Wheatabix and almond milk, high BS

[khskel]

Does the nurse use insulin? Personally I find weetabix quite spiky but find lizis granola with unsweetend almond milk works a treat.

 

[DeusXM]

The nurses are adamant to give the dose right before or even after the meal...

That's also because (and this is incredibly cynical), for individual members of the health service, it's in their professional interest to have patients with high blood sugar readings.

There is a common misconception among people without diabetes that a hypo is the single most catastrophic thing that can happen to someone with diabetes, and must be avoided at all costs. Those with diabetes are aware that a hypo has the potential to be catastrophic, but also that a hypo can be dealt with so quickly and easy that effectively, they are minor inconveniences .

Because those in the healthcare professional believe hypos must be avoided at all costs, they are prepared to sacrifice the long-term control of their patients to achieve it. Patients with higher blood sugars tend to not have hypos. And by advising patients to avoid taking actions which could potentially lead to hypos (such as injecting insulin earlier), the healthcare professional protects themselves against any accusations of negligence. If a nurse advises a patient to take their insulin earlier before eating, and that patient has the misfortune to suffer a catastrophic hypo, there is a clear and easy cause and effect that can be pursued through the courts - "the nurse gave the patient advice which caused the hypo, therefore the nurse is responsible for the consequences" would be the line used.

The complications from long-term high blood sugars, however, tend to take years to manifest themselves and cannot be attributed to one single piece of advice in the same way. So by the time a patient with a high A1C ends up with complications, the individual who advised them will likely be long gone either somewhere else in the health service, retired or even dead. Plus, there is the plausible deniability that the patient will have seen dozens of professionals during their time, and the ol' "the patient was non-compliant" line can be used.

That's why, for most people with diabetes, it is better to take on board the advice of healthcare professionals AND those with diabetes to determine what is best for them, and to rigorously test and take every precaution they can to balance out their blood sugar.

In other words, do what suits your little one not what suits them. And if thats pre bolus (10mins,30 mins, half and half in case she doesnt eat the lot, whatever) then pre bolus. And dont tell them if they kick up a fuss.

I would actually say that if one of us does something against the advice of a nurse/doctor that ultimately improves our control, we have a duty to each other to inform the nurse/doctor what we've done and why they're wrong. It might mean that the next patient they see ends up getting slightly better advice. It doesn't always work - it drove my last consultant utterly insane that I did the exact opposite of his diet advice ("you use butter for frying? Oh my god, no no no no no....") but my cholesterol ratio was effectively higher than optimal, my trigs were low even for someone without diabetes and my A1C was 0.1% over non-diabetic, and he still tried to describe me as non-compliant.

 

[Shivles]

Exact same breakfast today and 11.2 after 2hrs, how odd.

Unsure what to do now, I see it's not the best breakfast for her but I need her to have a quick breakfast with school run.

 

[Shivles]

That's also because (and this is incredibly cynical), for individual members of the health service, it's in their professional interest to have patients with high blood sugar readings.

There is a common misconception among people without diabetes that a hypo is the single most catastrophic thing that can happen to someone with diabetes, and must be avoided at all costs. Those with diabetes are aware that a hypo has the potential to be catastrophic, but also that a hypo can be dealt with so quickly and easy that effectively, they are minor inconveniences .

Because those in the healthcare professional believe hypos must be avoided at all costs, they are prepared to sacrifice the long-term control of their patients to achieve it. Patients with higher blood sugars tend to not have hypos. And by advising patients to avoid taking actions which could potentially lead to hypos (such as injecting insulin earlier), the healthcare professional protects themselves against any accusations of negligence. If a nurse advises a patient to take their insulin earlier before eating, and that patient has the misfortune to suffer a catastrophic hypo, there is a clear and easy cause and effect that can be pursued through the courts - "the nurse gave the patient advice which caused the hypo, therefore the nurse is responsible for the consequences" would be the line used.

The complications from long-term high blood sugars, however, tend to take years to manifest themselves and cannot be attributed to one single piece of advice in the same way. So by the time a patient with a high A1C ends up with complications, the individual who advised them will likely be long gone either somewhere else in the health service, retired or even dead. Plus, there is the plausible deniability that the patient will have seen dozens of professionals during their time, and the ol' "the patient was non-compliant" line can be used.

That's why, for most people with diabetes, it is better to take on board the advice of healthcare professionals AND those with diabetes to determine what is best for them, and to rigorously test and take every precaution they can to balance out their blood sugar.



I would actually say that if one of us does something against the advice of a nurse/doctor that ultimately improves our control, we have a duty to each other to inform the nurse/doctor what we've done and why they're wrong. It might mean that the next patient they see ends up getting slightly better advice. It doesn't always work - it drove my last consultant utterly insane that I did the exact opposite of his diet advice ("you use butter for frying? Oh my god, no no no no no....") but my cholesterol ratio was effectively higher than optimal, my trigs were low even for someone without diabetes and my A1C was 0.1% over non-diabetic, and he still tried to describe me as non-compliant.

My OH said this about the nurses too, in particular the ones in the hospital as they seemed reluctant to give baby her insulin at all even though levels were over 20 🙄

 

[DeusXM]

My OH said this about the nurses too, in particular the ones in the hospital as they seemed reluctant to give her insulin at all even though she was over 20 🙄

That's probably because even qualified people sometimes have trouble understanding that adults can have T1 diabetes. At the age of 27 I was told by a nurse taking my blood that I was 'so young' to have diabetes, so I put her straight and said that if she thought 27 was 'so young', she should have seen me getting diagnosed at 14. I swear some people out there think we either grow out of T1 or just magically disappear.

 

[Ljc]

That's probably because even qualified people sometimes have trouble understanding that adults can have T1 diabetes. At the age of 27 I was told by a nurse taking my blood that I was 'so young' to have diabetes, so I put her straight and said that if she thought 27 was 'so young', she should have seen me getting diagnosed at 14. I swear some people out there think we either grow out of T1 or just magically disappear.

I while back I read a post from a member, (not sure if it was on here or the other one 🙄) who is T1 being told by doc or consultant that now he was 40 he was now T2 😱

 

[bilbie]

Exact same breakfast today and 11.2 after 2hrs, how odd.

Unsure what to do now, I see it's not the best breakfast for her but I need her to have a quick breakfast with school run.

With a meal of ~70% carb, all the natural variables are magnified. insulin absorption and a host of other things. Our diet until the 70's was roughly 40%C 20%P and 40%F.
http://www.joslin.org/ are now recommending a carb intake from 30-45%

Precooked frittatas are quicker than weetbix for all the kids and can be handheld if needed.They store in the fridge and can also freeze well. They will defrost if placed into the fridge the night before.
My favorite is cooked in a big muffin tin. Line each with deli-sliced ham, place egg n veg mix and fold over ham, for ham pies

A google of 'kids lower carb breakfasts' should give some ideas on how to strike a balance.

A trick we learn't with our youngins. A good catcher bib can also act as a serving plate, for 'food on the go'

 

[KookyCat]

Have you tried oatabix? They're a bit slower to digest than weetabix but still quick to prepare. Ironically I tolerate rice exceptionally well so rice crispies work a treat (I say ironically because I can't stand rice, vile stuff 😱) so they might be worth a try? Lots of us struggle with breakfast foods, porridge works for me most of the time but occassionally it trips me up with a nice spike, not sure how it'd taste with soya milk but it's nice with almond milk. Hope you find something that works for her 🙂

 

[khskel]

I would be tempted to try bolusing 10 mins before and see if that made a difference and then another 10 mins etc

 

[Shivles]

Waited 10 minutes before giving her breakfast today, started eating at 07:15 - 4.7, 08:20 - 13.2, 09:07 - 11.4, 09:41 - 6.5, 10:28 - 3.3 😱

Maybe the cereals just need to go in the bin

 

[Radders]

Shivies do you know what happens to her levels if she doesn't eat anything? I am just wondering whether part of that spike might be dawn phenomenon.

 

[Shivles]

Shivies do you know what happens to her levels if she doesn't eat anything? I am just wondering whether part of that spike might be dawn phenomenon.

I don't because you don't argue with a hungry 16 month old

 

[Radders]

I use Apidra, which I think is one of the fastest acting insulins, and for breakfast I give it 30 minutes!

 

[Annette]

I don't because you don't argue with a hungry 16 month old

How about trying a carb free breakfast? Not a true basal test but would perhaps give an idea - so maybe an egg, or (desperately trying to think of carb free things a 16month old would eat) a glass of sugar free almond milk/soya milk, some dairy free cheese, a carrot stick, some cucumber - I know, not strictly carb free but low carb enough to keep her happy for an hour or so while seeing if her numbers go up anyway.

 

[bilbie]

You said in the other thread that you often check her night numbers, do you have them handy, It may help for the T1s to see how the basal is to give an opinion?
https://mysugr.com/basal-rate-testing/

If the basal is right, there may be a need to bolus for some of the protein in the egg
TAG ‘total available glucose’
https://healthonline.washington.edu/document/health_online/pdf/CarbCountingClassALL3_05.pdf

 

[Shivles]

That's the last few days, I think her basal is okay as any night hypos (thankfully only had a few ) have happened before midnight

 

[Shivles]

I added a spoon of peanut butter to her breakfast this morning (she has it hot so it's kind of like porridge) and she was 4.4 before 11.1 an hour later and 7.6 after 2hrs

 

[Annette]

Does sound like its the speed shes digesting it then. So, maybe try a few different cereals, see if any have a lesser effect.

 

[Shivles]

Does sound like its the speed shes digesting it then. So, maybe try a few different cereals, see if any have a lesser effect.

I'm wondering if wholemeal toast and scrambled egg might be better, I just need to work out what I can throw together in 5 minutes and doesn't require much thinking as I'll be pre coffee at their breakfast time 😱

 

[Annette]

I'm wondering if wholemeal toast and scrambled egg might be better, I just need to work out what I can throw together in 5 minutes and doesn't require much thinking as I'll be pre coffee at their breakfast time 😱

Make a batch of frittata muffins and freeze them. Get one or two out the night before to defrost and serve with a slice of wholemeal toast. Lower carbs so less of a spike (hopefully), can spread with peanut butter as well if you want to slow it down further, and not too much thinking about...