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Re: [IPp] Post-breakfast highs

 At the risk of highlighting my ignorance, what 'meal plan'? Thanks to starting
the pump at the same time as solid foods, we've never had a meal plan. We are
vegetarians. Aside from that, Ailsa can eat whatever (healthy) foods she wants.
We did try the highest fiber kid-friendly cereal we could find (recommended by
the nutritionist at Joslin clinic) and that always sends her BG the highest of
all. Regading protein, my husband can't make eggs every morning and Ailsa gets
pretty finicky about eating the same thing every day anyway.

 I realize that the numbers are a bit screwy due to checking so soon after the
meal, but sugars should not be more than 100 points over the pre-meal value
regardless of the time checked. I'm not looking for 'normal' values after
breakfast, but it concerns me that she is going from 88, for example, to 350 in
one hour.

 Do y'all think I should just ignore it, as long as she is in range at 2 hours

Sent via BlackBerry by AT&T

-----Original Message-----
From: "Suzanne Henbest" <email @ redacted>

Date: Mon, 7 Jan 2008 15:09:03 
To:<email @ redacted>
Subject: Re: [IPp] Post-breakfast highs

Hi Octavia, sounds like my situation all over again.  A couple of things, 
since Alisa isn't a big breakfast eater it sounds like the meal plan needs 
to be adjusted to fit her needs.  If you realistically think you can get 30g 
of carbs ( 1/2 bananna and a waffle) and maybe a protein (cheese stick or 
egg)  for example,  I would push your endo to adjust her insulin to fit what 
she is likely to eat in a reasonable setting.  You can always add a little 
more to her snack and lunch to make sure she gets the recommended daily 
allowances.  Second, the fact that you are checking her BS within such a 
short period of time of her completing her meal will  give you a high 
reading, the carbs have hit her BS but the insulin hasn't.  If you can get 
some protein in with that cereal or waffle that would help tremendously.  I 
use fibersure in my daughters cereal every day, it disolves into the milk 
and she doesn't know it is there, the 5g of fiber can actually be subtracted 
from your carb grams.  Another piece of information, many of the items you 
mention, cereal, waffle, bananna, raisins all tend to have a pretty high 
glycemia index, meaning they absorb into her BS very quickly and the insulin 
comes in after meal so it has to catch up, thus the reason for the peaks.  I 
was so frustrated trying to force Megan to eat food she wasn't hungry for 
(or juice boxes to make up the shortage) so that I could then give her 
insulin to offset it and it just doesn't make sense.  Not to mention insulin 
is a hormone which effects the children in other ways.  We were all much 
happier when we designed her meal plans to fit with what she would 
realistically eat.  Given her age I know you have to make sure she is 
getting all the nutrients she needs but maybe there is a way to spread it 
out over the entire day so it fits with her eating style better.  As she 
gets a little older her appetite and change and her meal plan will need to 
be adjusted many times but this might help for the short term.  Good luck, 

----- Original Message ----- 
From: <email @ redacted>
To: <email @ redacted>
Sent: Monday, January 07, 2008 2:25 PM
Subject: [IPp] Post-breakfast highs
> I know this is a common problem time for lots of kids, based on reading 
> this
> list for the past 3 years, but maybe someone has a 'magic' tip that can 
> help...
> Ever since starting pre-school 18 months ago, Ailsa has had a horrible 
> time
> with post-breakfast highs. We get her up at 7 am and her BG is pretty good
> usually - often between 80 and 140 (her official target) and only rarely 
> as high
> as 200. If she is high, she gets a correction right away. She is never
> interested in breakfast, even if she wakes up low, so she won't start 
> eating
> until 7:30 and frequently drags the whole thing out for 30 min. My husband 
> takes
> her to school around 8:15. Before droppong her off at school, he checks 
> her BG
> and she is rarely UNDER 300! Since changing the carb ratio to 1:20 a few 
> months
> ago (which is pretty aggreesive, compared to lunch and dinner - around 
> 1:35),
> she remains sky-high after breakfast but at least has enough IOB to cover 
> it. By
> 9:30, when the teacher checks before snacktime, she's back down in target 
> range
> again.
> Our endo rightly suggests more leadtime for breakfast, but, since she is 
> so
> fussy about eating anything at breakfast-time, we are hesitant to bolus 
> sooner
> than right when she finally starts to eat. Even then, we usually only do a
> partial bolus for 10 carbs or so and give any additional bolus needed when 
> she
> finishes eating. Even finding a food she is willing to eat for breakfast 
> is a
> challenge. Typical options offered include: a banana (altho usually only 
> eats
> half), a half-cup serving of cereal (a real carb blowout!), one frozen 
> waffle
> with jam, an apple, raisins in applesauce (typical toddler fare!). Aside 
> from
> the ceral, no option is better. On weekends, she'll have a fried or boiled 
> egg,
> altho won't always eat it. We have resisted bolusing more before eating as 
> she
> will end up getting candy to cover the excess insulin - not how we like to 
> start
> the day. If we let her skip breakfast, she gets hungry before snacktime at
> school, which ends up being disruptive for the teachers and not a good 
> start to
> her day.
> Okay, that's a big set up, but if anyone made it through the whole message 
> and
> has any ideas, I'd love to hear them!
> Thanks,
> Octavia, mom to Ailsa, 4.5 yrs and pumping Animas over 3 years
> Sent via BlackBerry by AT&T
> .
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