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From Illinois, USA:

Unlike after other meals, our daughter's bedtime blood glucose numbers are good after eating pasta, but they then rise as the night goes on. This seems to suggest that the carbs in the pasta release more slowly than the carbs in other foods. I have heard that others have experienced a similar problem with pizza (perhaps because the fat in the cheese delays the release of the carbs). Our daughter is using an insulin pump so it would be easy to adjust the nighttime basal rate, but the pattern is not consistent. Any suggestions on what to do?


Your daughter's nighttime rising sugar might relate to the food composition, or to the dawn phenomenon: she'd have to get bedtime, 3 A.M., and dawn blood sugars to begin to sort this out. I'd tend to handle the whole thing empirically: if a food elevates the blood sugar more than expected, adjust the pump's settings accordingly, and recheck blood sugar to see if the adjustments were correct. And, if the effect is inconsistent, I'd prefer to err on the side of safety: namely, don't risk nocturnal hypoglycemia by over-increasing insulin doses!

As you've heard, pizza is notorious for raising blood sugar levels higher than logically expected. I think the exact reason is still unknown.


Original posting 2 Mar 97


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