Do you bolus for caffeine?
I was running a basal test Friday morning. Starting at 6am, and testing every hour until noon. No food, no bolus, no variables (or were there?).
6:00 - 94 mg/dl - wow! I'm actually near my target! Good job Scott!
7:00 - 96 mg/dl
8:00 - 101 mg/dl
9:00 - 141 mg/dl - start of drinking diet coke
10:00 - 163 mg/dl - some more diet coke
11:00 - 176 mg/dl - yes, more diet coke
12:00 - 177 mg/dl - end of test, correction bolus taken
I got a few interesting things out of this test.
1) I woke up at around 7:00. Was at work by 8:00. I was under the impression that my bg rises significantly just from getting up and preparing for my day. But, you can see that my bg went up only 4 mg/dl - which is pretty close to exactly the same, considering the variability between tests (different meters, different samples, etc).
2) between 8:00 and 9:00 by bg rose by 40 mg/dl - which is significant enough to test for again. If I can nail that increase down to that particular time, I will adjust my basal rates to prevent it. This will take at least a couple more tests to figure out (never make changes on a single experiment). And if the pattern is not clear (ie, the increase is due to something other than the time of day), it will take many more tests to figure out what is to blame.
3) 9:00 is when I had my first sip of diet coke. I had two 20 ounce bottles between 9:00 and 12:00, and was watching my bg steadily rise.
Was it the caffeine or do I rise like that all the time? Only time, more testing, and trying to avoid the caffeine will tell.
I have heard conflicting stories about whether or not to bolus for caffeine. One very credible source, Gary Scheiner, in his book Think Like a Pancreas, even has a table with suggestions on how much certain levels of caffeine will raise blood sugars! Gary is awesome, and I highly recommend the book.
Some people I know will bolus for their AM coffee, others can drink 4 or 5 cans of diet dew before 9 bells and not see their bg increase at all.
So - do you bolus for caffeine? What is your formula? Is it a calculation, or a SWAG bolus?
6:00 - 94 mg/dl - wow! I'm actually near my target! Good job Scott!
7:00 - 96 mg/dl
8:00 - 101 mg/dl
9:00 - 141 mg/dl - start of drinking diet coke
10:00 - 163 mg/dl - some more diet coke
11:00 - 176 mg/dl - yes, more diet coke
12:00 - 177 mg/dl - end of test, correction bolus taken
I got a few interesting things out of this test.
1) I woke up at around 7:00. Was at work by 8:00. I was under the impression that my bg rises significantly just from getting up and preparing for my day. But, you can see that my bg went up only 4 mg/dl - which is pretty close to exactly the same, considering the variability between tests (different meters, different samples, etc).
2) between 8:00 and 9:00 by bg rose by 40 mg/dl - which is significant enough to test for again. If I can nail that increase down to that particular time, I will adjust my basal rates to prevent it. This will take at least a couple more tests to figure out (never make changes on a single experiment). And if the pattern is not clear (ie, the increase is due to something other than the time of day), it will take many more tests to figure out what is to blame.
3) 9:00 is when I had my first sip of diet coke. I had two 20 ounce bottles between 9:00 and 12:00, and was watching my bg steadily rise.
Was it the caffeine or do I rise like that all the time? Only time, more testing, and trying to avoid the caffeine will tell.
I have heard conflicting stories about whether or not to bolus for caffeine. One very credible source, Gary Scheiner, in his book Think Like a Pancreas, even has a table with suggestions on how much certain levels of caffeine will raise blood sugars! Gary is awesome, and I highly recommend the book.
Some people I know will bolus for their AM coffee, others can drink 4 or 5 cans of diet dew before 9 bells and not see their bg increase at all.
So - do you bolus for caffeine? What is your formula? Is it a calculation, or a SWAG bolus?
posted by Scott K. Johnson | 8:52 AM
13 Comments:
I think this is one of those things that affects people differently. As for me, no bolus.
For me - BOLUS. I take one half of a unit to cover my morning coffee. I also have some dawn phenomenon stuff going on, so my basal creeps from .45u per hour to a whopping .8 from about 6 am - 10am. I don't need to bolus for afternoon coffee - just morning coffee. Weird.
Caffine used to lower my blood sugar slightly! I've since quit caffine, but it used to anyway.
I only give myself insulin for lattes or decaf coffee with sugary creamers!
For me there can be a change upwards with espresso but it's very temporary, so I don't bolus. But Diet Coke, caffeinated or not, I had to give that stuff up years ago because my body thought it was the regular stuff- it always caused a huge rise in BG.
I am a sodaaholic so this is news to me. I am going to have to do some testing of my own. I will keep an eye on this one.
I don't have a good answer, but as chance would have it, I was just wondering the same thing. Did a fasting test yesterday AM, and saw a rise around breakfast time, when I only drank coffee, didn't eat anything. Is is the coffee, or the basal? I guess next time I need to skip the coffee as well... d'oh.
I am the definitive Diet Pepsi consumer and have never given a thought to how if affects my bg. I always have a 20 oz bottle with my breakfast, which I eat at my desk at work, so maybe my morning dose is already calculated to include the c. effect.
However, the amount I consume in the afternoon varies a lot, and I have always experienced some wildly inconsistent numbers before dinner - certainly is possible that it could be the c.
I read Think Like Pancreas when it first came out and don't recall him mentioning caffeine (of course now I don't remember where the book is either).
Thanks for this tip Scott. I am really going to give it some consideration.
Wow. I've been drinking lots of Diet Coke for several years now. I've never noticed it affecting my blood sugars (although I've never really looked).
For me, no bolus.
Hey!! I have the SAME thing happen when I get up from sleep. I am a shift worker - so 2 - 12 hr days, 2 - 12 hr nights then 4 days off.....so I am sleeping at different times of the day - hard to figure out any patterns!!!
Anytime I get up out of bed - I am guranteed for my sugar to rise approx 2 mmol/L. It would be hard to change my basal rate due to my shift work - I may try to put in some "patterns" - but either way, I have that initial rise as well. It is annoying when I wake up - my sugar level is fine ... and by the time to get to work I have gone up 3 - 4 mmol / L. Annoying!!!
Caffiene does seem to cause a slight rise for me - and causes havoc on my GI system (haha!!!) but it does not stop me!!!! I bolus half a unit for a coffee - but I also have a small dribble of milk in it....Cheers
Scott,
Like Kerri, I also bolus half a unit to cover my morning coffee and my dawn phenomenon. I don't seem to need the extra insulin in the afternoon, however.
I'v also noticed that if I chew too many pieces of gum, albeit sugar free, my blood sugar will rise. I guess those sugar alcohol carbs in gum add up - at least they do for me! I know others find no bg rise with gum, but I seem to. This puts me in a real pickle since I'm addicted to gum.
Laura
Darn it, I've so been trying to ignore the fact that I need to do basal testing....Hmmph
and I don't bolus for caffeine because sometimes I rise and sometimes I don't. I don't rise enough to warrant a bolus when I do rise (usually no more than 40 points) and bolussing for that 40 points when I am unsure if I will actually rise the 40 points or not would put me at risk for a low.....And since lows freak my out since I generally don't feel them until I am either in my 30's or 40's I just don't bolus....
For me, I bolus extra in the am if I'm drinking coffee, but that's because of the milk and splenda (put enough in and add the milk and it has enough carbs for a little insulin).
My CDE mentioned that caffeine will keep your blood sugars elevated. So I always interpreted that to mean that caffeine's acting like protein. However, as with the rest of the Diabetes junk, I'm sure there's no clear answer (that's evident just from all these comments).
For me, no bolus for diet coke/pepsi. However, it takes me all day to get through a 20 oz usually (I used to drink more). Different amounts I'm sure make all the difference as well.
Hi Scott, looks like I'm finally getting to blog to other people's blogs after switching to beta blogger.
I have a dawn phenomenon, but I also always have a large toasted almond turbo with cream and one splenda, just before I hit the gym, Monday through Friday. For those who don't know, that drink is a Starbucks wannabe from Dunkin' Donuts, only with a 'flavor shot'.
I'm a very early riser, around 430 - 500 during the week, so I rely on the coffee to get me through the morning.
I'll have to do some testing to determine which part of the am rise is due to the coffee, and which part is due to the normal dawn phenomenon.
Very interesting observations on caffeine.
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