you inject/eat).

As Tumbler says, your ratio may not be spot on.

The muffin, assuming white bread, along with the jam acts like sugar and whizzes through to your blood. The peanut butter would delay it slightly, so hard to judge.

The thing to do is to add an extra unit and see what happens. If you go low, then eat a small amount of fast carbs (jelly baby) to correct just enough to get into range. Then you can divide the carbs you had including the correction by the units, and assuming your routine was fairly normal, then that's your ratio for breakfast.

But try to avoid white (or plain brown) bread and only a smear of jam. Go for seeded or wholegrain bread where possible.🙂

Rob

 

[RSVP]

Tesco's wholegrain muesli 90g weight & 150g weight of natural yog gives 72ish g carb sprinkled with a few blueberries.

No spike just a nice steady way to start the day.

Of course it all depends on your starting level and how soon after checking bloods do you eat.
Another problem can be when you check on waking then "guess" where you are when injecting. Sometimes you can shoot up a hell of a lot or drop a hell of a lot in a short space of time. Especially with external stresses, weather and extra activity.

It may mean testing a good 7-10 times a day to start seeing the patterns and sadly for a while sticking to the same foods for a bit.

Sounds boring but believe me it pays in the long run.

Sarah 🙂

 

[ChrisR]

I ate about ten minutes or so after testing - maybe sooner. Hmm

Okay, now its 11:45 and my BG is 9.7....still rising

I feel hungry and want to have lunch, so -

Insulin - 10u novorapid

Food - 3 x slices bread (really seeded - 16.9g per slice), chicken, grated cheese, mayo, spinach. Should total around 51 grams carbs, if Im correct

 

[RSVP]

Just bear in mind that the cheese & mayo may slow down absorption.

So you may drop low, then climb back up to silly levels especially if you over treat a hypo!!!

If that happens try & remember the 15/15 rule for hypos. 15g carb (3 jellybabies OR a mini can of coke) then wait 15mins and test again. do same if still not back in range after 15 mins.

I know its not nice being hypo and is very scary but over correct a hypo and you end up bouncing all day


IF you stay in range all afternoon then whoop you got it Well for today LoL 🙄

HTH

Sarah 🙂

 

[everydayupsanddowns]

ChrisR

Haven;t kept up with this thread, so you may have considered this already.... but might it be your basal?

More often than not my ratios stay very steady and if meals which are *usually* OK begin to play up, 9 times out of 10 it turns out to be my basal that's mucking me about. 1u + or - can make a ridiculoous difference (requiring 6u odd of rapid or constant munching of fruit pastilles).

Sometimes where my basal is a bit 'in between' I need to cover with a unit or two of bolus adjustment, and sometimes it's just an absorption issue with a dose or two, but where 'old faithful' meals (like regular breakfasts) begin to misbehave over a few days I always look at basal.

Might be worth a try. Have you ever run a basal test? Basal driving me bonkers

 

[ChrisR]

Just for clarity, I inject I dont have a pump

My night time is levemir, for which I am currently taking 24.

How do I actually test that against whether its correct or not? is it as simple as doing a bg test each night before injecting it?

 

[Northerner]

Just for clarity, I inject I dont have a pump

My night time is levemir, for which I am currently taking 24.

How do I actually test that against whether its correct or not? is it as simple as doing a bg test each night before injecting it?

For a basal test you need to skip a meal and see if your levels stay steady. Say you were 6.5 when you woke up, don't eat, then test again before lunch. If you are still within one or two mmol of the 6.5 then your basal is probably about right for that part of the day - the problem is that your basal needs may change through the day, so you would also need to try a day where you skip lunch and again observe any rise. Some people split their levemir into two injections because they can give more to cover the times of the day when they are more resistant (often the morning) and less when they are more sensitive. A pumper would just set different basal rates, not so easy getting it right when injecting.

 

[everydayupsanddowns]

Basal testing is often seen as an important part of pump therapy, but somehow the concept rarely gets applied by teams to folks on MDI.

I'd not heard of it until a few years back when I found the online community of Diabatics and is was an instant AHAAAAAA! moment for me. Many of my previous periods of 'stupid diabetes chaos this doesn't make any sense' were explained by my basal being wrong. The knock on effect of which it that my usual meal ratios/correction doses do not work as expected (eg because a proportion of those doses has to make up for lack of basal).

I also didn't appreciate how much my requirement shifts and changes through the year. Up a bit... down a bit... back up a bit... every few months

Might be worth skipping a few meals and watching what happens to your BG. You can do different meals on different days, but it pays to be systematic and realise that it might take a while to get an understanding.

You might find you need to split your basal dose, or simply change the timing (I moved Lantus from 10pm to 7am and solved a big problem with overnight hypos pretty much overnight). Different things work for different people, but it;s about trying to keep your levels as steady as possible without meals/boluses messing you about/confusing the picture.

Once you've got it set basically right only small tweaks are usually required.

 

[novorapidboi26]

God I hate diabetes - never the same results, even after 20 odd years

Breakfast time bg - 7.7

Insulin - 6u Novorapid

Food - 1 muffin (27.9g) plus jam and peanut butter (extra 5?)


10:30 bg - 9.4

Im pretty sure that usually that would be far lower....

Everyday can be different for me, its a pain.......

What time did you have your breakfast?

What is your ratio?

How much jam and peanut butter did you have, and was it on its own?

I would say theres roughly 80grams of carbs in that breakfast going by your assessment.

If that was a 1.5-2 hours post meal test, then its not that bad..........

 

[ChrisR]

Everyday can be different for me, its a pain.......

What time did you have your breakfast?

What is your ratio?

How much jam and peanut butter did you have, and was it on its own?

I would say theres roughly 80grams of carbs in that breakfast going by your assessment.

If that was a 1.5-2 hours post meal test, then its not that bad..........

Breakfast was 7:30
I have no idea on my ration, but its usually a bit less than that I think going by results

according to the packet, one toasted muffin is 27.9 g, and I had barely a teaspoon of peanut butter and jam on each half so that cant be any more than an additional 5-10 surely?

 

[RSVP]

Hi Chris

Might it be worth looking into getting a carb book or even an app for your phone/i-touch if you have one?

We have my fitness-pal on my touch which allows access to thousands of nutritional info about various foods, even shop own brands.

An average 1tbsp of jam is coming back with total 13.8g carb - obv flavor etc will play a part.
Sun-pat peanut butter smooth 20g/1tbsp serving 6g. Peanuts are slow release so may not have helped with the later rise.


Sarah 🙂

 

[novorapidboi26]

Breakfast was 7:30
I have no idea on my ration, but its usually a bit less than that I think going by results

according to the packet, one toasted muffin is 27.9 g, and I had barely a teaspoon of peanut butter and jam on each half so that cant be any more than an additional 5-10 surely?

So the post meal result you had may have been higher if taken earlier.........your ratio is simply how many grams of carbohydrate 1 unit of insulin deals with..........I personally need 3 units for every 10grams at breakfast.....so its definitely worth establishing......

Going by the information RSVP provided, the whole meal may have only came to 40-50grams in total.................so if that was me, I would be taking 15 units..........so your 6 units for it wouldn't be far off it assuming you need 1 unit for every 10 grams.....

Post meal spikes can be avoided with the timing of your injections, but this is only really effective if your dose is right [on target 4-5 hours later] and if your background is right too............

 

[RSVP]

Really don't want to over confuse you so I will back out & let the others help.

My final thought has to be injection sites ? Fatty lumps can alter the way the insulin is absorbed by the body as can where you inject.

Try not to do too much at once. There is a danger with to much info to try everything at once. You'll never know what works for YOU then and that is what is important.

Slow steps alter 1 thing at a time

Take Care


Sarah 🙂

 

[ChrisR]

Everyday can be different for me, its a pain.......

What time did you have your breakfast?

What is your ratio?

How much jam and peanut butter did you have, and was it on its own?

I would say theres roughly 80grams of carbs in that breakfast going by your assessment.

If that was a 1.5-2 hours post meal test, then its not that bad..........

Hi Chris

Might it be worth looking into getting a carb book or even an app for your phone/i-touch if you have one?

We have my fitness-pal on my touch which allows access to thousands of nutritional info about various foods, even shop own brands.

An average 1tbsp of jam is coming back with total 13.8g carb - obv flavor etc will play a part.
Sun-pat peanut butter smooth 20g/1tbsp serving 6g. Peanuts are slow release so may not have helped with the later rise.


Sarah 🙂

I do have the pictorial book about carbs and meal portions, which is useful.

Scaling down a tablespoon to a teaspoon, perhaps that would be half the amount? So 7 and 10 - which if so, is still double what I'd estimated, bringing my total breakfast to 29 + 17 = 46. So instead of 6 units / 35g it could have been 8-9 units / 46g?

 

[everydayupsanddowns]

I'd be interested to see what your BG did if you didn't eat any breakfast at all.

M

 

[ChrisR]

I'd be interested to see what your BG did if you didn't eat any breakfast at all.

M

Me too. I think I might try that one day this week

 

[Vicsetter]

You might like to try Whole Earth Peanut butter (i get mine from Morrisons), does not have any cane sugar so ends up only 9.9g carbs/3.9g sugar/100g, quite a lot less than some other brands and very tasty. Every little bit helps.