Bolusing for Cereal (& other foods that make me “spike”)
*this blog is not medical advice. Work with your healthcare team always before making adjustments to your insulin!
Before we get started, a small (but important) tangent.
This title is total clickbait. In fact, I cringe writing it because I hate the phrase “XXX makes me spike”. Why?
Saying a food makes me spike gives all the control to the food. It implies that no matter what I do with my insulin, I will spike. Which is totally not true. You may not believe this (I didn’t for a long time), but there is a way to bolus for EVERYTHING while staying in range. Even pizza. Even cereal. Even bananas. Even *enter food here you love but have trouble bolusing for*.
(important note here that a slight rise in glucose after eating is normal even for people without diabetes. When I say spike, I mean something up, up, up there. Not just a bump in my graph)
Shifting that perception from:
Cereal makes me spike to I haven’t learned how to bolus for cereal yet
gives the control back to me! It creates the mindset that I still can figure this out.
Now don’t get me wrong, just because there is a way to bolus for everything that keeps you in range, doesn’t mean all foods are easy to bolus for. There are absolutely foods that I haven’t nailed yet and probably never will. This isn’t because I don’t think I can, but more because those foods I don’t like enough or eat often enough to give it the time and energy to find something that works.
Obviously, if you want to continue saying “XXX makes me spike”, I will not be bothered or offended. I will lose no sleep at night. The world will keep turning. But this is something that really helped me (especially in terms of relationship with food) and may help you too.
Now for the main event.
TRIAL AND ERROR with CEREAL
There are a lot of types of cereal. Personal favorite: lucky charms. And because all cereals are different, I am NOT going to give a step by step guide of what I do, but rather how I went about finding what worked for me.
This process can be used for all foods, not just cereal. But I ate cereal this morning and the questions flooded in, hence why the food I’m using in the example is cereal.
All “spikes” are caused by either inaccurate insulin timing or inaccurate insulin amount.
Sure, there could be other variables of why your blood sugar increased beyond just the food. You could be sick, have started a new medication, had a bad night sleep, period is coming, pump in a spot with bad absorption etc.
BUT still, the fact remains that the reason you went out of range was because you had either inaccurate insulin timing or inaccurate insulin amount.
Below are the questions I ask myself to navigate the scenario when I have a high blood sugar after eating. This will really only give me accurate answers if I know my basals are in check (through basal testing). So I would check that out first to rule it out. Now for the process:
1. Is this a pattern with this food?
If yes, I continue evaluating to figure out a solution.
If no, I chalk it up to another variable (see next Q).
2. What other variables could have impacted the outcome?
If it’s a variable that occurs a lot in my life, I will make note to adjust future boluses when this variable is present. If it’s something that doesn't happen often, I just move on and accept that diabetes is tough and I’m not always gonna get it perfect.
3. Did the spike come down on its own (without additional corrections)?
If yes, I know it’s probably an insulin timing issue. I would play with increasing my prebolus time until I find what works.
If no, the spike did require additional corrections, then it’s probably an insulin amount issue. I play with increasing the insulin amount. (there may also be an insulin timing issue, but I address the insulin amount first then the timing in future trials)
Now if i’m still increasing hours after eating, I would explore an extended bolus or a split bolus. That’s beyond the scope of this blog, so I will write one up about that another time! But something to consider.
When I’m re-trying the food with my adjustments to insulin timing/amounts, I make sure I’m keeping as many variables the same as I can. For example, I’m eating the same amount (measure!) of cereal, same kind and amount of milk, relatively the same time of day, etc.
Once I have had it a few times and know I can nail the bolus, then I loosen the reigns and can change up variables and eyeball more than measure.
It can take a few times to get it right (trial and error), but eventually I get there! And while this is never a formal process for me, it helps to set the intention and follow through by writing what happens in the notes section of my phone (you can also use pen and paper).
I include
starting BG
amount/type of cereal
type of milk
time of day
bolus +timing of insulin
and then blood sugar 2 and 4 hours after eating
Then IN THE MOMENT, I make note of how much I will adjust by (time and/or amount) next time. This is key so I remember what to try next time!
When I rejected the idea that every food’s carbs needed the same amount of insulin, I finally empowered myself to make these kinds of adjustments. I use my insulin to carb ratio as a starting point, but not as the final destination.
To sum it up, anything is possible (to bolus for). But it does take a bit of work. You never have to give up the foods that you love!
A lot of foods also have “easier-to-bolus-for” options. For example, three wishes and magic spoon are lower-carb, higher protein cereals that can make this trial-and-error process easier (and maybe not even needed).
Sometimes I do go for these options, but I also think it’s empowering (especially if you LOVE the food) to figure out the hard-to-bolus options. Like pizza? Cauliflower crust has come a long way but still doesn’t hold a candle to the real thing.
