Low impact breakfast - DAFNE Online

September 30, 2011 12:12

Chchch
Mid Yorkshire Hospitals 17 posts

Hi everyone

I'm interested in finding out if anyone has any tips for breakfasts that don't raise their post-meal readings too much. I always eat toast, sometimes white, sometimes brown, with butter or cream cheese, and it doesn't matter if I do a dual wave or a square wave (I'm on a pump) I end up with quite a pronounced rise (normally goes up at least 3). It's something I'd like to get right as post prandial levels are really crucial when you're pregnant.

September 30, 2011 12:17

novorapidboi26 DAFNE Graduate
NHS Lanarkshire 1,819 posts

Low GI items would be good..........

I have a yoghurt in the morning, this helps with my dawn phenomenon by being released slowly so as not spiking the BG too much and tells my liver to go back to normal glucose production......

You can also try it with granola and the like, this may slow the absorption further.........

Have you tried carb free breakfasts like, eggs, bacon/sausage................not completely fat free mind you but wont affect the BG much, its only for 9 months................. Wink

September 30, 2011 16:04

caroline15 DAFNE Graduate
Harrogate and District NHS Foundation Trust 45 posts

Last time I saw my consultant (in March) she suggested that I have porridge instead of yoghurt for breakfast (not pregnant or trying to be though). I'm still in my first month of being on a pump so haven't quite got it sorted yet re dual or square wave.

September 30, 2011 16:31

Carolin DAFNE HCP
Sheffield Teaching Hospitals 83 posts

Chchch said:
Hi everyone

I'm interested in finding out if anyone has any tips for breakfasts that don't raise their post-meal readings too much. I always eat toast, sometimes white, sometimes brown, with butter or cream cheese, and it doesn't matter if I do a dual wave or a square wave (I'm on a pump) I end up with quite a pronounced rise (normally goes up at least 3). It's something I'd like to get right as post prandial levels are really crucial when you're pregnant.

You have 2 options really and you may need to try each or both together:
1 Try a really low glycaemic index CP like granary bread, porridge, etc. Keep the portion size as small as you can and maybe snack later when your insulin resistance is lower.
2 Bolus / inject QA 15-30 min before eating, particularly if your starting BG is raised.
Evidence from continuous glucose monitoring (CGM) studies suggests that BG will always peak after meals even with the modern QA analogue insulins. Square or extended wave Boluses on pumps really offer no advantage as they miss the peak of the BG after CPs, so standard bolus options seem to be better. OR maybe use a combination bolus with 80% taken immediately 15 min before your meal and the remainder as you eat.
Good luck.
Carolin

October 02, 2011 16:59

Chchch
Mid Yorkshire Hospitals 17 posts

That is really great, thanks for all your replies. This is a fabulous resource! I am going to try the yoghurt, and will also definitely try bolusing well before eating. I've found that for me BG is raised just as much with granary as any other type of bread (I haven't succombed to pumpernickel yet, I just can't face it!) and porridge seems to be the same. As for carb free, I get ketones almost immediately after having a completely carb free meal even though my BG remains steady, so that's a bit out of the question at the moment. Thanks again!

October 03, 2011 13:16

novorapidboi26 DAFNE Graduate
NHS Lanarkshire 1,819 posts

What levels of ketones would you be talking about............?

Remember ketones are naturally occurring and are used by the brain overnight...........obviously processing them with insulin to maintain just a trace is our aim....... Wink

October 03, 2011 16:13

chrisinbrum DAFNE Graduate
University Hospitals Birmingham NHS Foundation Trust 41 posts

Carolin said:
Chchch said:
Hi everyone

I'm interested in finding out if anyone has any tips for breakfasts that don't raise their post-meal readings too much. I always eat toast, sometimes white, sometimes brown, with butter or cream cheese, and it doesn't matter if I do a dual wave or a square wave (I'm on a pump) I end up with quite a pronounced rise (normally goes up at least 3). It's something I'd like to get right as post prandial levels are really crucial when you're pregnant.

You have 2 options really and you may need to try each or both together:
1 Try a really low glycaemic index CP like granary bread, porridge, etc. Keep the portion size as small as you can and maybe snack later when your insulin resistance is lower.
2 Bolus / inject QA 15-30 min before eating, particularly if your starting BG is raised.
Evidence from continuous glucose monitoring (CGM) studies suggests that BG will always peak after meals even with the modern QA analogue insulins. Square or extended wave Boluses on pumps really offer no advantage as they miss the peak of the BG after CPs, so standard bolus options seem to be better. OR maybe use a combination bolus with 80% taken immediately 15 min before your meal and the remainder as you eat.
Good luck.
Carolin

I'm not on a pump but have recently used CGM, and I'd totally agree with what Carolin says in point 2. I was amazed at what a difference only 5 or 10 minutes can have. I have porridge, mainly because it is always quoted as low GI, but I've found I actually like it now! Smile

My mid-morning BG can be a bit erratic and I actually considered that maybe a 'less healthy' low GI breakfast would be better because it might be in and out of my system quicker, and might match the humalog profile better (has anyone considered whether high or low GI foods match their insulin profile??).
Anyway, I tried the CGM a few weeks ago and with my humalog immediately after my usual porridge my BG went up and peaked 1-2 hours after breakfast. When I tried the humalog 10 mins before my porridge the CGM seemed to show no real peak in BG at all - in fact it only really increased by a couple of units and soon came back down to the pre-breakfast BG and stayed there 'til lunch. I was amazed! Obviously my experience is only based on a couple of days, so I'm pleased to read what Carolin says about other evidence showing the same.

October 04, 2011 07:42

novorapidboi26 DAFNE Graduate
NHS Lanarkshire 1,819 posts

I too have also noticed those results, I actually inject at different times for each meal, for breakfast, immediately before, lunch is 45 minutes before and dinner is 15 minutes, I dont get perfect results every time, but I have had a few days were my BG results have been on target pretty much every hour of the day, its possible..... Smile

September 30, 2011 12:12 Chchch Mid Yorkshire Hospitals 17 posts	Hi everyone I'm interested in finding out if anyone has any tips for breakfasts that don't raise their post-meal readings too much. I always eat toast, sometimes white, sometimes brown, with butter or cream cheese, and it doesn't matter if I do a dual wave or a square wave (I'm on a pump) I end up with quite a pronounced rise (normally goes up at least 3). It's something I'd like to get right as post prandial levels are really crucial when you're pregnant.
September 30, 2011 12:17 novorapidboi26 DAFNE Graduate NHS Lanarkshire 1,819 posts	Low GI items would be good.......... I have a yoghurt in the morning, this helps with my dawn phenomenon by being released slowly so as not spiking the BG too much and tells my liver to go back to normal glucose production...... You can also try it with granola and the like, this may slow the absorption further......... Have you tried carb free breakfasts like, eggs, bacon/sausage................not completely fat free mind you but wont affect the BG much, its only for 9 months.................
September 30, 2011 16:04 caroline15 DAFNE Graduate Harrogate and District NHS Foundation Trust 45 posts	Last time I saw my consultant (in March) she suggested that I have porridge instead of yoghurt for breakfast (not pregnant or trying to be though). I'm still in my first month of being on a pump so haven't quite got it sorted yet re dual or square wave.
September 30, 2011 16:31 Carolin DAFNE HCP Sheffield Teaching Hospitals 83 posts	Chchch said: Hi everyone I'm interested in finding out if anyone has any tips for breakfasts that don't raise their post-meal readings too much. I always eat toast, sometimes white, sometimes brown, with butter or cream cheese, and it doesn't matter if I do a dual wave or a square wave (I'm on a pump) I end up with quite a pronounced rise (normally goes up at least 3). It's something I'd like to get right as post prandial levels are really crucial when you're pregnant. You have 2 options really and you may need to try each or both together: 1 Try a really low glycaemic index CP like granary bread, porridge, etc. Keep the portion size as small as you can and maybe snack later when your insulin resistance is lower. 2 Bolus / inject QA 15-30 min before eating, particularly if your starting BG is raised. Evidence from continuous glucose monitoring (CGM) studies suggests that BG will always peak after meals even with the modern QA analogue insulins. Square or extended wave Boluses on pumps really offer no advantage as they miss the peak of the BG after CPs, so standard bolus options seem to be better. OR maybe use a combination bolus with 80% taken immediately 15 min before your meal and the remainder as you eat. Good luck. Carolin
October 02, 2011 16:59 Chchch Mid Yorkshire Hospitals 17 posts	That is really great, thanks for all your replies. This is a fabulous resource! I am going to try the yoghurt, and will also definitely try bolusing well before eating. I've found that for me BG is raised just as much with granary as any other type of bread (I haven't succombed to pumpernickel yet, I just can't face it!) and porridge seems to be the same. As for carb free, I get ketones almost immediately after having a completely carb free meal even though my BG remains steady, so that's a bit out of the question at the moment. Thanks again!
October 03, 2011 13:16 novorapidboi26 DAFNE Graduate NHS Lanarkshire 1,819 posts	What levels of ketones would you be talking about............? Remember ketones are naturally occurring and are used by the brain overnight...........obviously processing them with insulin to maintain just a trace is our aim.......
October 03, 2011 16:13 chrisinbrum DAFNE Graduate University Hospitals Birmingham NHS Foundation Trust 41 posts	Carolin said: Chchch said: Hi everyone I'm interested in finding out if anyone has any tips for breakfasts that don't raise their post-meal readings too much. I always eat toast, sometimes white, sometimes brown, with butter or cream cheese, and it doesn't matter if I do a dual wave or a square wave (I'm on a pump) I end up with quite a pronounced rise (normally goes up at least 3). It's something I'd like to get right as post prandial levels are really crucial when you're pregnant. You have 2 options really and you may need to try each or both together: 1 Try a really low glycaemic index CP like granary bread, porridge, etc. Keep the portion size as small as you can and maybe snack later when your insulin resistance is lower. 2 Bolus / inject QA 15-30 min before eating, particularly if your starting BG is raised. Evidence from continuous glucose monitoring (CGM) studies suggests that BG will always peak after meals even with the modern QA analogue insulins. Square or extended wave Boluses on pumps really offer no advantage as they miss the peak of the BG after CPs, so standard bolus options seem to be better. OR maybe use a combination bolus with 80% taken immediately 15 min before your meal and the remainder as you eat. Good luck. Carolin I'm not on a pump but have recently used CGM, and I'd totally agree with what Carolin says in point 2. I was amazed at what a difference only 5 or 10 minutes can have. I have porridge, mainly because it is always quoted as low GI, but I've found I actually like it now! My mid-morning BG can be a bit erratic and I actually considered that maybe a 'less healthy' low GI breakfast would be better because it might be in and out of my system quicker, and might match the humalog profile better (has anyone considered whether high or low GI foods match their insulin profile??). Anyway, I tried the CGM a few weeks ago and with my humalog immediately after my usual porridge my BG went up and peaked 1-2 hours after breakfast. When I tried the humalog 10 mins before my porridge the CGM seemed to show no real peak in BG at all - in fact it only really increased by a couple of units and soon came back down to the pre-breakfast BG and stayed there 'til lunch. I was amazed! Obviously my experience is only based on a couple of days, so I'm pleased to read what Carolin says about other evidence showing the same.
October 04, 2011 07:42 novorapidboi26 DAFNE Graduate NHS Lanarkshire 1,819 posts	I too have also noticed those results, I actually inject at different times for each meal, for breakfast, immediately before, lunch is 45 minutes before and dinner is 15 minutes, I dont get perfect results every time, but I have had a few days were my BG results have been on target pretty much every hour of the day, its possible.....