Egg Omelet for Breakfast? Guaranteed High Blood Sugar at Noon. Help!

EVERY time my son has an egg omelet for breakfast with ANY other carbs (usually between 15-30) his blood sugar is between 200-230 at noon.

Here's the facts:

It doesn't matter if he is 80 or 180 before the meal.

I have tried to "pad" the carb number a little to help. (3 grams per egg used).  Doesn't matter.

People think I am crazy.  I have put this to the test over, and over, and over, and over during the last 2 months.  Canteloupe, milk, cereal for breakfast = target lunch number.  Canteloupe, milk, cereal, and omelet  = 200+ lunch number.  It doesn't seem to matter what the carbs are:  cereal, strawberries, milk, steel cut oatmeal, instant oatmeal, any of it gives us a target number.  Add an omelet to it and he's high.  Take it away, he's perfect.

The omelet is just eggs, bacon or ham sometimes, and a sprinkle of cheddar.  No milk in it.

DexCom data shows a steady climb after breakfast; leveling off (at the high point) about 3 hours post meal and staying there until lunch which is 4 hours post breakfast.

We are fairly new to the pump and have played around a little with combo bolus.  I thought maybe this was the answer.  Today we "padded" the carbs by 3 grams for each egg eaten (is this just nuts?) and then did a combo bolus of 75% immediately and the other 25% over the next 2 hours.  He was still over 200 at lunch.

I am not able to get much help with the combo bolus feature.  I just keep hearing that it's trial and error.  Trial and error if on myself would be one thing.  Trial and error on my 11 year old is a little more nerve wracking.

Maybe I can kill 2 birds with one stone here.  Do you experienced pumpers add additional units to your dose when you are performing a combo bolus.  Because here's what seems to happen.  If he eats mexican and we dose for the entire carb load 15 minutes before the meal -- it holds his number just perfectly for about 4 hours --- then LOOK OUT!  300's here we come.  I am just sure the combo bolus should be able to handle these situations.  I just don't know how. 

OK, there you go.  Answer one question or answer them both.  Just please answer.

With MDI my daughter seems to pop over 200 for a bit with almost every meal. Maybe that combo bolus is the right path for you.

Just a little more tweaking needed. You can try some exercise added after those meals too to help keep it down.

If you're adding bacon, cheese, etc to the omelet, the fat content could be slowing the absorption of the carbs, spiking him later than you expect.

Post breakfast can be very tough for many of us because of morning insulin resistance. I've sadly found that certain breakfast foods just have to become lunch foods. :(

No, I don't add extra units when combo bolusing and I don't think that's a usual practice.

I don't really have an explanation as to why your son is high after eating omelets, but usually when a person is high at the 3-hour mark and stays there, it's a sign that not enough insulin was given to cover the meal eaten.

If you know this happens every time, why not keep increasing the "pad"? I have heard of some people covering 50-60% of grams of protein with a bolus when eating a high protein + fat meal.  So if an egg as 12g of protein, you would need to cover an extra 6g of carb (as compared with the 3g you've tried).  I don't do this, but my sister does as she is sensitive to proteins. 

I have also heard of some people needing to bolus when having coffee or other high-caffiene drinks.  My point is: everyone's body is different.  So while you may not want to 'experiment' on him, you may need to in order to have better outcomes in the long run.  Sometimes there's no black & white answer to these problems and we need to just do whatever works!

Keep us posted if you try anything.

[quote user="spaghettio"]

  So if an egg as 12g of protein, you would need to cover an extra 6g of carb (as compared with the 3g you've tried). 

[/quote]

Whoops, sorry. 1 egg has 6g of protein.  So if you've tried 3g, maybe try 4?

First, maybe you could try egg beaters or an all-whites egg substitute and see if the reduced fat makes a difference?

Second, my dietitian told me that sometimes there are certain foods that simply make you go higher no matter what the carb content, and that it varies from person to person.  She said that doesn't mean you can't eat them, but that you just might have to take more insulin with that food.  So maybe start "padding" that carb count more and more until you get the results you want?

Thank you.  As soon as I read your post; I went to the frig and checked the protein in the eggs.  Same result as you.... 6g.  However, I will take a look at the bacon and little bit of cheese that I add ----- maybe it all adds up.  Good info though....

Keep the info coming.  This is exactly the kind of stuff I like to hear (from all of you).

Riley was 211 at breakfast and 2 hours after 399 she seems to have dawn phenomenon and hormonal highs. She can eat a low carb (3 carbs) breakfast  and end up higher than your son in the mornings so yeah I am no help cause I am at a lost myself.

[quote user="Daniels Mom"]I went to the frig and checked the protein in the eggs.  Same result as you.... 6g.  However, I will take a look at the bacon and little bit of cheese that I add ----- maybe it all adds up.[/quote]

PROTEIN for 2-egg omelet:

2 eggs - 12g protein

1 slice bacon - 2g protein

1/4 cup cheddar - 7g protein

TOTAL: 21g.

 

We experience similar numbers!  Emma does go through phases with this though.  She swims on a swim team and if she swims the night prior she doesn't seem to be bothered by the eggs at all!  It's the fat and protein not the carbs.  Either way you don't have enough insulin going in if the numbers remain high.  Bolus more with breakfast and check 2 hours after not at lunch.  Mexican is the same.  We just hit dinner harder fromthe get go and then Emma seems to hold just fine without getting a high sugar after dinner.  I understand you are nervous but don't be if you are checking every 2 hours and do it on the weekend.  We have a pump and I have type 1 as well.  I am not a big fan of combo bolusing.

I would assume the protein and fat is spreading the carb intake to the point it exceeds the reaction time of short term insulin. I'd increase my N dosage on those days.

I'm just starting to experiment with the combo bolus for my 5 y/o. I think I did 50% with pizza and 50% over next 2 hours. That actually worked out great. W/o combo, he'd be low 2 hours after pizza and then SKYROCKET after treating the low. It is the fat/protein combo. I have tried other combinations before with not so great results. No lows, but not target post meal BGs either.

Could you also see what his BG does if he only has the omelet and no carbs for breakfast? That might help you figure out how much to count the 'carbs' in the omelet components. Try it on a weekend maybe?

Finally, what if you cut down the fat in the omelet by removing the bacon and did a veggie omelet instead? (I am not a fan of egg beaters. Gross, IMO). A lot of it is guess, check and write it down and try something a little different the next time.

Breakfast is always a hard time for us. I eat a single packet of plain oatmeal (plain! oatmeal!) The healthy kind. And I will hit 200 without fail by lunch. It kills me! I used to eat huge bowls of cereal, bagels, all kinds of things (before dx) so the fact that even oatmeal messes me up is just too bad. So now I experiment :-) Someday I will have a breakfast that works!

If he's fine when he eats other foods for breakfast then it sounds like your exchanges and basal rates are fine. (I use my highest basal from 4 am to about 10am, also my "lowest" exchanges then, i think a lot of diabetics do).

I've never heard of anyone dosing for protein but if there is no other explanation.... Keep experimenting, you will solve this!

(And a final thought. Every day is different. Sometimes my numbers are bad and I just don't know why. Could this be a coincidence?)

Does he eat toast with the omelet? Some breads and cereals make my blood sugar skyrocket and others not at all. I used good 'ole trial and error to figure out the right breakfast foods in the right amounts.I've never experienced very high blood sugars from an omelet though. Maybe try switching to lower fat/sodium meat and cheese in the omelet and hopefully you will see some improvement! Like others have said, sometimes sugars go out of whack for no particular reason. Good luck!

I have always been a morning exerciser and I see the benefits of insulin sensitivity all day.  Most people with diabetes are very insulin resistant in the morning hours.  Give it a try!