# Breakfast Spike



## hkk1970 (Feb 18, 2016)

Hi, Harry, 7 is on accucheck combo and we self fund the libre. The libre shows us high spikes after breakfast, he can be 5 before breakfast, rise to 15 most days then back in range by lunchtime, with no corrections. I  have tried giving more insulin up front on a multiwave , different foods but still we get the spike. I am cautious to give his insulin prior to eating as I don't want him to hypo especially when at school. Any ideas??


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## SB2015 (Feb 18, 2016)

I also use a combo. I was also finding that I spiked after breakfast, going up into the teens as Harry does.

I can understand your concern about the possibility I of hypos when trying out the timing of the insulin for breakfast.  I am currently trying out delivering a bit before breakfast but I don't then go to school.
However other parents will be able to help you more on that.

I reduced my spike by just changing breakfast.  I read on here a description of a bowl of cereal as simply a bowl of sugar in disguise.  I have switched to toast which is lower carbs.  If I am then going to be more active, as no doubt Harry will be at school,  I will have a banana a bit later and use a reduced slow delivery on the pump for that. The Paediatric Diabetes team will have a lot of experience of such issues.  Are you able to contact/ see them?

Let us know how you get on.


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## pottersusan (Feb 18, 2016)

I have to give myself my insulin (Novorapid) about an hour before I eat breakfast to avoid spikes - but again I don't have to go to school and have the benefit of a cgm.

I have bacon, egg and a slice of Burgen - any cereal sends my bg really high really quickly.


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## hkk1970 (Feb 18, 2016)

Hi, we have his check up clinic tomorrow, I will ask them, though I have asked before and they just say most young children have spikes after breakfast ..
Unfortunately he likes his carbs too much, I'm a bit mean ! and don't let him have cereals so he has wholemeal bread toasted with some jam, or croissants as a treat , both with fruit..


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## Ally beetle (Feb 18, 2016)

Hi new here but what is it that he eats for breakfast. If it is very high in carbs I notice that whatever I do my blood glucose will not go down for a good wile. It's almost like a carb overload that the body can't deal with? Breakfast is usually just loads fast acting carbs all in one go.

You could try to change what he eats for breakfast  for less fast acting carbs and more  slower acting carbs. 

Another good thing to remember is the insulin works for 3 to 4 hours so it maybe helpful if you look at what his bm is at 3-4 hours after breakfast and see if it is in normal range. Do not worry too much about spikes right after meals. 

Hope this helps you a little


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## everydayupsanddowns (Feb 21, 2016)

My thinking about multi-waves and square waves is that they help me when the food is slow to hit my system, because some of the insulin is delayed and only delivered (and therefore available) much later. 

I can understand your caution, but do wonder whether a longer gap between bolus and food (possibly with a different food chalice) might be the way forward. Could you try it on a weekend and scan/swipe every hour or so to see what happens?


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## trophywench (Feb 21, 2016)

The other choice you have is what they sometimes term a 'Superbolus' - where when bolusing, you borrow some of the normal basal dose for the next hour/couple of hours, to try and avoid the 'spike' after the food.

Unrelated though this may seem, where T1 ladies are preg, especially in the last trimester when BGs are going to become mega anyway, no matter what the heck they do - and it's also mega important to avoid spikes cos they cause shedloads of damage to both mum and baby - superbolusing is very useful.  Mike - do you remember Winni on DSF doing this? - she swore by it!  LOL  She was a teacher, BTW !

Discuss it with your team.


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## Sally71 (Feb 21, 2016)

We have just bought a Libre and I am also shocked at the huge spikes after breakfast - not sure what to do about it really!  Don't always want/have time to do scrambled eggs every day, and as yet haven't managed to even think about bolusing early (and don't have chance on school days).  If anyone has any brilliant ideas I'd love to hear them!!

Then again the last week or so everything has gone crazy, daughter is high far too much of the time and nothing I do to try to counteract it seems to have much effect, think we might be battling the dreaded hormones, in which case we're probably a bit stuck anyway...


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## SB2015 (Feb 24, 2016)

I can understand why dealing with the diabetes in the the morning makes timing that bit tighter before school.  You commented on my levels being good after breakfast, (I am the porridge person) and that started very quickly after changing the timing of the bolus.  The only way I manage it is to do my test as soon as I get up and stick to the same breakfast each day during the week (All different at the weekend). Not maybe what a ten year old wants to do, but I was amazed at the difference it made.

I am very interested in getting the Libre so will watch with interest to see what reports appear about it.  They seem a bit mixed at present.

I hope that things settle  down soon.


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## Sally71 (Feb 25, 2016)

Thanks @SB2015 - will have to try that if I can! Our initial impressions of the Libre are excellent and I'd recommend it to anyone, haven't had any dodgy sensors yet though lol (in fact have only just started the second ever!) and I think that's where most of the dissatisfaction comes in.


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## Adrasteia (Feb 25, 2016)

@hkk - My son is exactly the same, and the only thing that made the blindest bit of difference was giving him his bolus a minimum of half an hour before (we're still MDI). Even low carbing he spiked, though not quite as badly. Ever since we started bolusing early I think we've had two hypos at pre-school but they've been mild and very manageable, and about half as many readings in the high teens. It is a pain because time is squeezed before school but we just have two or three 'set' breakfasts for weekdays where we know the carbs so we don't have to work anything out in advance and we know how he'll typically react to them so we bolus as soon as he wakes, get ready and eat just before he leaves. Better that than his previous usual 18mmol at 10am, or the whopping 26mmol (blooming croissants) the school once called us about! 

@Sally - we had uncontrollable highs for the whole of December and until about 2 weeks ago. Since then we've had two hypos a day minimum, adjusted back down every ratio (his daytime basal is a fifth of what it was!) and it's only just calming down a bit. We think ours was down to xmas excitement and a bit of worry (we moved house in January), could there be anything like that? I'm afraid I don't have any good advice, but I can empathise!


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## Sally71 (Feb 25, 2016)

Thank you @Adrasteia, things are settling down a bit now after some fairly hefty basal increases!  I had got used to only needing to make tiny changes but clearly now daughter has grown so much I need to start making bigger ones!

Have also discovered that mini Weetabix don't seem to spike anywhere near as badly as Rice Krispies did, so that's useful to know 

The Libre is a revelation, isn't it


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## everydayupsanddowns (Feb 28, 2016)

SB2015 said:


> I can understand why dealing with the diabetes in the the morning makes timing that bit tighter before school.  You commented on my levels being good after breakfast, (I am the porridge person) and that started very quickly after changing the timing of the bolus.  The only way I manage it is to do my test as soon as I get up and stick to the same breakfast each day during the week (All different at the weekend). Not maybe what a ten year old wants to do, but I was amazed at the difference it made.
> 
> I am very interested in getting the Libre so will watch with interest to see what reports appear about it.  They seem a bit mixed at present.
> 
> I hope that things settle  down soon.



Exactly my tactic for breakfasts too! And I can conclusively see that what we eat and timing of doses is only a part of the picture for post-meal BGs. When basal changes (at least once a month for me) it can make the difference between 8.0 an hour and a half after eating and 15!!


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## SB2015 (Feb 29, 2016)

The frequency of changes in basal rates is useful to know Mike.  

I don't think that I have monitored changes in my basal rates that closely. (I feel a Libre rising to the top of the list again).  I tend to assume that other things have caused ups and downs, unless there is a big change in things such as exercise or changes to medications. Thanks for that.  

All these little bits of new info add up to make a difference I hope.  I shall be interested to see what my next HbA1c is to see whether it will have had an impact.


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## Bloden (Feb 29, 2016)

I don't use a pump, but I used to have BIG post-brekkie spikes so I changed to a low-GI breakfast with fibre and some fat to slow down digestion, and it works!

This is a breakdown of the 50g carb I eat: 10g muesli (without raisins - they're pure rocket fuel!), 5g Greek yogurt, 20g high-fibre fruit, 5g dried apricot, 10g semi-skim milk and coffee. I also add a tiny sprinkling of flax/pumpkin/sunflower seeds and a teaspoonful of crunchy almond butter - more fibre to slow down digestion.

Obviously, this isn't to everyone's taste, 10-year-olds included!


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