July 6, 2015

5 Tips for Keeping Your Blood Sugar Stable All Morning

Lyfebulb8.PictureMy blood sugar is not a morning person. It’s lethargic, moody, and slow to respond when I wake up. But I’ve discovered ways to maintain smooth sailing throughout this tricky time of day. Here’s how I do it:

1) Wait to eat breakfast. My insulin absorption tends to be delayed in the morning. It can take up to an hour before my blood sugar responds to a bolus. Because of this, I add up all the grams of carbohydrates I expect to eat, take my breakfast bolus, and then wait. In about 40 minutes, I verify that the insulin is taking effect by checking my continuous glucose monitoring system. Then, it’s time to eat!

2) Continuously review and adjust nighttime basal rates. It’s easiest to identify necessary basal rate adjustments at night. This is because I’m not eating, exercising, or blousing while I’m asleep. Thanks to my continuous glucose monitor, I can review what my blood sugar was doing when I wake up. If I notice any patterns that I don’t like, I add or take away basal insulin as needed.

3) Bolus before getting out of bed. The first thing my blood sugar wants to do each morning is hit the sky. It doesn’t matter what time I wake up or whether I wait a few hours to eat breakfast, or even if I’ve had stable glucose levels all night.  It doesn’t seem to be related to the Dawn Phenomenon or the Somogyi Effect either. But regardless of why it happens, this seems to control it: I take a small wake-up bolus of insulin, just to get my day started right.

4) Measure carbs and eat a balanced meal. Taking the right amount of insulin depends on knowing exactly how many grams of carbohydrates I’m eating. Since my blood sugar is most sensitive in the morning, I’m usually most careful with breakfast measurements. I check nutritional facts, weigh, or measure everything. I also aim to get some protein and vegetables into my meal. Today, I ate about 70 grams of carbohydrate for breakfast. The breakdown went like this:

6gm milk in my coffee

26gm toast with jam

15gm plain yogurt

15gm banana

8gm celery with peanut butter

5) Adjust for alternate routines. Saturday and Sunday are my morning boot-camp days at the gym, and I can’t eat right before these workouts. So I’ve developed an alternate routine for weekends. It goes like this:

  • Wake-up an hour before class (the gym is a five-minute walk from my apartment, so an hour is plenty of time)
  • Take 0.7 wake-up bolus, plus enough bolus to cover a mini protein shake
  • Set a one hour, temporary basal rate of .75% on my pump (this will begin to take effect when I’m working out)
  • Get ready for the workout.
  • Drink a mini protein shake.
  • Run to boot-camp class!
  • Monitor blood sugar throughout the class.
  • Get home, measure carbs, and take the breakfast bolus.
  • Shower and wait 40 minutes.
  • Eat breakfast.

I hope these tips help you start your day off on the right foot too!