What a Difference a Little Protein Makes

We have mentioned in other posts our difficulties with managing the post-breakfast glucose spike. The fact that breakfast choices include so many high sugar foods, especially when considering those options that most young kids prefer, makes this a very challenging time of the day. There was a time when BGs over 300 happened more often than we would like to admit, and readings in the mid 200s felt like success. We have recently made a change to Emerson’s breakfast that has allowed us to make significant progress towards putting those days behind us.

During a trip to Emerson’s endo in early October we talked a bit about this period of the day. She asked if we had tried incorporating more protein in with breakfast, as she thought this might slow the absorption of carbs and reduce the magnitude of the spike. She suggested maybe a turkey sandwich for breakfast or including some other high-protein foods, such as peanut butter. While the sandwich certainly wasn’t going to go over well with Emerson, we got the idea.

Since that time we have simply added 1 TBSP of peanut butter to her breakfast every day and it has made a significant difference. Here are some stats to illustrate. In the 4 months before adding the PB, Emerson’s average pre-breakfast BG was 177. Her average mid-morning BG during that time was 241. We couldn’t seem to find a formula that would control the spike without sending her low by lunchtime. Since we have made the change, her average pre-breakfast BG has been 176 and her average mid-morning BG has been 200.

This has been a significant improvement, but we don’t think it has all been directly the result of the additional protein. The lower spike has allowed us to further tweak our formula and not have to worry about her going low later in the morning. So this is an indirect benefit of the change. Can’t say this will work in all cases but it is certainly something worth trying if you too are losing the battle against the post-breakfast BG spike. Emerson many times will eat the PB with a banana but has gotten to the point where all she needs is a spoon.

Special Treat

Well, here it is - our 1 year anniversary of Emerson’s diagnosis. So far it has gone much like the previous 364 days, but we decided to change it up with a special treat. We have kept Emerson on a pretty healthy diet over the last year, except for the occasional birthday party or rare splurge. We do usually allow her to have a small, not so healthy treat on Fridays. Today isn’t a party or a Friday but we surprised her with a trip to Dairy Queen to commemorate this day. Why Dairy Queen? Their menu, including nutritional information is available online, making for easy pre-planning!

Overcoming the Impulse

Last weekend we took Emerson to see Disney on Ice while it was in Indianapolis. We knew with her love of princesses and curiosity toward ice skating that this would be something she really enjoyed. What we tend to forget about when going to things like this though is how difficult it is when the vendors come around selling things like cotton candy and shaved ice in pretty princess cups. While a benefit of being on an insulin pump is the added flexibility and enhanced ability to manage such scenarios, we keep Emerson’s consumption of treats pretty limited. In fact, we generally only allow her to have special treats (candy, ice cream, etc.) once a week, which we have been able to do with very little issue because Emerson has always been a very good eater and likes a wide variety of foods. It is not that we don’t want her to enjoy being a kid, but her BG has been extremely volatile since day one and we do all we can to keep her in range. So when attending things like this there is always the dreaded food vendor that pops up out of nowhere. We are fortunate that Emerson does not make a big deal about not having these things like the other kids, but it doesn’t make it any easier as we know that it is times like these that make her hate having T1D. We take these opportunities to talk to her about the importance of a healthy diet but it doesn’t take away the heartbreak of her seeing other kids getting things that she is unable to enjoy without getting insulin and the after effects of so much sugar. We are hopeful that helping her to maintain a good diet now will make it easier for her to continue to eat healthy once our ability to control and then influence how she eats is a thing of the past.

We do expect that we will become more relaxed about the occasional splurge in the future. Our experience over the recent holiday period allowed us to see that we can keep her BG relatively stable even when deviating from the normal diet. After 10 months with T1D, we decided to allow Emerson to eat some of the normal holiday treats, but not without a lot of apprehension. She thoroughly enjoyed consuming cookies, cupcakes, and pie over a two week period around Christmas. After surviving the season and looking back we were happy to realize that while we did have the occasional spike and subsequent low, there was virtually no difference in her average daily BG during that period when compared to the weeks before and after. This gave us a good deal of confidence in our ability to effectively dose for these types of foods and keep her somewhat in control. We had an appointment with Emerson’s Endocrinologist right after the holidays and found that her A1c had increased slightly since our last appointment. The doctor immediately thought that this was due to the holidays but we were happy to be able to say that we felt it was not due to that but rather a 10 day stretch that saw numerous periods of elevated BGs due to repeated issues with our pump.