Recently a slip in my morning routine created an opportunity for me to experiment with my breakfast food choices.   First, I do a fasting blood sugar check, then fix breakfast, take my insulin bolus, and eat.  But this fateful morning I simply forgot to take my bolus before eating my breakfast.   No problem, you say, just take it during or right after eating.

Well, I didn’t realize I had missed my bolus until 3 hours later!  Too late for a bolus but I might need a correction dose of insulin to reduce that high I just knew I would see on my meter.  Off I went to stick my finger and wait the few seconds for my reading.

To my surprise, I really did not need a correction dose because my meter reading was 139.  My breakfast is a very high carb affair:  a bowl of high fiber, high carb cereal, with 2% milk, fruit, and a few walnuts thrown in.  Um, about 75 carbs or more if I am heavy handed with the cereal and fruit.  Since my early mornings are not usually high activity times, I give myself a bolus of 5 to 8 units depending on my morning blood sugar reading.   My two hour after meal reading is usually at the lower end of my target range, but I often have found that my before lunch reading is at or below 100.

I believe that numbers are information, and the information from this event made me wonder did I really need a bolus each morning I ate this same high carb breakfast?  Or just a smaller bolus?  To find the answer, I decided to experiment each morning for the next 4 days to see if my two hour after eating blood sugar reading would be < 180, which is the ADA recommendation, without taking a bolus of insulin.

The result, I am happy to report, is I was well under 180 each morning 2 hours after eating this high carb breakfast, but it was not in my desired target range.  Of course, I did not achieve the same number each day because of variations in my fasting blood sugar number and in the level of morning activity. 

Now I have decided to think about my morning routine first, and if there will be little or no real physical activity after breakfast, I will give myself a smaller bolus than I previously did.  If I plan on being “on the go” that morning, I may skip the bolus entirely or reduce it even more.  Reducing the amount of my bolus at breakfast will help prevent the dip in energy and blood sugar just before lunch and will keep my after breakfast blood sugar in my target range.

I will continue monitoring this new morning routine and will adjust my bolus to ensure that my two hour after meal blood sugar reading is not only < 180 but in my personal target range.  I am all about taking less insulin, but not at the expense of higher blood sugar.  Yes, I could change the foods I eat, but I enjoy this breakfast fare.  It is quick to fix, and I believe that it is a healthy way to start the day for me.

This lapse in routine and subsequent experiment taught me that no matter what I think I know about carb counting, I should stay open to opportunities to learn more about the foods I eat and their effect on my blood sugar.  Knowing, rather than assuming, the effect of a food on my blood sugar will help me do better at portion control and determining my insulin bolus.