Bolus question - breakfast

[JimBear]

Hi folks,
Another question for you I'm afraid!

My blood glucose readings through the day tend to be pretty stable since going basal/bolus (type 2 here), and indeed I three consecutive readings of 5.6 for pre-lunch, 2 hours post lunch, and pre-dinner! Typically my going to bed numbers are only 0.1-0.2 higher than my waking numbers so I am well pleased.

But... even though I weigh out my breakfast and calculate my carbs very closely, my 2 hours post breakfast numbers are high (say, 9.7-11.7), but drop by lunch to around 4.8-5.2.

Can anyone tell me why my morning breakfast numbers go so far out even though I am using the same ratio of insulin-to-carbs I do for every other meal? Do I need to work out an alternative ratio for breakfast?

Your help and advice is always appreciated 🙂
Jim 🙂

 

[Robin]

Hi folks,
Another question for you I'm afraid!

My blood glucose readings through the day tend to be pretty stable since going basal/bolus (type 2 here), and indeed I three consecutive readings of 5.6 for pre-lunch, 2 hours post lunch, and pre-dinner! Typically my going to bed numbers are only 0.1-0.2 higher than my waking numbers so I am well pleased.

But... even though I weigh out my breakfast and calculate my carbs very closely, my 2 hours post breakfast numbers are high (say, 9.7-11.7), but drop by lunch to around 4.8-5.2.

Can anyone tell me why my morning breakfast numbers go so far out even though I am using the same ratio of insulin-to-carbs I do for every other meal? Do I need to work out an alternative ratio for breakfast?

Your help and advice is always appreciated 🙂
Jim 🙂

The fact that you drop back to 4.8-5.2 by lunchtime suggests that your ratio is correct, what it may be is a timing issue. How far in advance of eating your breakfast do you inject? It may be worth injecting a bit earlier, and seeing how you get on. Experimentation is the only way!

 

[Ljc]

Like @Robin has said it may be you need more time. I've found I need about 30 mins before brekkie and much less time for other meals We can be more insulin resistant in the mornings , I've no idea why though.
Seems you're getting on very well with MDI 🙂

 

[JimBear]

Wow! Quick replies! Thanks 🙂
I generally inject immediately prior to eating. According to the leaflet it starts to work within 10 minutes. When I was on the mixed insulin, it was supposed to act within 30 minutes, but often I would hypo before finishing a meal so I used that immediately before eating too. I would be worried about using the quick one any earlier to eating. I know timing can have some impact and I tried injecting the basal about 45 mins before breakfast (for convenience as I was getting dressed) but although everything seemed OK, I hypoed immediately before lunch, so I do that immediately before brekkie too.

 

[Kaylz]

It also depends on what you are eating too, I find that my breakfast which consists of honey granola and skyr yoghurt mixed with honey I have to inject put the pen away and instantly grab my pot from the fridge if I wait even 5 minutes to eat I tend to hypo yet at lunch and dinner I inject 10 minutes before and everything is fine x

 

[Robin]

Wow! Quick replies! Thanks 🙂
I generally inject immediately prior to eating. According to the leaflet it starts to work within 10 minutes. When I was on the mixed insulin, it was supposed to act within 30 minutes, but often I would hypo before finishing a meal so I used that immediately before eating too. I would be worried about using the quick one any earlier to eating. I know timing can have some impact and I tried injecting the basal about 45 mins before breakfast (for convenience as I was getting dressed) but although everything seemed OK, I hypoed immediately before lunch, so I do that immediately before brekkie too.

I can understand your worry, but what you'd do, is gradually do your injection, say, five minutes earlier, then another five, and so on gradually over a number of days, until you either see a difference, or start to go lower than you'd like at any point.

 

[Greyhound Gal]

I had exactly the same issue @JimBear, and only at breakfast. I followed advice from @Robin and @Ljc then and started to gradually inject earlier for brekkie. I find with toast, needs to be about 10-15 mins before, but porridge is 40-45 mins before. However, banana and yoghurt I'm OK to inject just before. It is just a matter of experimenting as they suggest.
Good Luck!

 

[JimBear]

This is really interesting! Thanks for all your input 🙂 This morning was better, but I started a new cereal this morning so maybe that had something to do with it. I tend to have different things at the weekend, so I shall see how I go on Monday and take it from there 🙂

 

[TheClockworkDodo]

Good luck!

I can inject a bit early for breakfast - about 20 minutes before I eat - but I couldn't do that for any other meal without hypo-ing mid meal. I also find I need a different ratio of insulin:carbs at different times of day, with by far the most insulin needed in the morning.

 

[stephknits]

I agree with others, I need to inject earlier for breakfast than other meals. I generally have porridge and need to inject around 30- 40 mins before. For me I think it's to do with dawn phenomenon in that my blood sugars are rising and I need to counteract that first, before taking on breakfast.

 

[Robin]

I agree with others, I need to inject earlier for breakfast than other meals. I generally have porridge and need to inject around 30- 40 mins before. For me I think it's to do with dawn phenomenon in that my blood sugars are rising and I need to counteract that first, before taking on breakfast.

My problem exactly!

 

[Matt Cycle]

Aside from all its other benefits, exercise will give you reduced insulin doses and increases insulin sensitivity allowing it to work much quicker.