Blood Glucose Spikes--Thought about cause?

I tested at 117 when I went to bed last night and woke up at 110. Flat lined overnight. Checked at 11 this morning and was 195. It started to rise at 9:30 and at 1 point, jumped 50 points in 20 minutes. I corrected and it is coming down, so it is not my pump or insulin.

This has been happening sporadically without rhyme or reason. I eat the same thing every morning 1/3 cup cottage cheese (4 carbs.) One day I will ride along with a flat line all morning and then out of the blue, I will have a rise like this.


So, you wake up at some point earlier than 9:30 am, have a breakfast of cottage cheese (covering with a bolus for for 4g of carbs, or no?). In most cases, no problems. Occasionally, you will get this 9:30 am to 11:00 am spike?

Sounds like Dawn Phenomenon, but I have no idea why it is sporadic for you.

Just checked my pump and I cover mine with a bump in basal rate combined with a pretty hefty decrease in my carb ratio to cover breakfast.

Yea forgot to say, the 117 was at 7:30. And, yes, I took a bolus for the carbs. I already bump up my basal for DP. My 7 to noon basal is .8, where other times a day it ranges from .2 to .325, so it is a pretty big bump.

Can DP change radically from day to day?

Are you sure you don't have some gastroparesis?

Oy - it sounds maddening. Does this type of surge only happen at breakfast or at other times of day as well?


Sorry Spock, I just don't know how it manifests itself in others. I will get sporadic spikes that could be attributable to DP, but I will usually wake up with an elevated BG somewhere in the 200s in those cases (I wake up at 5:30 am for work but around 7:30 am on weekends), rather than having the spike later in the morning. In those cases, I just bolus aggressively or head to the gym before breakfast.

Only in the morning.

I do think I have some gastroparesis (OK Can someone please come up with shorthand, like DP, PWD, etc for this? It takes me forever to spell it...) It usually occurs with fattier foods like Chinese, etc. and in the evening. It has not been an ongoing problem.

However, what would the unshorthanded malady have to do here? I ate dinner at 6 pm, so the rise began 15 hours after the meal. The 3/4 cup of cottage cheese? Hmmmmm. I am still unclear about my relationship with the unshorthanded malady...


While going to bed is 117 and getting up roughly the same, and seems a nice flat line, is it? Do you ever wake up in the middle of the night and test? There is the chance depending on types of food the night before for a hypo in your sleep and the morning random high being a rebound effect. If you can get a CGMS for a while that might show one way or another if anything is occurring during sleep.

Another possible outside the Dawn Phenomenon is if your liver is possibly kicking in and releasing a load of carbs due to certain activities? Something different some days, running around a little more at work, more stress, anything else possibly?

I so flatline overnight and am very proud of that. It took a LOT of work to get there, so I am certain all is good. I have a CGM and it is pretty accurate, so I truly believe the numbers.

And I regularly test basals (HATE IT) overnight, so am pretty comfortable that it is not lows and liver dump.

Funny thing is that we ate the same exact thing Tuesday and Wednesday night. Did great Wednesday, and not today.

I can't seem to run more than 3 days of super flatlining without having a huge AM spike at the second or third day. Maybe I get carried away celebrating the day 3 evening but I think that DP may be variable and "programmable" in that if you are "hungry", which is often the case when I'm flatlining as it generally involves either less carbs or more working out or maybe both, it seems to "fire" whatever hormones jack up my BG and I'll wake up out of whack.

Hmmm. Need to consider that. I am rarely hungry anymore, as I am kind of afraid of food and what happens. I eat very little--not unhealthy--but small plates.

I don't know what might be causing it but this type of thing is happening to me frequently too and I have no idea why. my bg jumps 50-100 points with no reason apparently.. sometimes when I haven't eaten for several hours.. we upped my basal dose for that but it still happens. The other day I woke up and had not slept enough but I was hungry so I ate my first meal, about 9 grams... with 4 units.. I went back to sleep for 2 hours and woke up at 160 or so... normally I would be at 75-90 after that meal. I have to automatically take 1-2 units of novolog at certain times through out the day now, with no food to stop these spikes. I notice the jumps, like yours, also seem to happen after a near flatline of bg for a few hours. I take a split basal 8 units at night and 4 in the early am now.. but I'm thinking I may need to split it in three doses instead. As soon as my basal seems to run out I will often spike like this but it is never predictable for me.

I would guess since it is in the morning it was dp maybe? For me I feel sometimes my liver is doing it, but I'm not sure why as I'm not usually low before the spike, do you think it could be that?

Not sure about the liver dumps, especially if I have been running 90-110 overnight. I'll see what happens this morning as I flatlined (CGM numbers) but woke to a meter reading of 59. Interested to see-if it spikes today, I would begin to think my GCM is off and I had ridden all night around 60, as there is about a 30 point gap between the readings. Will let you know what happens.

My BG will spike 50 -80 points in the am until about 11:00am, several times each week.I have my CGM set to alarm at 140 and I just start correcting on the days that this happens. I'm sure it's not food the night before or my morning meal and a basal setting just causes a hypo on days my body doesn't dump sugar. It's like a second wave of DP that is trigger by the act of getting out of bead. I don't remember this happening until I turned 50+ I think when younger I was up and out of the house long before this sugar dump happened, it's also probably why I have never had a bad Hypo in the AM they always seem to happen around noon or later.

I personally don't think there is a fix for me...but YMMV

Sounds exactly like my issue, so at least we are not alone...or crazy. My last night meal was very tame and I did well overnight. I did spike to 131 from 91, but that is no biggie.

I am VERY careful not to stack and I let my pump decide on correction doses. But after a series of corrections to get the morning high down, I tend to crash about 4:00.

it makes sense if you were running at 60 all night and spiked it could be glucagon

It is so variable for me.. sometimes I can sleep through an stay in the 60's -80's and sometimes spike when it's in the morning... for me, which is later because I'm nocturnal.

Judith: Excellent comment and I followed your advice by documenting my own Diabetes by writing a book:

At the Precipice - by jim snell. My three year Journey from Stroke to Good Health with Type 2 Diabetes.

And as you indicate, this is an excellent forum for discussion and advice.

When my BG rises I think 2 things 1 ) airbubble in tubing 2 ) I delayed doing a set change ...airbubble maybe too late to notice , if that is the cause ...most of the time it's because to not changing infussion set on time .I use the Sure-T's and 2 days fly by toooo fast .Don't you hate it having to figure out diabetes ...I do at age 72 plus :)