I am a type 1 diabetic, and I notice that even cereals such as plain Cheerios digest very quickly, causing a brief spike in sugar until the insulin catches up with it. In my case, I can avoid this by injecting my insulin a little bit before breakfast to give the insulin a head start unless my waking blood sugar is too low to allow for this. Another option would be to add some fat or protein to slow down the digestion time of the cereal. Fats in particular will slow down digestion times.
The carb and protein combination at bedtime sound ideal. Again, the idea is to have him eat something that will digest slowly. Nuts are good as proteins, and they also contain fats that slow down digestion. Healthy fats, at that.
Cereal in the am is fine. You do not indicate when the testing is being done in relation to the meal. Right before? right after ? couple hours after? and when his levels get back to normal? These are the keys to correcting the issue.
Testing before the meal is ideal. And taking bolus to match the carbs taken in. If he is having a high carb cereal then he will need to bolus more. Also when his levels are back to normal is a key issue. If it is quickly - like in a couple hours or less it is a timing issue of cereal or insulin working sooner than the other and no big deal. If it is several hours to recover then he is not bolusing enough to cover the amount of carbs in the cereal.
If you need to post more details I can try to answer more but this should give you the basis to calculate the change if needed.
He gets up at 7am and b/s is tested. Our ratio in the morning is 5:1. His cereal is 30 carbs, milk is 12 = 42 carbs = 8 units of Novalog.(with a good b/s reading: not high or low). The school will check him around 9:45-10 am. she will usually call and say he is high (300-400). Each time he eats ceral (all different kinds) he will be high afterwards. Do you think his carb to insulin ratio should be lower(say 4:1)? He really likes ceral and begs for it in the mornings. I try to keep his carbs to around 45 in the morning, 70-80 for lunch and supper. What would be a good suggestion to add to his breakfast when he has cereal that would help in slowing the digestion down? Something that I would not have to add any more carbs to his meal with.
As far as the 9pm snack before bed: we do the slice bread & ham or sometimes slice bread and peanut butter. I was told to give him slice bread and peanut butter/jelly mixture. This seems to make his b/s get high during the night. We went back to just plain peanut butter. I am a worrisom mother. We check his b/s about 8-10 times a day. The school checks him in the morning, at lunch and before he gets on the bus in the afternoon. He has had Type 1 for 1 1/2yrs. It consumes my every minute. I just want to make sure I did everything for him now that he can live a long life as a grown up.
I think JDRF-VOL-SG's suggestions are very good, and would only add that it is common to have a different carb ratio for breakfast than for other meals. That's not only because of the type of food eaten, but because it is mornings when the liver is the most active with dumping glucose into the body. It's called the Dawn Phenomenon. It sounds like you're figuring things out really well, and I'd just suggest adjusting the breakfast carb ratio to see what happens.
I read your topic and wept when I you wrote that your son's diabetes consumes your every minute. My daughter was also diag. a year and a half ago and she is now nine. She is very active in sports and i am constantly worried that she will go low. I feel that diabetes is running my life and I cannot stop the worrying. (i try to be as matter of fact with it so she can continue to treat it like this is just what she needs to do). I have been fortunate that she is very resilient. However, I still have yet to let her go on a sleepover. Periodically,she still has lows overnight. She too, experiences highs after eating cereal but we have adj. her carb to ins. ratio and increased her morn. basal. It did my heart good to find this forum. Good luck to you.
Thank you so much for your comment. It is great to know that there is someelse out there like me. Sometimes I feel that everyone feels I am so obsessed with my son and his diabetes. We almost lost him when he was 2 1/2. had got bacterial menegitus and almost did not make it thru that. Now he's developed Type 1 diabetes. So yes I am obsessed when it comes to him. I too will not let him sleep over or have anyone to care for him. He has gone low several time while being asleep and has had about 4 seizures. I am afraid no one but us(parents) knows what to do if that happens or how to count carbs and measure insulin dose, etc.etc.... some of the other moms I have been around that have children (my sons age 12) with diabetes are so laid back and leave it up to their children to be responsible for making sure they check their sugars and count their carbs and give the right dose of insulin....wow I could not do that at this point. My son can check hisself and give hisself injection (after I have drawn the insulin up) but that is as far as that goes. I will always be monitoring his sugar levels myself. Maybe one day I can, as we say "loosen up" I just don't see that happening soon. We have adjusted the insulin dose in the mornings, seems to work a little better. I love this site also. Just found it a week ago. It's great.Hope your daughter is doing great. We just worry over our kids. Nothing wrong with that!