Since my two hour postprandial numbers have been high, but my four hour postprandial numbers have been low/almost low she didn't recommend changing my morning bolus ratio and, because my breakfast isn't always at the same time, she said my basal rates shouldn't be the issue. I inquired about whether I should go back on the symlin injections, but because I am breast feeding she insisted that I do not since there isn't any information about whether or not artificial amylin is transmitted in breast milk and, if it is, it'd create an unsafe situation for GV.
Removing all the "simple solutions" to the issue and still without a clear path forward, Dr. Rogacz inquired about what I usually eat for breakfast. Telling her that my everyday (yes, the same thing, everyday) go to breakfast is a bowl of cream of wheat and a cup of coffee, she made an "ah ha" sound and proceeded to break my heart by saying "your problem is probably the cream of wheat." Citing the high glycemic index of wheat, as we loving call it in this house, she instructed me to drop it and similar "dense" carbs out of my diet in order to keep my sugars under better control.
(Insert mopey, pouty face here)
So what is the glycemic index (GI)? The GI is a measurement of how much each gram of carbohydrate in a certain type of food raises a person's blood glucose level once it is consumed. Foods that breakdown quickly in digestion and rapidly release glucose into the bloodstream are "high" (over 70) on the GI scale, where as foods that break down more slowly will gradually release sugar into the bloodstream and therefore are considered to be "low" (under 55). Here are some examples for you:
High: Rice, plain white bread, potatoes, breakfast cereal and watermelon.
Medium: Sweet corn, bananas, raw pineapple, raisins, pita bread and regular ice cream.
Low: Raw carrots, peanuts, raw apple, grapefruit, peas, skim milk, kidney beans and lentils.
Because a lower glycemic response usually means less insulin is required to maintain a healthy HgA1C, foods that are low on the GI tend to improve long-term blood sugar control and cause less spikes in sugar like I am currently seeing at my two hour postprandial. So, you see, on top of needing to be carbohydrate conscious on the basic this is bread that is pork level, my body has decided for the first time since becoming diabetic that it cares what carbohydrates I am eating and is forcing me to forfeit the lusciously dense carbs I emotionally love.
I know my doctor is right in making this recommendation and I'm only just beginning my research on what this actually means as a lifestyle choice, but my first response is that I am thoroughly peeved. I am annoyed with my diabetes for messing with me again and on something so indulgent as my favorite breakfast. I mean at least the doc didn't tell me to give up coffee (Lord knows THAT would have been impossible) so I at least still have that, but what to have with it will take some time. I expect after an adequate period of mourning that I'll come up with something else to whip together in half sleepy delirium, but for the time being, in a state of melodramatic protest I refuse to replace it with something sub-satisfactory.