Importance of Scheduling Meals

By BobbieNJ1000 Latest Reply 2012-03-18 17:54:19 -0500
Started 2012-03-12 19:45:15 -0500

Although my doctor hasn't said anything about it, I've read that eating meals on a regular schedule is important, but I find that pretty difficult, and I'm not really sure why it's important.

Recently I had to reduce my basal insulin because of overnight lows. Now I wake up with an acceptable BG, but by the time I'm ready for breakfast an hour later, it can shoot up 50-60 points. I'm assuming this is because my morning basal requirements are higher than nighttime. Can I solve this problem by getting up earlier, or am I likely to have the same problem earlier in the morning? The clock change didn't seem to help, but perhaps another hour earlier might?

Any insight you can offer will help!

12 replies

Type1Lou 2012-03-18 12:22:47 -0500 Report

Dear Bobbie, It sounds like you are on a pump. I was on MDI (Multiple Daily Injections) of Novolog and Lantus before going on the pump last August. Both insulin delivery systems gave me the freedom to eat meals according to MY schedule. I've loved not being tied to the clock and being able to bolus when I need/want to! If you are pumping, it takes several months before the settings are fine tuned for YOUR body. We're still tweaking mine a bit. Continue to work with your doctor on this. I do find that by morning, my BG's are usually higher than at bedtime or even at 3am. There is something called the Dawn Phenomenon or the Somogyi Phenomenon that may cause this. Scheiner talks about it in his book"Think Like a Pancreas". I am on thyroid meds which state to wait an hour before eating. I asked my prescribing endo whether this was necessary and he advised it was more important to take the Synthroid at the same time each day so I've never waited (in 30 years) to have breakfast although usually 20 to 30 minutes elapsed after rising and before I do eat it. Hope this helps, Hugs,

BobbieNJ1000 2012-03-18 13:33:47 -0500 Report

Thanks for your thoughts. I'm on MDI - Novolog and Lantus, but I think a pump will give me better control as my nighttime basal needs appear quite a bit lower than daytime. I also want to have more precise bolus dosing. I'm seeing the endo tomorrow and I keep working at it!

I'm surprised at your doctor's response to the eating question with Synthroid. My previous endo said I should not eat, drink anything but water, or even take any other medicine until 1 hour after taking it! Although I've always thought that as long as you have a regular habit - eat or don't eat - it's easy enough to adjust the med so that you've got the right levels even though it is not as well absorbed in the presence of food! However, I've been obedient about 90% of the time for the last 15 years.

Type1Lou 2012-03-18 17:32:11 -0500 Report

Dear Bobbie, I had been on MDI of Novolog and Lantus under the care of my PCP for at least 7 or 8 years. It worked well until about 2 years ago when I started having serious and scary morning lows. Not happy with my PCP's approach to this problem (he kept upping my Lantus and reducing my Novolog), I sought out an endo. The endo actually reduced my Lantus, changed the time I took it from evening to morning and got me on a sliding scale for my Novolog. That was in December 2010. They suggested I try the pump (which I'd been resisting for years) and I agreed. I've not regretted it. There have been a few bumps on the road but no more scary morning lows and better BG levels.

BobbieNJ1000 2012-03-18 17:54:19 -0500 Report

Yup. I had those scary morning lows until i lowered the Lantus quite a bit. I've got a good formula for my Novolog, tho I'm still tweaking it. I'm not as patient as I could be, I guess. I've only been on MDI 3 mos.

Young1s 2012-03-17 15:11:45 -0500 Report

I guess that depends upon the hour you wake for the day and the hour you eat breakfast. If the times are separated by 30 mins - hours, then the question becomes are you eating or drinking something in between times.

BobbieNJ1000 2012-03-17 21:12:49 -0500 Report

I have to wait 60 mins after rising before I can eat, because of early morning meds.

Young1s 2012-03-17 21:40:06 -0500 Report

Depending upon what they are, it's possible that the different meds are causing the rise. But I'm not completely sure about this. Maybe someone else will be better able to answer this.

BobbieNJ1000 2012-03-17 22:11:12 -0500 Report

No, that's unlikely. Really I'm pretty sure it's the increase in basal insulin required in the morning hours compared to overnight. But my higher basal requirement seems to be a little later than the curve. I'm wondering if that has to do with the time of rising or if it really is just tied to the clock.

Young1s 2012-03-18 08:17:29 -0500 Report

Sorry I couldn't be of more help. Hopefully someone else can give you a better answer or suggestions.

BobbieNJ1000 2012-03-18 13:35:10 -0500 Report

Thanks! I'll talk to the endo about it. There is a new question / surprise every day with this challenging condition!

Nick1962 2012-03-13 10:45:23 -0500 Report

A lot of folks get hung up on the word "meal". I eat 5-6 times a day, but they aren't all by any definition "meals". For me it serves the purpose of regulating the amount of nutrition my body has at any given time, and it really does a good job of eliminating high and low BG throughout the day. Kind of like keeping just the right amount of gas in your car - too much and you lose mileage due to the excess weight, too little and you risk running out. Maintaining a good daily level also helps those morning numbers (the Dawn Effect or Liver Dump). Eating a little something (like some good protein) before bed helps also.

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