# Wheatabix and almond milk, high BS



## Shivles (Aug 31, 2016)

Little one is 16mo, has dairy intolerance, she has 2 wheatabix every morning pretty much with 250ml of a dairy free milk. Last week she was on soya which she wasn't too keen on so went back to almond milk which is 3g carbs per 100ml, she is at 17.4 2hrs later! Could it be the almond milk? We've had issues with highs after breakfast before and couldn't work out why


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## SB2015 (Aug 31, 2016)

I wonder whether it is more likely to be the Weetabix.  I used to love having these and I was always on target by the next meal.  Then i got my Libre monitor, and realised how high the spike was after breakfast!! Someone on here described breakfast cereal as a a bowl of sugar in disguise.  That was the end of Weetabix for me.
Now it is porridge for me (but I know that others find that that causes spikes for them as well)

For post meal spikes, you could have a look at the timing of the bolus.  Cereals often lift the BG very rapidly because of the simple carbs in them, so shifting the bolus to some time before the meal can allow the insulin to get active and meet the increase in BG head on rather than trialling behind it.


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## Radders (Aug 31, 2016)

I switched to Oatibix and only have one, with a sprinkle of Lizi's low GL granola. They've also brought out a higher protein Weetabix which has slightly lower carbs. I still get a bit of a spike but not as bad as it used to be. As I am vegetarian and need the vitamins and fibre in my cereal I've done a bit of experimenting! Others find it best to abandon cereal altogether.


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## Shivles (Aug 31, 2016)

SB2015 said:


> I wonder whether it is more likely to be the Weetabix.  I used to love having these and I was always on target by the next meal.  Then i got my Libre monitor, and realised how high the spike was after breakfast!! Someone on here described breakfast cereal as a a bowl of sugar in disguise.  That was the end of Weetabix for me.
> Now it is porridge for me (but I know that others find that that causes spikes for them as well)
> 
> For post meal spikes, you could have a look at the timing of the bolus.  Cereals often lift the BG very rapidly because of the simple carbs in them, so shifting the bolus to some time before the meal can allow the insulin to get active and meet the increase in BG head on rather than trialling behind it.


I wondered this too in the beginning and asked her nurse about changing her breakfast but they said no :/ also she has it almost every day and all last week on soy milk all her 2hr post breakfast readings were within target. It's very confusing lol. Just checked her again and she is coming down now...


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## Annette (Aug 31, 2016)

If you use the unsweetened almond milk, its less than that, btw. Like, about 0.1g per 100ml. But 3g of carbs is unlikely to make her spike that much. (if you consider a weetabix is about 10g or so?)


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## Shivles (Aug 31, 2016)

Annette said:


> If you use the unsweetened almond milk, its less than that, btw. Like, about 0.1g per 100ml. But 3g of carbs is unlikely to make her spike that much. (if you consider a weetabix is about 10g or so?)


I thought that but nothing else has changed... could her insulin just have absorbed slower for some reason?


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## SB2015 (Aug 31, 2016)

With Diabetes nothing stays the same.  I do wonder how much of my time I spend wondering Why ...

I have no idea why the change of milk would have such a big impact.  However back to the Weetabix.  Your daughters levels may be back on target after two hours with the usual milk but I suspect that there are some big spikes happening straight after the meal, and the same would happen with other cereals.


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## SB2015 (Aug 31, 2016)

Radders said:


> I switched to Oatibix and only have one, with a sprinkle of Lizi's low GL granola. They've also brought out a higher protein Weetabix which has slightly lower carbs. I still get a bit of a spike but not as bad as it used to be. As I am vegetarian and need the vitamins and fibre in my cereal I've done a bit of experimenting! Others find it best to abandon cereal altogether.


I shall look out for the Oatibix.  Perhaps I could have a treat now and then.  Thanks Radders


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## Shivles (Aug 31, 2016)

3.5+ hrs later she's back in range

Every time I think I'm on top of it something happens that makes no sense


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## Annette (Aug 31, 2016)

Ok, might be a long shot but...Have you tried almond milk on its own to see if it affects her BGs? Just a cupful, test after 1 and 2 hours. because I doubt its the carbs (its too few) but it could perhaps be an intolerance to it - which can cause an inflammatory reaction, which could include raised BGs?


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## Shivles (Aug 31, 2016)

Annette said:


> Ok, might be a long shot but...Have you tried almond milk on its own to see if it affects her BGs? Just a cupful, test after 1 and 2 hours. because I doubt its the carbs (its too few) but it could perhaps be an intolerance to it - which can cause an inflammatory reaction, which could include raised BGs?


I will try that to rule it out, thank you


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## bilbie (Aug 31, 2016)

What about half or one weetbix and a boiled egg, as part of a healthy breakfast. I can understand the nutritious wheat germ and fibrous bran (which sometimes both are taken out),


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## Shivles (Aug 31, 2016)

bilbie said:


> What about half or one weetbix and a boiled egg, as part of a healthy breakfast. I can understand the nutritious wheat germ and fibrous bran (which sometimes both are taken out), It's the high sugars and starches, I can't understand.
> 
> I can't help with what the nurse said. I'm still trying to get my head around, it's ok to give high fat breast milk for 12 months, but as soon as they're weaned, it's low fat?


These are only 1.7g sugar for 2 biscuits so thought they were a good option! :dohh: 

I think the tables are turning on low fat and lots of people are being recommended a low carb high fat diet as healthier. Change the rules all the time don't they haha


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## bilbie (Aug 31, 2016)

Dam, I edited my soap box too late, I had second thoughts 
Yes, weetabix is low sugar but high starch/carb. Sometimes it might be worthwhile adding some more proteins and fats, to balance up the carb/protein/fat macros.

weetbix is 77% carbs 10 of which are fiber.
http://www.weightlossresources.co.uk/calories-in-food/breakfast-cereals/weetabix.htm


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## SB2015 (Aug 31, 2016)

It is important to look at the carbohydrates, not the sugars (which are only part of the carbs) on the foods.  The insulin needs to be matched to the total of all the carbs.  These pesky carbs are hidden away in lots of things.

The news does not help us at all in this as it continually goes in about 'sugar' and some nurses and GPs also feed this misconception.


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## bilbie (Aug 31, 2016)

Shivles said:


> 3.5+ hrs later she's back in range
> 
> Every time I think I'm on top of it something happens that makes no sense


If the BG came back without correction, it may have been timing of the bolus? assuming the basal is adjusted right.
I hope one of the T1s see this, they may be able to advise on when to give the injection/pump bolus. Until you can see your nurse.

Though it's hard with little ones, you pre bolus for all the carbs and some of the protein. Then they don't eat the whole meal and they have too much IOB. It's catch 22.


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## Ralph-YK (Aug 31, 2016)

Shivles said:


> I wondered this too in the beginning and asked her nurse about changing her breakfast but they said no :/


Well round here the Health Care Professionals don't want patients doing anything to manage their condition.


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## Shivles (Aug 31, 2016)

bilbie said:


> If the BG came back without correction, it may have been timing of the bolus? assuming the basal is adjusted right.
> I hope one of the T1s see this, they may be able to advise on when to give the injection/pump bolus. Until you can see your nurse.
> 
> Though it's hard with little ones, you pre bolus for all the carbs and some of the protein. Then they don't eat the whole meal and they have too much IOB. It's catch 22.


The nurses are adamant to give the dose right before or even after the meal... OH has suggested giving it 10 minutes before a meal though to see if it helps


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## Shivles (Aug 31, 2016)

SB2015 said:


> It is important to look at the carbohydrates, not the sugars (which are only part of the carbs) on the foods.  The insulin needs to be matched to the total of all the carbs.  These pesky carbs are hidden away in lots of things.
> 
> The news does not help us at all in this as it continually goes in about 'sugar' and some nurses and GPs also feed this misconception.


The carbs has matched the dose all week that's why I'm confused lol


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## Annette (Aug 31, 2016)

Shivles said:


> The nurses are adamant to give the dose right before or even after the meal... OH has suggested giving it 10 minutes before a meal though to see if it helps


The nurses arent dealing with your little ones D. You find out what works and you do it. Listen to their advice but remember, only you know what works and if thats totally at odds with what they are saying, smile and wave. (Anyone recognise the quote?) 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.


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## khskel (Aug 31, 2016)

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


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## DeusXM (Sep 1, 2016)

Shivles said:


> 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.


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## Shivles (Sep 1, 2016)

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.


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## Shivles (Sep 1, 2016)

DeusXM said:


> 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 .
> 
> ...


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


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## DeusXM (Sep 1, 2016)

Shivles said:


> 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.


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## Ljc (Sep 1, 2016)

DeusXM said:


> 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


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## bilbie (Sep 1, 2016)

Shivles said:


> 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'


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## KookyCat (Sep 1, 2016)

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


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## khskel (Sep 1, 2016)

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


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## Shivles (Sep 2, 2016)

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


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## Radders (Sep 2, 2016)

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.


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## Shivles (Sep 2, 2016)

Radders said:


> 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


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## Radders (Sep 2, 2016)

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


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## Annette (Sep 2, 2016)

Shivles said:


> 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.


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## bilbie (Sep 2, 2016)

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


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## Shivles (Sep 3, 2016)

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


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## Shivles (Sep 3, 2016)

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


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## Annette (Sep 3, 2016)

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


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## Shivles (Sep 3, 2016)

Annette said:


> 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


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## Annette (Sep 3, 2016)

Shivles said:


> 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...


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## Radders (Sep 3, 2016)

I don't think I can eat anything ever without a spike at one hour, without seriously overdosing on insulin. Reducing the carbs means the insulin is lower as well. I only look at the two hour reading or I would starve!


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## Shivles (Sep 4, 2016)

So tried her with eggy bread this morning which was better although we only have Warburton toastie in so maybe it will be better with wholemeal


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## Radders (Sep 4, 2016)

Shivles said:


> So tried her with eggy bread this morning which was better although we only have Warburton toastie in so maybe it will be better with wholemeal


Good stuff. Does she like multigrain, it's meant to be slower release than whole meal?


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## Shivles (Sep 5, 2016)

Radders said:


> Good stuff. Does she like multigrain, it's meant to be slower release than whole meal?


I've not tried her yet with it but will give it a go! In typical toddler fashion she refused to even eat the white bread version this morning which resulted in rich tea biscuits in the pram on the way to school


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