Tuesday, 17 January 2012 | by Mike K

Rediscovering porridge

Someone I 'met' on a forum who started on an insulin pump a year or so before me said that in some ways she had to relearn much of what she thought she knew about her diabetes. Many tried and tested observations, and theories as to what was happening seemed no longer to apply. Switching to a pump so fundamentally 'changed the rules' that almost everything had to be evaluated from scratch.

I've had a glimpse of what she meant recently when I decided to retry porridge (oatmeal for US readers) as a breakfast choice.

I've always quite liked it in the winter and it has a reputation for being helpful cholesterol-wise. Mostly though it has a reputation for releasing its carbohydrate slowly and steadily which is very useful if you are trying to keep BG (blood glucose) levels after meals under control. For many years I ate cereals for breakfast, basing my choices on what I had been told - this is low GI, that is slow absorption, blah blah blah...

For many, many diabetic years I tested primarily before meals with ad-hoc other tests if I 'felt funny' or needed to drive. This was OK in its way, but never really let me see or evaluate what was happening after eating different foods. I didn't look at those choices critically enough for them to make any real sense. It was only really after 'meeting' folks with Type 2 Diabetes online who have food choices as their primary weapon in the struggle to control BGs that I realised how little I knew from testing about what to expect from different foods.

GI values are all very well, but they are only an average from a pretty meagre sample. And averages (as anyone with a BG meter can tell you) can hide a multitude of sins.

Having embarked on some after-breakfast testing a few years ago I quickly determined that all cereal is evil. There was just none that I found I could eat and remain in single figures (below 10.0mmol/L 180mg/dl) at 1-2 hours after eating. Porridge seemed a particularly bad example. I may as well have been eating jam.

So I concluded that for me porridge was not slow release at all, and stuck to Burgen soya and linseed toast with much better results.

I knew that at least part of the problem was a 'gap' in basal coverage that made breakfast particularly tricky time for me. I took my Lantus at breakfast time and while the last dose had faded and the next dose was still dragging its heels in 'onset' I had perhaps an hour with less basal insulin than I needed.

The pump of course, has fixed this. Continuous almost infinitely tweakable rolling patterns of basal insulin trickles can allow for the most challenging of basal requirements.

Once I had a basic basal pattern working OK I began to wonder whether I might be able to cope with a little porridge every now and then. The first few results are very encouraging. This morning I rose from 4.7 (85) before breakfast to 6.9 (124) an hour and a half later.

Porridge it seems is back on the menu. Score 1 for teampump.

12 comments:

Tim said...

Hurrah for porridge - I have it every morning, without any problems!

Mike said...

I would expect nothing less. Presumably in a salty kilt?

Tim said...

Aye, I eat it while tossing my caber.

Dave said...

And drinking (diet) Iron Bru?

Great post Mike and fantastic that your breakfast mush of choice is back on the menu.

Brian said...

Porridge every morning with a chopped banana, cinnamon and maybe a spoon of honey ... no spikey BG afterwards. Nom Nom Nom.

Have same issue with basal gap at dinner in the evening though. Levemir doesn't last the full 24 hrs ...

Mike said...

Levemir's short duration/affinity with split doses was one of the things that attreated me to it before going for the pump Brian. Have you investigated running it as two doses approx 12hrs apart?

Brian said...

Yep i split it 4 evening 2 morning (i'm still on tiny sized doses only 1 ye since dx). 4 keeps me steady overnight. If I take anymore than 2 in the morning I'll creep low by lunch. Still have gap issue although not as bad as with 1 single evening dose. From what I've read Levemirs duration is relative to the number of units taken , so I reckon at my VERY low dose it just doesn't last quite as needed http://dailymed.nlm.nih.gov/dailymed/archives/fdaDrugInfo.cfm?archiveid=8918

Mike said...

Ah yes... I suspect that was why splitting Lantus never worked for me. Smaller doses=shorter duration. Sounds like you need a pump :)

Brian said...

yeah no too worried about it right now since HBA1C 6.3 so its just more annoying than anything else. MDI is fine for now - pump is an option of course at some stage.

keep faith with the porridge for breakfast Mike - its good stuff!

Jess said...

yay! and i find oatmeal magical in the mornings as well, for the bgs anyways. :)

Sophie7 said...

Breakfast is the nightmare for me too! I've tried square and every percentage on the dual bolus - I was at the point of giving up! The pump was my saving grace - The only cereal that really seems to work for me is weetabix, which is strange because I know loads of people find it terrible. The pump really helps me here - I do 3units for it, but I put it in as a1hr dual wave - 40% straight in and 60% over the next hour. I admire you for porridge, as I personally tried it and just didn't like it - I know a lot of other people who have said it's really good though - good luck! :)

Mike said...

Thanks Sophie. I've recently cracked another breakfast-based problem (dealing with non gym weekdays) where I was spiking between 9 and 11. It seems to respond well to a 2 hour 200% TBR.

And you are right about Weetabix being unusual - goes through me like rocket fuel! Glad it works for you though :)

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