Friday, December 11, 2009

Breakfast Highs- Over Easy

In the earliest years with diabetes, managing breakfast blood sugars had always been a challenge for us. First, there's a period of insulin resistance that naturally occurs in the early morning called the "dawn effect." Sometimes this would lead Cassie to have relatively high blood sugar levels, and it would take an unusually large amount of insulin to bring down. This was really hard to treat when she was an infant on shots.

Once we put Cassie on the pump, it got a little easier. We were able to adjust for the dawn effect with slightly higher basal rates, and we set up a different insulin to carb ratio for her breakfast bolus. And here's the magic step that brought everything together- we gave her the breakfast bolus (around 30 grams worth) about 45 minutes before eating. The pre-bolus routine usually meant that upon waking, we'd grab the glucometer to check; do a correction bolus if she was high; then also tack on a 30 gram "breakfast bolus." At times, we'd get into trouble if she wasn't hungry once she got to the table. At that point we'd try to load her up with really sugary things like orange juice or even candy- anything to counteract the insulin we'd already put into her system.

But making smart food choices are also a key method for morning control. Sugary cereals are notorious for causing huge blood sugar spikes in throughout the morning, and the spike is usually followed by a quick crash.

We encourage our daughter to have higher protein breakfasts- bacon and eggs or a fruit smoothie are great choices especially if she wakes up high. Another not so sugary and wonderful option is oatmeal with berries and brown sugar. It's filling, yummy and healthy. Plus by adding the brown sugar yourself, you can control the sugar amount, rather than having to be stuck with what Kelloggs decided.

If your child only wants "bready" things, think mini. Mini portions that is. Kelloggs makes Eggo brand frozen mini pancakes, and waffles. That way, it's easier to do portion control. Don't forget to use "lite" low-carb maple syrup.

It's a lot to think about when your head's still fuzzy from a night's sleep. But hopefully this technique that we've come close to perfecting over the years helps you out.

No comments: