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RE: [IP] Advice needed (Keith) long
The doctors never seem to warn people, but it
seems like breakfast is the most difficult meal
of the day for keeping BGs in a good range. I
think it's a combination of insulin resistance
first thing in the morning (or even after a long
nap for me) and high-glycemic index foods.
If I were you, this is what I would do.
Remember, though, that everyone is different, so
take all advice with caution and remember YMMV.
My guess is, either your basals are off, of your
bolus is not matching your food.
Check your morning basals by doing a fasting
basal test. You can get instructions for basal
testing on the IP how-to pages, or in Pumping
Insulin. Basal testing is a pain, but it's the
very best way to get them right.
If your basals are good, then your insulin is not
matching your food. This can be the timing of
the peak, not just your carb:insulin ratio.
For low glycemic foods (e.g. high fat, high
protein), your BG may peak after your insulin,
resulting in a low at 2-3 hrs, and a high some
time later. This scenario is why so many of us
have trouble with pizza and Chinese food, and is
a perfect time to try a square wave. I
would not use a square wave for your problem.
My guess is you'd only be higher in the short
term and lower at lunch.
For high glycemic-index foods (like breakfast
cereal), your BG may peak before your insulin,
resulting in a high 2 hr after eating, but
normal at 3 hr (or whenever Humalog finishes for
you). This may be the case for your breakfast
I have stopped eating almost all breakfast
cereals for breakfast because I can't keep my BG
from spiking. Same goes for bagels (at any time
of the day). At the moment, the only cereals I
can eat are Fiber One, All Bran, and Kashi Go
Lean. They all have high fiber, low sugar, and
therefore a lower glycemic index, thus causing a
smaller spike. You can test this by having a
different breakfast that has a lower effective
glycemic index. This could be one of the
cereals I mentioned, or adding some fat or
protein to your usual breakfast. Since you're
already having metamucil, this may not work.
Does metamucil have any sugar in it? Even though
it's high fiber, the glycemic index may not be
low if it's sweetened.
Hope this helps.
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